When abrupt opioid discontinuation becomes part of the plan...

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LUCEMYRA is the first and only FDA-approved, non-opioid, non-addictive treatment for relief of multiple symptoms of opioid withdrawal to facilitate abrupt opioid discontinuation in adults.1 Learn more

Learn more about Opioid Withdrawal Syndrome (OWS) and how it can affect your patients

Joseph Pergolizzi, MD
Pain Specialist

Consider non-opioid treatment to help relieve withdrawal symptoms and facilitate abrupt opioid discontinuation

The AAPM recommends that clinicians frequently evaluate the benefits and harm of continued opioid therapy2

  • If benefits do not outweigh harm of continued opioid therapy, clinicians should optimize other, nonopioid therapies
  • Physical dependence to opioids can occur after only 5 days of use3
    • After 1 month of opioid use, 30% of patients still use opioids 1 year later3

Challenges associated with opioid withdrawal symptoms

  • May prevent a large percentage of patients from completing discontinuation4
  • May be confused by patients with their original pain symptoms5
  • May discourage many patients who fail to discontinue from trying again6

Opioid withdrawal symptoms can perpetuate opioid use6

  • 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%)

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 body

Symptoms of opioid withdrawal include8:

  • Aches and pains
  • Stomach cramps
  • Feeling sick
  • Muscle spasms/twitching
  • Insomnia/problems sleeping
  • Feelings of coldness/chills
  • Muscular tension
  • Heart pounding
  • Runny eyes
  • Yawning

OWS can affect patients with physical opioid dependence or Opioid Use Disorder7,9

Post-Withdrawal Management

  • 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.

References:

  1. LUCEMYRA® (lofexidine) [Prescribing Information]. Louisville, KY: US WorldMeds, LLC; 2018.
  2. American Academy of Pain Medicine. Use of opioids for the treatment of chronic pain. February 2013.
  3. 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.
  4. Data on file. Louisville, KY: US WorldMeds; 2017.
  5. Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Exp Clin Psychopharmacol. 2008;16(5):405-416.
  6. 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.
  7. Shigakova F. Clinical manifestations of the opiate withdrawal syndrome. Int J Biomed. 2015;5(3):151-154.
  8. 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.
  9. Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain–Misconceptions and Mitigation Strategies. N Engl J Med. 2016;374(13):1253-1263.
  10. National Institute on Drug Abuse. Treatment Approaches for Drug Addiction. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction. Revised January 2018. Accessed January 8, 2019.
  11. Kosten TR, George TP. The neurobiology of opioid dependence: implications for treatment. Sci Pract Perspect. 2002;1(1):13-20.