• Pharmacotherapy-based withdrawal regime

Diarrhoea

• Atropine Sulphate/Diphenoxylate Hydrochloride (Lomotil)
• Loperamide Hydrochloride (Imodium)
• Drink plenty of fluids - 6 - 8 glasses of water a day
• Eat regular meals

Headaches

• Paracetamol (Panadol)
• Massage

Nausea and Vomiting

• Flu-like illness: people present pale and restless with dilated pupils, hot and cold sweats, body aches, sweating and goosebumps (cold turkey).
• Watering eyes and nose
• Diarrhoea 
• Severe cravings
• Fatigue
• Abdominal cramps
• Anxiety, irritability and dysphoria
• Back aches, cramps and joint pain

Onset

• Opiate withdrawal can start within 12 hours of last using and symptoms kick in properly after 24 hours. Withdrawal is worst on day 3 to 4.
• Methadone symptoms emerge 36-48 hours after last dose

Duration

• The worst of the ‘detox’ is over in 4 - 5 days although people will not begin to feel back to normal for a couple of weeks. 
•  For methadone withdrawal, low grade symptoms can remain for 3-6 weeks

• Anxiety, depression and insomnia
• Intermittent Tachycardia 
• Tremor
• Risk of seizures
• Confusion, psychosis and delirium
• Excessive Sweating 
• Auditory, tactile, and visual hallucinations 
• Hypertension 
• Nausea and Vomiting 
• Diaphoresis

Onset

• Within 1 to 6 hrs after last dose. 

Duration

• 2 weeks or more.

Headaches

• Paracetamol (Panadol)
• Massage

Nausea 

• Eat small meals and snacks often
• Drink plenty of water
• If vomiting, stop eating solid food and try small sips of liquid, or sucking an ice cube. Try a small amount of food once you have kept fluids down for a few hours
• Rehydration/sports/isotonic drinks such as ‘Powerade'
• Avoid citrus and caffeine on an empty stomach

Pronounced agitation or insomnia

Withdrawal symptoms are varied but people often report:

• Excessive Sweating
• Bad headaches like a severe hangover
• Abdominal pains and nausea
• Shaking, trembling, tiredness and muscle cramps
• Severe cravings in the first few days
• Hallucinations or visual disturbances 
• After a week anxiety, depression, aggressive outbursts, trouble concentrating and irritability often occur. 

Onset

• Symptoms can occur within a few hours or days of stopping 

Duration

• Can last for several weeks

Headaches

• Paracetamol (Panadol)
• Massage

Pronounced agitation or insomnia