Whether it is due to curiosity, a desire to plan how to take the time away for treatment, or hesitation to enter treatment for alcohol or drug addiction to begin with, people commonly have questions about the need for detox and what the withdrawal experience may be like.
In the U.S. there are a significant number of people struggling with prescription drug abuse involving opioid medications. Understanding the timeline, potential symptoms, and overall withdrawal management process for Demerol or other opioids can ease fears and hopefully encourage individuals to seek medical detox help. A safely and comfortably managed withdrawal experience is important during early recovery and will set the stage for additional needed rehabilitation work.
Demerol for Acute Pain Management
Demerol, a brand name for meperidine, is a synthetic opioid agonist. Demerol may be used in clinical settings to treat severe pain. Previously available in several formulations, including oral tablet and solution, branded Demerol is now only available as an injectable solution. Demerol is indicated for use as a preoperative medication, as an adjunct to anesthesia, for managing obstetrical pain and other severe pain situations in which alternative pain management strategies (non-opioids or opioid combination analgesics) are inadequate.1
As described in documentation from the Food and Drug Administration, Demerol acts similarly to morphine in the central nervous system to achieve its therapeutic effects of sedation and pain management. Demerol may be less likely to result in constipation and diminished cough reflex than comparable doses of morphine.1 Despite once-widespread use in clinical settings, Demerol is an opioid medication and, as such, it is still subject to abuse and addiction liability.
Demerol Detox and Withdrawal Management
With regular use of Demerol and other opioid drugs, people may develop physical opioid dependence—an adaptation to the consistent presence of a drug and its pharmacologic influence on the body that may lead to the onset of withdrawal symptoms when the drug is no longer used.
Acute opioid withdrawal can be quite unpleasant, which can present challenges to early recovery. Because of this, a period of detoxification and medical withdrawal management commonly takes place at the start of treatment for Demerol abuse or other opioid use disorders.2,3
The abrupt discontinuation of opioids can lead to withdrawal. Slowing use or altogether quitting Demerol after a person has developed physiological dependence can give rise to opioid withdrawal symptoms such as:1,2,4
- Increased blood pressure, heart rate, breathing rate.
- Muscle aches and pains.
- Abdominal cramps.
- Nausea and vomiting.
- Watery eyes.
- Runny nose.
- Intense cravings.
Opioid withdrawal can be extremely uncomfortable, and they are sometimes severe enough to make the person relapse simply to stop the pain. Some people have reported that opioid withdrawal makes them feel like they’re dying; however, these symptoms are very rarely fatal. Still, because severe opioid withdrawal can prove to be such a challenge to early recovery, unmanaged detoxification attempts are commonly discouraged.3
MORE ON SUBSTANCE WITHDRAWAL:
General Withdrawal Timeline
Demerol is a short-acting opioid. Though opioid withdrawal timelines, including the character and severity of the withdrawal symptoms that may be experienced, will be influenced by the type of opioid being used, the duration of use, as well as the average dose and frequency of dosing being used, other relatively short-acting opioids such as heroin are associated with an acute withdrawal duration of roughly a week.
Such a timeline might resemble the following:5,6
- 6-12 hours after stopping use: Withdrawal symptoms begin to be felt several hours after the last dose.
- Days 1-3: Symptoms gradually peak in severity.
- Days 3-7: Symptom severity decreases and largely resolves within a week of last drug use.
- Weeks to months: Less acute symptoms such as dysphoria, anhedonia, anxiety, and difficulty sleeping may persist for several weeks after last use.
Though some symptoms during this time can be eased with over-the-counter medications, and other conservative management, acute opioid withdrawal is often managed via a medical detox under the oversight of a drug addiction professional and accompanying treatment team. These professionals can appropriately administer opioid agonist medications—such as buprenorphine or Suboxone—to stabilize a patient in withdrawal and maintain them through longer-term recovery.3,5
Different People, Different Timelines
The timeline above is only a rough estimate. In fact, each individual will have a slightly different withdrawal timeline, based on a number of factors, including:
- The general state of health.
- The presence of any concurrent mental health issues.
- Any concurrent alcohol or other substance dependence.
- The presence of concurrent kidney disease or other significant medical issues.
For example, as explained in the FDA information on the medication, people with compromised kidney function may have a much longer period of elimination for both meperidine and its metabolite normeperidine,1 which not only increases the risk for certain adverse drug effects but could also impact the withdrawal timeline somewhat.
Due to such individual differences, each person may have a somewhat different withdrawal experience—potentially longer or shorter than the above timeline. Despite variations in the precise withdrawal timeline, medical detox and withdrawal management—including frequent monitoring and adjustments to the treatment medications, when needed—can keep a person as safe and comfortable as possible during this challenging period of recovery.
Risks of Demerol Withdrawal
One of the biggest challenges of opioid withdrawal is that cravings and other unpleasant symptoms commonly lead to attempts to relieve them—in other words, relapse risks are high.6 Compounded with the discomfort of withdrawal, cravings can obviously present an immense challenge to continuing forward with recovery attempts.
Additionally, though life-threatening complications are much rarer in association with opioid withdrawal than with alcohol and sedatives, certain serious medical issues may arise. For instance, severe gastrointestinal symptoms such as vomiting and diarrhea can sometimes lead to fluid and electrolyte disturbances. Heightened autonomic symptoms such as rapid heart rate and increased blood pressure could exacerbate certain cardiac conditions.5
The risk of relapse alone is an important reason for seeking the supervision and support of professional detoxification, but the added risk of complications (though rare) make professional withdrawal management a recommended course of action for many people.
Getting Detox and Withdrawal Support
Professional detoxification and rehabilitation have helped many people recover from opioid use disorders. With supervision and caring support, medical detox and withdrawal management can provide a safe and comfortable environment in which a person can clear meperidine from the body, symptoms can be minimized, and the potential for relapse can be reduced.
Another important element of detoxification services is that they help facilitate a transition into ongoing treatment for Demerol abuse and addiction.5 In either an inpatient/residential or outpatient rehabilitation program, recovering individuals can learn how to better deal with triggers or cravings that might arise, as they learn to manage addiction in the long-term and curtail their chances of future relapse.
To learn more about how American Addiction Centers offers an evidence-based combination of medical detox and behavioral treatment at Greenhouse or any of our reputable facilities throughout the country, call . One of our caring admissions navigators will be happy to have a confidential conversation with you about your options.
- U.S. Department of Health and Human Services—Food & Drug Administration. (2019). Drugs@FDA: FDA-Approved Drugs: Demerol.
- U.S. National Library of Medicine—MedlinePlus. (2020). Opiate and Opioid Withdrawal.
- Substance Abuse and Mental Health Services Administration. (2020). Treatment Improvement Protocol—TIP 63: Medications for Opioid Use Disorder.
- S. National Library of Medicine—MedlinePlus. (2019). Meperidine.
- Substance Abuse and Mental Health Services Administration. (2015). Treatment Improvement Protocol—TIP 45: Detoxification and Substance Abuse Treatment.
- Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.