What are some of the best ways to mitigate opiate/heroin withdrawals?


Detoxification with prescription opioids (descending dosages of methadone, codeine,dextropropoxyphene or buprenorphine) is the simplest and less umconfortable way for heroin/opiate withdrawal. If, for any reason, these drugs are not used, clonidine could be an option. A detoxification program should be supervised by a trained professional. Unfortunately, detoxification programs are not available in all the world. A detailed, complete guideline on pharmacological and physical interventions in opioid detoxification can be found here:

https://www.nice.org.uk/guidance/cg52/evidence/drug-misuse-opioid-detoxification-full-guideline-196515037 (pages 75-144)

Clonidine can be an option if prescription opiates are not available. Clonidine acts on abdominal pain, shivering, muscular cramps and other physical symptoms but it is not very useful for anxiety and insomnia. Short time use of oral benzodiacepines like chlorazepate or midazolam can help for these symptoms.

http://www.pnsd.msssi.gob.es/en/Categoria2/publica/pdf/GuiaClinicaOpiaceos.pdf (page 28)

L-acetyl-carnitine acts on pain in methadone detoxification. It can be useful for some patients in a 2 gr daily dosage to releive symptoms as muscular tension, muscular cramps, and insomnia


General measures: good hydration, soft meals, resting…are useful, too.In any case, these are general orientations, pattern of treatment and selection of drugs must be customized.

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