Let’s Start at The Beginning: Why Withdrawal?

When someone uses opioids regularly, their body gets used to having these drugs in its system. Opioids change how the brain works. These changes make the brain think it needs the drug to feel normal. If the person stops taking opioids suddenly, their body reacts because it's missing the drug. This reaction is what’s called withdrawal, and it comes with a laundry list of symptoms. Withdrawal can begin just a few hours after the last opioid use and might stick around for a week or even more.

Meet the 11 Opioid Withdrawal Symptoms and the COWS Scale

Think about withdrawal as the exact opposite of the effects of the drug. The best way to summarize the symptoms of withdrawal is that it feels like the worst flu you’ve ever had. But more accurately, doctors use the Clinical Opioid Withdrawal Scale (COWS) to track and measure withdrawal symptoms and their severity.

Below are the 11 opioid withdrawal symptoms measured using the COWS.

1. ‍Resting Pulse Rate (BPM): The number of times your heart beats per minute when you are at rest, like when you are relaxed, sitting, or lying down. Normal BPM is 60-80 beats per minute
2. ‍Sweating : The observance of moisture on the skin‍
3. ‍Restlessness: The inability to sit still‍
4. ‍Pupil size: The size of pupils and their reactions in different light settings. Pupils get really small when taking opioids and get really big when in withdrawal.‍
5. ‍Bone or joint aches: The patient’s report of pain in bones or joints not accounting for any injury‍
6. ‍Runny nose or tearing: Mucus from the nose or tears in the eyes not accounting for allergies‍
7. ‍GI Upset: Vomiting and/or diarrhea, gut cramps‍
8. ‍Tremor: Body chills or shaking‍
9. ‍Yawning: The frequency of yawning during the assessment‍
10. ‍Anxiety or irritability: The degree of nervousness or sensitivity/anger levels‍‍
11. ‍Gooseflesh skin: “Goose bumps” on skin not accounting for extremely cold room temperature

When withdrawal is managed by a physician, measurements of these symptoms may be taken several times throughout the withdrawal process to track your progress as you get to the other side. Symptom measurement helps you and your care provider identify and safely treat any symptoms so you can comfortably move through the withdrawal process and into recovery.

If you’re managing withdrawal at home, you can use the Subjective Opioid Withdrawal Scale (SOWS), which is similar to the COWS, to track and measure your own progress.

But wait, there’s more…

The COWS is a great way to measure most opioid withdrawal symptoms, but there are still other symptoms not measured by the COWS. Those include:

• Insomnia (can’t sleep)
• Dehydration
• Hot and cold flashes
• Loss of appetite
• Hypertension (high blood pressure)
• General aches and pains

Fasten Your Seatbelts – Opioid Withdrawal Without Help is a Bumpy Ride‍

Opioid withdrawal without help and support can be a tough ride, even for the most experienced person. Managing one or two symptoms can take down the best of us, but 11+ symptoms at once can be more than overwhelming.

There are some ways to ease a range of symptoms so the road through withdrawal is less rocky. Some of these options you can manage on your own, but some may require gathering your support system, including your care provider. If you have or had any conditions or illnesses affecting your heart, including but not limited to high blood pressure, stroke, heart attack, diabetes, hardening of blood vessels, high cholesterol, abnormal heart rhythms, chest pain, or shortness of breath, make sure to talk with your care provider before stopping opioids.

6 Tips to Tackle Opioid Withdrawal Symptoms

1. ‍Get Professional Help (Healthcare providers and Treatment Programs): If you don’t already have a care provider or treatment program, now is a good time to seek one out. Doctors and clinics can offer most, if not all of the support you need to get through opioid withdrawal.‍
2. The Slow Goodbye (Tapering Off): Going cold turkey from large doses of opioids can wreak havoc on your system, not to mention it can be dangerous. But, gradually reducing opioid use could make the whole process smoother. Be sure to talk to your care provider for a good, safe taper schedule. Again, if you have any conditions that could affect your heart, like mentioned above, definitely talk with your care provider before stopping.‍
3. Comfort Medication: The use of medications to ease withdrawal symptoms does not mean swapping one drug for another. They are the temporary use of a range of medicines — from over-the-counter to prescription drugs —that can really help tone down the opioid withdrawal symptoms. Just be sure to ask your care provider what may work best in your situation before you begin the withdrawal process. And, it’s important to share any other medications you may be taking so they can manage any potential drug interactions or additional side effects.‍
4. Talk It Out (Counseling and Therapy): Sometimes, a good listener or sage advice from a trained professional can really help you sort out the emotional rollercoaster of withdrawal. Don’t be afraid to get connected to a counselor or therapist to start working on the emotional side of recovery. Fear, Uncertainty or Dread (FUD) are normal emotional responses when thinking about stopping opioids. A counselor or other trained professional can help you handle those feelings in a healthy way, so they don’t derail your recovery process. Overcoming FUD is a great self-esteem builder!‍
5. Finding Your Crew (Support Groups): Sharing and learning from others in the same boat can be super helpful. Support groups have a bunch of people who’ve been through withdrawal and can offer guidance, understanding, compassion, and encouragement so that you can make it through, just like they did. They can be the hand that helps you get to the other side. ‍
6. Gadget Magic (Transcutaneous Auricular Neurostimulation): Not really magic, but one new way to manage withdrawal symptoms is with Sparrow Ascent wearable neurostimulation prescription for opioid withdrawal relief. Sparrow Ascent is a prescription-only device that offers a safe, comfortable, drug-free way to manage withdrawal symptoms from the beginning to the end of the withdrawal process. Plus, Sparrow Ascent can be combined with all the other options above and can be used for in-patient, out-patient, or at-home detox.

One last tip, if you’re planning on managing opioid withdrawal from home, check out this Step-by-Step Guide to Managing Opioid Withdrawal at Home.

We’re In Your Corner, Too

Dealing with opioid withdrawal is a brave step toward recovery. Knowing what to expect and how to manage symptoms can make a big difference. And hey, don’t forget to check out Sparrow Ascent for a fresh approach to easing these symptoms without additional meds.

Challenge Accepted?

Ready for a little pre-withdrawal challenge? See if you can count the number of opioid withdrawal symptoms this Sparrow Ascent patient was able to tackle during his withdrawal treatment. Hint – it’s more than six!

If you’re ready to tackle withdrawal and want Sparrow Ascent in your corner, take a look at Sparrow Ascent wearable neurostimulation information on this site, then take our qualification quiz to see if this opioid withdrawal management solution via telehealth is a good fit for you or your loved one. Or, you can find a Sparrow Ascent prescribing provider near you.

Just a Reminder...

While this guide aims to inform and support, it's always wise to talk with a healthcare professional for advice tailored to your specific situation.