Kadian Withdrawal Symptoms, Signs, and Detoxification
Kadian may be effective for pain but Kadian-dependent individuals can suffer a very uncomfortable withdrawal syndrome.
Kadian is a prescription medication containing morphine, a powerful narcotic pain reliever used to help control pain that requires round-the-clock management. 1
Kadian is available in extended release oral capsules, meaning the morphine is gradually released into your system. Doses range from 10 mg to 200 mg depending on the level of pain management required.1
Like other opioids, Kadian may be very effective for pain but is also associated with risks like abuse, dependence, and addiction. 1 Kadian-dependent individuals who abruptly cut back or stop taking Kadian can suffer a very uncomfortable withdrawal syndrome.1
What Is Kadian Withdrawal?
To understand the dangers of withdrawal, you have to understand the full impact that opioids have on your brain and body. Whenever someone consumes an opioid, the drug is absorbed into the bloodstream and distributed throughout the body. Once in the system, opioids cling to special opioid receptors in the brain to block the perception of pain.2
Someone who takes Kadian can easily develop a tolerance to Kadian, meaning that they’ll require more Kadian to feel its effects. 2
Long-term use, especially with frequent dose increases, can lead to physiological dependence, an adaption of the body and brain to the constant presence of the drug. When your body becomes dependent on Kadian, it needs the drug to function as expected. You may experience significant discomfort if you stop taking the drug or reduce your dose too quickly. 2
Kadian withdrawal symptoms begin to emerge when the opioid is no longer available at its normal levels. 2 Although Kadian withdrawal symptoms can be very unpleasant, they are not usually life-threatening to most people.
Who Will Go Through Withdrawal?
Not every person who uses Kadian will be at risk of experiencing unwanted withdrawal symptoms, especially if they only use it for a very limited amount of time. However, using it for an extended period, even according to prescription guidelines, increases the likelihood of developing significant physical dependence.1
People who intentionally misuse Kadian are also likely to go through withdrawal. In these instances, withdrawal may be very severe, depending on the average dose being taken and how long they’ve been misusing it. Abuse or misuse might look like:
- Using more of the drug more often than recommended.
- Taking Kadian without an active prescription.
- Taking the drug to get high.
- Taking it for longer than prescribed.
- Mixing the drug with other substances.
- Tampering with the drug (crushing, snorting, chewing, or injecting the substance) to circumvent extended-release mechanisms and elicit more potent effects.
Signs and Symptoms
As with many painkiller drugs, Kadian withdrawal symptoms are a predictable part of the process of quitting for someone who has become dependent on the opioid. These symptoms vary among individuals but often mirror very severe flu-like symptoms.
People in Kadian withdrawal may experience:1,3
- Excessive sweating.
- Tearing of the eyes.
- Stomach cramps.
- Nausea, vomiting, and diarrhea.
- Loss of appetite.
- Muscle and joint pain.
- Dilated pupils.
- Rapid heart rate.
- Increased blood pressure.
- Increased respiration rate.
- Increased pain sensitivity (i.e., hyperalgesia).
Alone, the physical withdrawal symptoms can be quite distressing. Additionally, acute Kadian withdrawal may also include several mental health symptoms that can be equally as troublesome as some of the physical symptoms. Someone withdrawing from opioids may feel:1,4
- Intense cravings.
- Low mood.
- Restlessness and irritability.
- Intense worry and anxiety.
- For those with preexisting anxiety disorders, symptoms may worsen.3
Aside from the intense discomfort that can lead to relapse, certain situations may arise that require the help of medical professionals. These complications may arise due to: 3
- Dehydration and electrolyte imbalance caused by vomiting and diarrhea.
- Preexisting heart conditions that are exacerbated by increases in blood pressure and heart rate.
- The effects of withdrawal on preexisting psychiatric conditions, especially panic disorders.
- Preexisting pain that is now untreated without the availability of an opioid, coupled with a lowered pain threshold.
Individuals in withdrawal will also have to contend with cravings that can feel overwhelming. Without support and a substance-free environment, relapse risk may be especially high. Especially concerning is the heightened risk for overdose after a period of sobriety, wherein tolerance may have decreased significantly. 2
The intensity of Kadian withdrawal symptoms may vary from person to person. There are some factors that can be used to predict the potential severity of withdrawal, such as:3
- The rate, dose, and duration of Kadian use.
