What is Precipitated Withdrawal and What Causes it? - ARISE

Drug and alcohol abuse can harm your body, mind, relationships, and other aspects of your life. Seeking treatment is essential to your success. Most treatment programs begin with treatment from a detox center, which allows you to stop using substances and manage the symptoms of withdrawal safely.

Detox centers typically use medications to treat withdrawal, but taking certain medications too early can cause people to develop a condition called precipitated withdrawal. Precipitated withdrawal can be uncomfortable and painful, and it can also make people feel frustrated, afraid, or discouraged. However, the support of your treatment team can help you overcome this condition and move forward in your recovery.

Reach out to the team at Arise Treatment Center to explore our detox and treatment programs or to find support at any stage of your recovery journey.

What is Precipitated Withdrawal?

Precipitated withdrawal occurs when someone suddenly develops withdrawal symptoms associated with medication-assisted treatment (MAT). Medication-assisted treatment is a form of substance abuse treatment that uses medications to help people safely stop using drugs, especially opioids.

Typically, people experience withdrawal symptoms when they abruptly stop using drugs after a period of heavy or regular use. A person’s body will react to the sudden absence of a substance, causing a range of uncomfortable–sometimes dangerous–symptoms. Precipitated withdrawal, however, is not caused by the lack of drugs or alcohol. Instead, a person’s symptoms are the direct result of the interaction between drugs that are still in the body (usually opioids) and medications used in medication-assisted treatment (such as buprenorphine or naloxone).

Typical withdrawal symptoms develop slowly and build to a peak over days or weeks. The precipitated withdrawal comes on very suddenly. Symptoms may be intense and unexpected, which causes people to feel afraid or distressed.

What Causes Precipitated Withdrawal?

Using opioid antagonists like naloxone during MAT can cause precipitated withdrawal if they are taken while opioids are still in your system. Opioid antagonists work by preventing opioids from binding to receptors throughout your body. When people take opioid antagonist medications, they can no longer feel the effects of opioids because opioid antagonists displace opioids from opioid receptors in the body. While regular withdrawal allows opioid receptors to gradually leave the system, opioid antagonists like naloxone displace all opioids at once, causing sudden and severe withdrawal symptoms.

People will only develop precipitated withdrawal if they take MAT medications, including buprenorphine, too early in the recovery process. It is critical that people only use MAT medications under strict medical supervision as part of a professional treatment program.

Usually, patients must wait 12-24 hours after taking an opioid before starting MAT medications. This time frame allows your body to eliminate opioids from the system and go into withdrawal before you start the medication. Your doctor can help you determine when it is right to start taking MAT medications so you can avoid precipitated withdrawal.

Understanding Medication-Assisted Treatment (MAT)

Medication-assisted treatment can help people overcome addiction and stop using substances safely. The primary goal of using MAT is to reduce the intensity and frequency of a person’s cravings and help them avoid relapses in the earliest stages of addiction recovery.

Medication-assisted treatment is most often used to treat people with opioid use disorder but it can also treat alcohol addiction and opioid overdose. Some of the most commonly-used medications for MAT include:


Commonly Used MAT (Medication-Assisted Treatment) Medications


  • Naltrexone
  • Methadone
  • Buprenorphine
  • Acamprosate
  • Naloxone

These medications can block some of the euphoric effects of drugs and alcohol, reduce cravings, prevent substance use, and reverse the effects of some drugs. Each has its purpose in medication-assisted treatment. Doctors and addiction specialists prescribe medications based on each person’s needs and goals during treatment.


Medication Assisted Treatment


Symptoms of Precipitated Withdrawal

Medication-assisted treatment can help people safely stop using substances and lead to life-saving recovery from addiction. However, it is not a perfect solution without risks. While MAT can be effective for many, some people develop precipitated withdrawal.

Precipitated withdrawal occurs when a person’s body is unable to adjust to the sudden absence of drugs or alcohol. Symptoms develop quickly and can include:


Symptoms of Precipitated Withdrawal


  • Insomnia
  • Sweating
  • Fever
  • Nausea and vomiting
  • Muscle aches
  • Dilated pupils
  • Cramping
  • High blood pressure
  • Heart palpitations
  • Diarrhea

Typically, precipitated withdrawal symptoms begin within just one or two hours of a person’s first dose of MAT medications. Unlike typical withdrawal, intense symptoms develop quickly. Symptoms of precipitated withdrawal may begin to fade within 6 to 24 hours.

Precipitated withdrawal should be treated as a medical emergency. If you suspect you are in precipitated withdrawal, please seek medical attention from a healthcare professional.

How Can a Detox Center Help With Precipitated Withdrawal?

A detox center provides the physical and emotional support people need to withdraw from drugs and alcohol safely. Those who develop precipitated withdrawal need the quick treatment and supervision that a detox center can provide.

Treatment for precipitated withdrawal includes:

  • Medications, including buprenorphine, to reduce symptoms
  • Increased doses of MAT drugs
  • A combination of naloxone and buprenorphine

The treatment team at a detox canter can also advise patients in practical ways to cope with the symptoms of precipitated withdrawals, including:

  • Drinking plenty of water to counteract the excessive sweating, vomiting, and diarrhea that is common
  • Reducing stress
  • Monitoring and treating symptoms as they occur, including using OTC medications to reduce muscle aches and diarrhea
  • Treating symptoms immediately instead of waiting for them to worsen over time

It’s important to note that you should only take buprenorphine and other MAT medications under careful supervision. The constant support of a detox center can help you manage withdrawal, even if you experience complications like precipitated withdrawal.

Find Help Now

If you or someone in your life needs support and treatment to safely stop using opioids or other drugs, reach out to the Arise Treatment Center team now to explore our Southern California detox programs. Don’t wait for another day to go by without getting the help you need. Start your recovery journey by calling us today.


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