Depression From Opiate Withdrawal
Depression from opiate withdrawal is a common side effect that can have long-lasting effects. Fortunately, depression and opiate addiction are both highly treatable. There are several medications and therapies available that have been proven to reduce opiate withdrawal symptoms and help people find recovery.
What Is Opiate Withdrawal?
Opiate withdrawal, also frequently referred to as opioid withdrawal, is the set of symptoms that occurs when opiate use suddenly stops. Opiates and opioids include drugs such as heroin, morphine, oxycodone, hydrocodone, and fentanyl, which all similarly affect the brain and body.
Opioid withdrawal symptoms are intensely uncomfortable and closely parallel severe flu symptoms. Fortunately, opiate withdrawal is not typically life-threatening, and opiate withdrawal treatment can vastly improve symptoms and help people break through this first phase of recovery.
How Long Do Opioid Withdrawal Symptoms Last?
But typically, detox from opiates results in symptoms that resolve in a week or two.
The opiate withdrawal timeline differs for everyone, depending on factors like:
- How long opiates were used
- Amount of opiates used
- Age
- Presence of co-occurring mental illness
- Use of more than one substance
But typically, detox from opiates results in symptoms that resolve in a week or two.
Symptoms of Opiate Withdrawal
The withdrawal symptoms of drugs such as heroin or oxycodone are the same, though they may vary in intensity or length depending on which drug has been used. Symptoms of opiate withdrawal include:1
- Depression
- Muscle aches
- Sweating
- Intense drug cravings
- Nausea
- Vomiting or diarrhea
- Insomnia
- Mood swings
- Chills
- Anxiety
- Sneezing
- Goosebumps
- Dilated pupils
Opiate Withdrawal Timeline
Opiate detox can last up to two weeks, but the severity of symptoms typically peaks after just a few days, then gradually gets better. The opiate withdrawal timeline has three stages; these stages will be detailed below.
Stage 1: Early Withdrawal
Early withdrawal typically begins 8 to 24 hours after opiates were last used. Early signs of opiate withdrawal include a runny nose, chills, and sweating. At this stage, people feel sick and uncomfortable. Cravings for opiates begin during this stage.2
Stage 2: Peak Period
The peak period of opiate withdrawal typically happens three or four days after opiates were last used. Signs of opiate withdrawal in this stage include nausea, insomnia, diarrhea, and intense mood swings.
If left untreated, this stage can be an incredibly intense and harrowing experience, as the withdrawal symptoms of drugs like heroin and oxycodone feel overwhelming.
Stage 3: Post Acute Withdrawal
After the peak period, the major symptoms of opiate withdrawal begin to subside. People may still feel sick for up to two weeks, but at a much lower intensity than during the peak period. However, post-acute withdrawal can last for months, if not years. This is where depression from opiate withdrawal can kick in, as lingering symptoms can lead people to feel that the promises of recovery have been left unfulfilled.
Oxycodone and depression go hand-in-hand during withdrawal, but mood changes can happen with several drugs, including heroin, morphine, and fentanyl. Depression is the most commonly reported symptom of post-acute withdrawal.3
How Do Opioids Affect Your Mental Health?
Opioids impact mental health by altering brain chemistry, emotional regulation, and cognitive functions. While they initially provide a sense of euphoria and relief from pain or emotional distress, their long-term use can lead to significant mental health challenges. Opioid misuse can impair cognitive functions, including memory and decision-making, contributing to increased impulsivity and difficulty coping with stress. This impairment can compound feelings of anxiety, irritability, and mood swings, which are common among those struggling with opioid dependence.
The connection between opioid use and mental health issues, such as anxiety, depression, and suicidal ideation, is well-documented. For instance, as the effects of opioids wear off, individuals often experience mood crashes or intense anxiety. In the long term, the neurochemical imbalances caused by opioids can leave individuals vulnerable to persistent mood disorders, even after they stop using the drugs.
Do Opiates Cause Depression?
When people feel depressed during the post-acute withdrawal phase, it happens for one of two reasons:
- Depression predated opiate use
- Depression developed as a side effect of opiate withdrawal
Opiates can contribute to depression in several ways, both directly and indirectly. Firstly, regular opiate use alters the brain’s reward system by flooding it with dopamine, creating an artificial sense of pleasure and well-being. Over time, the brain adapts by reducing its natural dopamine production and sensitivity, making it difficult for individuals to feel joy or satisfaction without the drug. This reduction can lead to anhedonia—a diminished ability to feel pleasure—which is a core symptom of depression.
Moreover, the cycle of dependence on opioids, followed by withdrawal, further exacerbates emotional lows. The post-acute withdrawal phase, where symptoms linger after the initial detox period, can leave individuals feeling hopeless, fatigued, and unmotivated, deepening depressive symptoms. For some, depression may predate their opioid use, leading them to self-medicate with these substances. For others, depression can develop as a result of prolonged opiate use, highlighting the complex and bidirectional relationship between opiate addiction and depression.
Opiates like oxycodone, morphine, and fentanyl, often misused for their euphoric effects, eventually become less effective over time due to tolerance. This tolerance requires higher doses to achieve the same effects, which can worsen depression as dependence grows. Overall, the impact of opiates on mental health is profound, making professional treatment and support essential for recovery.
Opiate Withdrawal Depression
Depression and opiate addiction can be related, as in the case of oxycodone and depression. Many drugs affect the brain through the dopamine pathway in the brain’s reward network. Opiate use causes a flood of dopamine to enter the brain, giving a strong sense of reward. The longer drug use continues, the more the brain adjusts to these new dopamine levels by cutting back on the receptors which process dopamine when it arrives.
This downregulation of dopamine receptors can make people feel less and less rewarded by pleasurable everyday experiences. Going to the beach for a day may sound great to most people, but someone with opioid use disorder may find the experience boring. This can lead to clinically significant depression from opiate withdrawal and is a key target for treatment.
Common Opiates Used to Self-Medicate
However, the use of opioids for depression that was already present is also common. Opiates used for depression include:
- Oxycodone
- Vicodin
- Codeine
- Morphine
- Hydrocodone
- Fentanyl
The use of opiates for depression may work in the short term. Still, it ultimately leads to a worsening of depressive symptoms, as well as the potential development of an opioid use disorder.4
Opiates and Depression Treatment
People experiencing depression from opiate withdrawal, whether from the use of opiates for depression or new depression resulting from opiate withdrawal, need professional addiction treatment to recover.
The best treatment centers will combine mental health and addiction treatment services, including:
- Opiate detox
- Peer support
- Individual counseling
- Medical support during detoxification
- Family education and counseling
- Step-down and transitional services
- Follow-up and ongoing support
These services can help people learn about the risks of substance use, develop healthy coping skills, repair and nurture their relationships, and treat co-occurring mental illnesses simultaneously.
Get Help for Opiate Withdrawal at San Diego Detox
When you’re ready to start opioid withdrawal treatment and get help for co-occurring depression, reach out to the professionals at San Diego Detox. From the moment you call our premier addiction treatment center, our experienced team will be there to support you every step of the way. Don’t delay treatment any longer — recovery is worth the effort.
Resources
- https://medlineplus.gov/ency/article/000949.htm
- https://www.ncbi.nlm.nih.gov/books/NBK310652/
- https://www.sciencedirect.com/science/article/pii/S1555415521005523?casa_token=Pq8f-JPakOcAAAAA:jsLs5TDLu6V8f1UuinhVEhiLj_1eo4mlwaaN7Vzw1J1Qqw_9arhpmadBEssZDIJmzZis0e9PJg
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175215/
