Oxymorphone Hydrochloride Withdrawal and Detox

Withdrawal symptoms from oxymorphone hydrochloride can begin within 14 to 16 hours of taking the last dose. Symptoms may include nausea, vomiting, muscle aches and pains, restlessness, irritability, and intense drug cravings. Other synthetic opioids may be administered to help wean the patient off of the drug.

Oxymorphone hydrochloride is ten times more potent than morphine. It’s high rate of addiction combined with the current opioid epidemic led the Federal Drug Administration (FDA) to ban oxymorphone hydrochloride from the US market in June of 2017. It was the first time in the FDA’s history that they removed a drug that was already in circulation. Generic versions of extended-release oxymorphone hydrochloride are still available by prescription in the US, however.

Due to the highly addictive nature of oxymorphone hydrochloride, post-acute withdrawal symptoms can be severe. The dosage of the drug should be gradually decreased before finally stopping use. Withdrawal symptoms can include chills, profuse sweating, lacrimation (tearing up), mydriasis (pupil dilation), nausea, vomiting, joint pain, and insomnia. Other symptoms may include restlessness, yawning, runny nose, muscle pain, abdominal pain, backache, weakness, hypertension (high blood pressure), irritability, anorexia, tachycardia (rapid heart rate), irregular heart rate, and increased respiration.
Oxymorphone hydrochloride has a long half-life compared to other synthetic opioids. Its half-life is seven to nine hours, meaning that withdrawals can begin 14 to 18 hours following the last dose. For most patients, withdrawals symptoms peak in intensity at around day two. Severe symptoms may continue for between five to seven days.

Early withdrawal symptoms are characterized by mild flu-like symptoms, anxiety, insomnia, restlessness, and drug cravings. After the first few days, symptoms can evolve into more intense flu-like symptoms, severe drug cravings, nausea, and chills.

Several factors can influence the severity and duration of oxymorphone hydrochloride withdrawal symptoms. The patient’s unique body chemistry and genetics can play a role in the severity of addiction and subsequent withdrawals. Individuals who have a family history of substance misuse may experience more severe withdrawal symptoms. Individuals who have abused the drug by taking high and frequent doses, snorting, smoking, or injecting the drug will likely experience worse withdrawal symptoms.

The generic form of extended-release oxymorphone hydrochloride is the only version that is currently available in the US. It is common for people who abuse oxymorphone hydrochloride to crush the pills up in order to snort, smoke, or inject the drug. Crushing up the drug bypasses the pill’s outer coating that would otherwise regulate the drug’s release. Taking extended-release opioids in this way increases the chance of an overdose since extended-release versions contain higher quantities of the drug than immediate release versions. By consuming the drug in this way, a large dose intended to be spread out over the span of 12 hours rushed immediately into the bloodstream, potentially shocking the patient’s system.

Due to the potent and addictive qualities of oxymorphone hydrochloride, supervised medical detox is strongly advised. Hospitals have several medications at their disposal that can help safely wean the patient off the drug and take the edge off of withdrawal symptoms. Doctors commonly administer less potent synthetic opioids in substitution for oxymorphone hydrochloride. This practice mitigates severe withdrawal symptoms by acting on the same opioid receptors as oxymorphone hydrochloride.

Methadone and buprenorphine are the most commonly used medications for this purpose. They’re long-lasting and require few doses to achieve the desired effects. Methadone use requires close medical supervision due to its potential for dependency.

Buprenorphine has a much lower misuse potential. Some versions of buprenorphine, such as Suboxone, also contain naloxone. When patients attempt to take too much of the drug to get high, the naloxone becomes activated. Naloxone is a powerful opioid antagonist. Once activated, it abruptly negates the effects of any opioids in the patient’s system. This makes Suboxone especially useful in the long-term management of recovery from opioid misuse.

Other medications may also be used as treatments for managing specific symptoms of oxymorphone hydrochloride withdrawal as well. Antidepressants and anxiolytics can be administered to manage depression and anxiety. Anti-nausea medications can be prescribed for gastrointestinal distress, and others can be given to treat restlessness and insomnia.

Several treatment options exist for individuals who are recovering from opioid abuse and addiction. Most patients are advised to enter an inpatient rehabilitation program following medical detox. Inpatient therapy provides a safe place to recover without the temptation of engaging in drug-seeking behavior. Programs typically last 28 days, although some individuals may be asked to stay longer. During treatment, patients live at the facility and participate in group and individual therapy throughout the day. Alternative inpatient programs exist as well such as wilderness programs.

If you have any questions about potential treatment options, The Recovery Village is glad to answer any questions you may have.

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.

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