How to Stop Chills From Opiate Withdrawal

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Both pharmacologic and non-pharmacologic strategies can stop the “chills” from opiate withdrawal.

“Chills” or Cold sweats are common in people who abruptly stop taking opioids. Some people are so uncomfortable during withdrawal that they return to drug use as a result of the symptoms. For this reason, it is important to address the symptoms of withdrawal, including cold sweats, to help prevent people from returning to opioid use.

Why Do You Get Chills From Opiate Withdrawal?

Each time you take an opioid, your brain releases dopamine. In time, your body becomes accustomed to this rush of dopamine. When you abruptly stop taking opioids, your body can experience a number of unpleasant symptoms including “the chills”.

While the withdrawal process is complex, researchers think sudden drug cessation leads to a condition called "adenylyl cyclase superactivation-based central excitation."[1] As part of this process, enzymes that control the widening and contraction of your blood vessels are altered.[2] As your tissues are flooded and then deprived of blood, you experience tremors and chills.

Medications to Ease Your Chills 

Opioid withdrawal syndrome is never life-threatening but it can be extremely uncomfortable.[2] If you develop several symptoms, including chills, your team can help you feel better, ideally right away, with medication assisted treatment.

Doctors typically choose one of these three medication options. 

1. Methadone

One of the oldest medications used to treat opioid use disorder available, methadone can soothe overly excited brain cells and ease your withdrawal symptoms.[2]

Treatment teams typically give large doses of methadone at the beginning of treatment, but they may taper to smaller and smaller doses as your brain adjusts. Some people stay on methadone for life while others chose to slowly wean off the medication, depending on what their needs are and their treatment goals. 

2. Buprenorphine 

A partial opioid agonist, buprenorphine can latch onto opioid receptors used by drugs like heroin and prescription painkillers. Instead of feeling high, you'll feel calm and normal and, if done correctly, should have minimal withdrawal symptoms and cravings for other opioids.

Your chills may stop, and you may not feel drug cravings. Some people stay on buprenorphine medications like Suboxone for months, years, or even indefinitely to keep relapse risks as low as possible. 

3. Clonidine 

Clonidine has no opioid medication in it and thus it is not considered the best or most effective treatment for chills associated with opioid withdrawal, however it can be a helpful medication to use in addition to Suboxone or Methadone, or in patients who do not otherwise tolerate Suboxone or Methadone, to help decrease chills. [3]

Once you feel better and your withdrawal progresses, you'll usually stop taking Clonidine. It is usually used short term on a limited basis for acute withdrawal symptoms such as chills. Methadone and Suboxone, in contrast, can be used more long term to prevent withdrawal and cravings and prevent relapse. 

Other Tips to Make Your Chills Stop 

Opiate withdrawal is a natural process, and it's the beginning of your new and sober life. But your chills are uncomfortable, and you want them to stop. What can you do?

As you move through withdrawal, consider these tips:

  • Stay calm. Your thoughts impact your health. The more worried, anxious, and upset you feel, the faster your heart races and the worse your chills get. Breathe as slowly as you can. Focus on your heartbeat or your breath. This can help to keep you present and more relaxed.
     
  • Drink water. Perspiration, vomiting, and diarrhea can leave you dehydrated and more prone to chills. Drink at least eight cups of fluids each day.[4]

  • Dress in layers. Put on a sweater or coat when you feel cold, and take it back off when you're too warm.

If your chills worsen as your withdrawal progresses, talk openly and often with your treatment team. You may need a medication adjustment to stay comfortable and on track.

Sources

  1. The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science and Clinical Practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/. July 2002. Accessed June 2022.
  2. Opioid Withdrawal. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526012/. March 2022. Accessed June 2022.
  3. Opiate Withdrawal Using Clonidine. JAMA. https://jamanetwork.com/journals/jama/article-abstract/368458. January 1980. Accessed June 2022. 
  4. Withdrawal Management. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. https://www.ncbi.nlm.nih.gov/books/NBK310652/. 2009. Accessed June 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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