When abrupt opioid discontinuation
becomes part of the plan…
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LUCEMYRA is the only FDA-approved, non-opioid, non-addictive treatment for relief of multiple symptoms of opioid withdrawal in adults1 Learn more
Continued opioid use almost inevitably leads to physical opioid dependence2
Anyone using opioid pain medication can develop a physical need for opioids in as early as 5 days4
After ONE MONTH of use, 30% of patients still use opioids ONE YEAR later4
Avoidance of withdrawal symptoms is a driver of continued opioid use5
According to a survey of patients originally prescribed opioids for chronic pain, more than half (57%) reported that avoiding withdrawal symptoms was their primary reason for current use, rather than for pain relief (23%), or wanting to “get high” (14%)
You and your patient should discuss the pros and cons of continuing opioid therapy at least every 3 months6
Opioid Withdrawal Syndrome (OWS) makes opioid discontinuation difficult and extremely unpleasant
Symptoms of opioid withdrawal, sometimes known as OWS, are associated with both psychological distress and physical discomfort7
- Signs and symptoms of OWS often present concurrently, ranging from actual physical pain, to emotional and sleep disturbances, to other bothersome sensations localizing in muscles, joints, skin, and other parts of the body7
Stopping opioid use suddenly can result in severe withdrawal symptoms, including7,8:
Aches and pains
Feeling sick (nausea, vomiting, diarrhea)
Muscle spasms (twitching)
Insomnia (problems sleeping)
Feelings of coldness (chills)
The peak severity and duration of withdrawal symptoms depend on the half-life of the opioid9,10
- For shorter-acting opioids, such as Percocet®, OxyContin®, or Vicodin®, withdrawal symptoms peak within 2 to 3 days and can last for 7 to 10 days9,10
- For longer-acting opioids, such as methadone, withdrawal symptoms peak at 3 to 4 days, but may last for 14 days or more9,10
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Challenges associated with opioid withdrawal symptoms:
- May prevent a large percentage of patients from completing discontinuation5
- May be confused by patients with their original pain symptoms11
- May discourage many patients who fail to discontinue from trying again5
Consider non-opioid treatment to help relieve withdrawal symptoms and facilitate abrupt opioid discontinuation
OWS can affect patients with physical opioid dependence or Opioid Use Disorder (OUD)
Tolerance is a hallmark of physical dependence and a precursor to OWS3
Successful OWS management can help both physically dependent patients and patients with OUD through opioid withdrawal.
When treating patients with OUD, LUCEMYRA should only be used in conjunction with a comprehensive management program for the treatment of Opioid Use Disorder.1
2020 ASAM National Practice Guideline Update:
Recommendations for Treating Opioid Withdrawal12
The American Society of Addiction Medicine (ASAM) recognizes two main strategies for managing opioid withdrawal—gradually tapering the dose of opioid agonists, or employing the use of non-opioid alpha-2 adrenergic agonists
Regarding the use of alpha-2 adrenergic agonists, the Guideline states:
“Lofexidine should therefore be the preferred choice for withdrawal management in an outpatient setting, where monitoring of blood pressure and management of hypotension is more difficult.”
– American Society of Addiction Medicine, 2020
- LUCEMYRA® (lofexidine) [Prescribing Information]. USWM, LLC; 2020.
- Volkow ND, McLellan AT. Opioid abuse in chronic pain–misconceptions and mitigation strategies. N Engl J Med. 2016;374(13):1253-1263.
- Kosten TR, George TP. The neurobiology of opioid dependence: implications for treatment. Sci Pract Perspect. 2002;1(1):13-20.
- Shah A, Hayes CJ, Martin BC. Characteristics of initial prescription episodes and likelihood of long-term opioid use – United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66(10):265-269.
- Weiss RD, Potter JS, Griffith ML, et al. Reasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain. J Subst Abuse Treat. 2014;47(2):140-145.
- Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain–United States, 2016. JAMA. 2016;315:1624-1645.
- Shigakova F. Clinical manifestations of the opiate withdrawal syndrome. Int J Biomed. 2015;5(3):151-154.
- Vernon MK, Reinders S, Mannix S, et al. Psychometric evaluation of the 10-item Short Opiate Withdrawal Scale-Gossop (SOWS-Gossop) in patients undergoing opioid detoxification. Addict Behav. 2016;60:109-116.
- Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. 2003;348(18):1786-1795.
- Kleber H. Opioids: detoxification. In: Galanter M, Kleber, HD, eds. Textbook of Substance Abuse Treatment. 2nd ed. Washington, DC: American Psychiatric Press; 1999:251-269.
- Rosenblum A, Marsch LA, Joseph H, et al. Exp Clin Psychopharmacol. 2008;16(5):405-416.
- American Society of Addiction Medicine (ASAM). National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update. 2020. https://www.asam.org/Quality-Science/quality/2020-national-practice-guideline. Accessed July 13, 2020.