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Exalgo is a controlled-release version of the opioid pain medication hydromorphone. Hydromorphone is a powerful opioid, also the active ingredient in brand-name drugs like Dilaudid. Exalgo is intended to be prescribed to people who require relief for severe, around-the-clock, ongoing pain. It’s not an as-needed medication. Exalgo should only be prescribed to people who are already opioid-tolerant because it is powerful and can cause fatal respiratory depression in people not already used to opioids. There are risks associated with the use of Exalgo, particularly if it’s diverted from medical use. Risks include misuse and addiction. Dependence can also occur. If someone’s dependent on Exalgo, they’ll likely have withdrawal symptoms if they try to stop using it. Opioid withdrawal isn’t typically life-threatening but can be very mentally and physically uncomfortable, increasing the chance of recurrence of use. Exalgo withdrawal symptoms can include:
- Muscle aches and pains
- Problems with sleep
- Cold sweats
- Nausea and vomiting
- Restlessness and irritability
- Shaking and tremors
- Feeling depressed or anxious
- Suicidal thoughts or behaviors
- Low blood pressure
- Panic attacks
- Loss of pleasure in daily activities
- Runny nose
- Teary eyes
The length of time Exalgo withdrawal symptoms can last depends on the person, how they used the drug, how often they used it, whether or not they also misused other substances and other individual factors. Since Exalgo is a long-acting, controlled-release version of hydromorphone, it can be days before withdrawal symptoms appear. Within the first 48 hours of withdrawal from hydromorphone, a person will start to experience symptoms like nausea, restlessness, anxiety and drug cravings. Once the initial Exalgo withdrawal symptoms appear, they will peak within around a week, although symptoms can continue longer than that. For weeks or even months after someone stops using Exalgo, they may experience ongoing withdrawal symptoms. Ongoing withdrawal symptoms are usually psychological. These can include anxiety, depression, and suicidal thoughts or behaviors. People withdrawing from Exalgo may also have cognitive impairment, especially related to memory, focus and attention and problem-solving.
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Opiates like Exalgo change the function of the brain and central nervous system, and the body tends to have trouble readjusting when the drugs aren’t present. Detoxification is the time when someone’s body is removing substances from the system. Managing symptoms of Exalgo withdrawal can be helped with medications and participation in a medical detox. Other options for managing symptoms of Exalgo withdrawal can include outpatient supervision by a medical or mental health professional. While opioid withdrawal isn’t typically deadly, it can be difficult and uncomfortable. When someone isn’t able to go through Exalgo detox because of the discomfort and cravings, recurrence of use may occur. When someone tries to go through Exalgo withdrawal on their own, in an at-home detox, the chances are that they won’t be successful. However, a person may be able to detox at home if they’ve received guidance from a medical professional on how to effectively manage their symptoms.
Certain medications can be given by a medical professional when someone is going through Exalgo detox. Medications that may be used during opioid detox include the long-acting opioid maintenance drug methadone as well as the partial opioid agonist buprenorphine. Purobuphine is a newer version of buprenorphine that is administered as an implant. Probuphine steadily releases a low dose of buprenorphine over a six-month period. Clonidine is a medication that can lower blood pressure and help with other symptoms of opioid withdrawal. There is also a medication called naltrexone. Naltrexone blocks opioid effects and helps minimize drug cravings. Naltrexone is available as a tablet taken daily and as a brand-name, once-a-month injection called Vivitrol.
A lot of people dependent on opioids like Exalgo find the most beneficial way to withdraw is at a medically-assisted detox center. A medical detox includes treatment from a team of physicians and medical professionals as well as mental health care professionals. Medical detox can help reduce the severity of withdrawal symptoms and improve comfort. People who might especially benefit from an Exalgo medical detox include individuals who are heavy, long-term opioid patients or people who have previously tried to stop using opioids unsuccessfully. When choosing an Exalgo center, there are some features to look for. First, it’s beneficial to choose a detox center that’s part of a rehab program. Detox isn’t a treatment for Exalgo addiction. Instead, it’s the first step of addiction treatment. Also, it is important to consider whether or not the detox facility offers dual diagnosis care for mental health disorders.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.