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What causes pain in entire body after opioid withdrawal?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I had my pain pump of seven years which had dilaudid, clonidine and marcane inside titrated down and removed. This was difficult but I did the titration in eight weeks. I originally had it implanted for chronic back pain after a fall. I wanted to see if my back pain could be tolerated and it was tolerable during titration. I am 48 hours post op and have a completely new symptom not gotten before removal. Every muscle in my body feels like it has been in a 10 day triathlon for which I have never trained. I am struggling to get control of this new pain and have dilaudid 4mg. clonidine 24/7 patch, nortriptiyline 500 mg, Tramadol 50 mg, Ativan 1 mg, Tylenol. Nothing is touching this new pain. Do you think it might be a new withdrawal which will self resolve? If this is the case I can XXXXXXX through it. I was given the clonidine patch for early withdrawal and it cut out most. I would appreciate someone's educated response and hope that I have provided enough information.
Posted Tue, 5 Aug 2014 in Smoking and Alcohol Addiction
Answered by Dr. Preeti Parakh 13 hours later
Brief Answer:
Opioid withdrawal likely.

Detailed Answer:

Welcome to Healthcare Magic!

The pain in the entire body that you have described is typical of that seen in opioid withdrawal. I guess you had not expected this since you had titrated down the pump before removal. However, in spite of titration, complete removal does involve an abrupt lowering of opioid levels in the blood and so, will cause some withdrawal symptoms. Clonidine is very effective in controlling withdrawal symptoms like loose motions, sneezing, running nose, lacrimation etc but not of much help in pains. Tylenol, dilaudid and tramadol have analgesic effects but of these, dilaudid and tramadol are again opioids. Though you are taking these two in a very low dose, please keep in mind that any fluctuation in their levels can also cause withdrawal symptoms.

I expect your body ache to gradually settle down in five to six days. I was wondering if your doctor would consent to adding a muscle relaxant to your regimen for the next few days. I personally feel that patients in opioid withdrawal are able to tolerate pain better when they are prescribed muscle relaxant. In fact, just changing Ativan to another benzodiazepine, diazepam, will make a difference as diazepam has better muscle relaxant activity.

I hope this helps you. Please feel free to ask in case you need any clarifications.

Hope you have a speedy recovery. You are very brave. It takes guts to decide to get off a pain pump.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
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