- The tendency to mix the medication with alcohol or other substances.
- Previous withdrawal experiences.
- Preexisting medical or mental health conditions.
How Long Will It Last?
All opioids share a similar group of withdrawal symptoms, but the withdrawal timeline can be quite different depending on the specific drug and how the drug is used. With a short-acting opioid like heroin, withdrawal symptoms can begin in as little as 6 hours after the last dose. 4 Stopping a longer-acting drug like methadone may not produce withdrawal symptoms until 4 days after last use. 4
The specific timeline of withdrawal may vary according to how the drug has been used/abused. Someone who consumes the drug by crushing/snorting, chewing, or injection may bypass the extended-release mechanism intended for this formulation to effectively deliver the full dose of the substance as an immediate-release hit.1 Withdrawal symptoms in these Kadian abusers will more closely approximate those seen in withdrawal syndromes associated with immediate-release morphine.
Most Kadian users can expect withdrawal symptoms to begin within a day after the last time they took it. Symptoms generally peak within 3 days and gradually dissipate over the course of a week. 4
The withdrawal symptoms mentioned are sometimes called acute withdrawal symptoms because they are time-limited to the initial withdrawal phase that immediately follows the discontinuation or significant decrease in drug dosing. In many cases, the nature of acute withdrawal is a relatively predictable phenomenon and quite the opposite of the intoxicating effects of the drug in question.5
Symptoms that persist beyond this acute phase of withdrawal are referred to as protracted, or post-acute, withdrawal symptoms.
Sometimes called a post-acute withdrawal syndrome (PAWS), a person suffering from protracted withdrawal might experience:5
- Poor focus.
- Dysphoria (low mood or blunted emotions).
- Anhedonia (inability to feel pleasure).
These symptoms can last for months or years.5 Fortunately, you don’t have to suffer the effects of withdrawal alone. There are numerous treatment options that you will provide you the support you’ll need to begin and stay on your path to recovery.
Withdrawal Treatment Options
In many cases, an abrupt, “cold turkey” discontinuation of a long-abused painkiller like Kadian might not be the most realistic option, as it is likely to result in markedly unpleasant withdrawal. Experiencing such a difficult withdrawal syndrome frequently compels immediate relapse and is one reason that professional addiction treatment, including a medical detox period, is so beneficial in cases of opioid dependence.
Kadian withdrawal treatment frequently begins with a detoxification process to better manage the symptoms and stressors that accompany withdrawal. Professional detox utilizes a specific set of tools and strategies to improve the withdrawal process by increasing safety and comfort.6 Attempting to withdraw without the support, guidance, and medications available in professional detox is a risky decision. Detox is an irreplaceable segment of many successful opioid dependence treatment plans.7 People who skip this step may jeopardize their recovery before it begins.
Professional detox programs will be comprised of 3 phases:3
- Referral to other services.
Each segment of detox is essential to ensure the problems of withdrawal are identified, addressed, and followed through on for the needed period of time.
Detox can be performed on an outpatient or inpatient basis. In both types of programs, a healthcare professional will create and implement a plan for safe withdrawal. If you have been taking a high dose of Kadian or have been using morphine for a long time, you might benefit from more intensive treatment options.
If you have questions about the type of Kadian withdrawal treatment program that is right for you or your loved one, be sure to seek out an addiction assessment from a trusted physician or addiction specialist.
Overall, inpatient treatment settings are more intensive than outpatient options because they offer 24-hour care and support from treatment professionals. According to the experts at the Substance Abuse and Mental Health Services Administration (SAMHSA), inpatient treatments will be the safest level of care for a person who may suffer the physical and mental health repercussions of morphine withdrawal.3
Inpatient options are separated into three categories based on the intensity, services, and location of care:3
- Medically managed detox – the most intensive form of treatment with ready access to physicians and nurses to care for needs as they develop. These detoxes are based in acute care hospitals.
- Medically monitored detox – an intermediate level of intensity with quick access to doctors, nurses, and other staff. One major difference is that medically monitored detoxes are usually in freestanding treatment centers, not in acute care settings.
- Social detox – the least intensive form of detox for people with milder symptoms. Rather than a medical focus, social detoxes utilize the encouragement and guidance from staff in a supportive, calm environment.
In detox, the treatment team will develop an individualized treatment plan based on the person’s symptoms, stressors, and supports. The treatment will likely follow one of three plans: 3, 7
- Tapering off of Kadian. Gradually reducing the dose over a long period of time can help prevent and manage any unpleasant withdrawal symptoms.
- Switching from Kadian to another opioid such as methadone or buprenorphine. This can help to reduce the cravings that may lead to relapse.
- Abruptly ending all Kadian use and offering medications to manage the withdrawal effects.
There is some stigma associated with the use of medications during recovery, as some people think it means you’re not really sober. However, this is not the case. Medications are a useful tool to reduce the severity of withdrawal symptoms and potentially prevent future relapse. As many as 4 out of every 5 detoxes is assisted with prescribed medications.8
Outpatient detox options allow the individual to live at home, maintain employment, and care for their children while undergoing detox. Outpatient care is a better fit for people with low risks and high supports from their family and friends.3 Sometimes, due to the length of time needed to taper from a high dose of Kadian, the detox will switch from inpatient to outpatient when the patient’s symptoms are stabilized.
What Happens Next?
Once you have completed detox, you will likely move on to the rehabilitation stage of recovery, which takes place on a residential or outpatient basis. During this process, individual, group, and family therapy will help you address the reasons behind your use of the drug and learn to live your life without Kadian.
Your care doesn’t have to end after the typical 30-90 days of treatment. For example, residential therapeutic communities are available that provide both Kadian withdrawal treatment as well as rehabilitation for durations of up to one year.7 These programs utilize caring staff and the wisdom of others in recovery to encourage long-lasting sobriety.
Medications are often part of the rehab process. At times, medications are used to address mental health issues, manage PAWS, or prevent relapse.7 In some cases, a doctor might prescribe a drug such as naltrexone to help you stay off Kadian. Naltrexone is an opioid antagonist that blocks opioids from attaching to your brain’s opiate receptors so that you do not experience any pleasurable effects when taking Kadian.7 Naltrexone is a very helpful medication taken orally or as a once-monthly injection, but you can’t use it immediately. If the medication is administered too soon, it can bring about very strong Kadian withdrawal symptoms. You’ll need to discuss with your doctor when to start (it must be after your withdrawal is complete).2
The variety of outpatient and inpatient Kadian withdrawal treatment programs means that there is certainly an option that can fit your needs or the needs of your loved one.
Pregnancy and Kadian Withdrawal
Kadian use during pregnancy may lead to neonatal withdrawal. Referred to as neonatal abstinence syndrome (NAS), this condition affects babies who are born to women who use opioids throughout pregnancy since opioid dependence develops in the unborn baby as well.1 An opioid-dependent newborn child will develop neonatal withdrawal syndrome shortly after birth, which can prove life-threatening if not detected and treated thoroughly.1
Just like opioid withdrawal, NAS is characterized by symptoms like:1
- Inconsistent sleep patterns.
- High pitched crying.
- Vomiting and diarrhea.
- Poor feeding/inability to gain weight.
Pregnant women looking to quit Kadian or other opioids should always consult with a physician or other addiction treatment professional to ensure their safety and the safety of their children. Buprenorphine may be recommended as a way to end the dependence to Kadian during pregnancy.7 Buprenorphine is still an opioid substance, but it works somewhat differently in the body than Kadian and will often result in fewer NAS symptoms in the child.7
New mothers who have been dependent on opioids during pregnancy should also seek out treatment and support from groups like NA, friends, and family, as the stress of caring for a high-needs infant early in recovery could compromise newly found sobriety. Some treatment programs offer services for both pregnant mothers and new mothers, emphasizing parenting classes, check-ups for mother and baby, and more to ensure both you and your child are getting the care you need and that you get the support required to manage this new transition without returning to opioids.
|Kadian Information at a Glance|
|Medication Name, Costs||Class of Medicine|
|Form, Intake and Dosage||Interactions and Complications|
|Effects and Adverse Reactions||Substance Abuse|
|Physiological Problem Signs and Symptoms||Dependence and Addiction Issues|
|Legal Schedules and Ratings|
Source: U.S. National Library of Medicine
- U.S. National Library of Medicine: DailyMed. (2014). Kadian.
- Kosten, T., George, T. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Science and Practical Perspectives, July 2002, 13-21.
- Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
- Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.
- National Institute on Drug Abuse. (2018). DrugFacts: Treatment Approaches for Drug Addiction.
- Drug Enforcement Administration. (2017). Drugs of Abuse.