From the Guidelines
Yes, opiate withdrawal can cause fever. According to a study published in Pediatrics in 2014 1, physiologic changes commonly seen in withdrawal include fever, among other symptoms such as increased muscle tone, nausea, vomiting, diarrhea, decreased appetite, tachypnea, tachycardia, sweating, and hypertension.
Key Points to Consider
- Fever is a recognized symptom of opiate withdrawal, as noted in the study 1.
- It is essential to rule out other causes of fever, such as infection and sepsis, when managing opiate withdrawal symptoms.
- The use of validated scales like the Clinical Opiate Withdrawal Scale or the Sophia Observation Withdrawal Symptoms Scale can help clinicians detect early signs of withdrawal and implement appropriate treatment strategies 1.
Management of Fever in Opiate Withdrawal
- Staying hydrated with water and electrolyte solutions is crucial in managing fever and other symptoms associated with opiate withdrawal.
- Non-prescription fever reducers like acetaminophen (Tylenol) can be used at standard doses to help alleviate fever.
- Medical supervision is recommended, especially for long-term or heavy users, as medications like buprenorphine, methadone, or clonidine can help manage symptoms and increase comfort during the withdrawal process.
From the FDA Drug Label
They may exhibit some or all of the following symptoms associated with acute withdrawal from heroin or other opiates: ... fever, ...
- Opiate withdrawal can cause fever as one of the symptoms associated with acute withdrawal from heroin or other opiates 2.
From the Research
Opiate Withdrawal Symptoms
- Opiate withdrawal has been described as akin to a moderate to severe flu-like illness 3
- Symptoms of opiate withdrawal include sweating, hot flushes, palpitations, nausea, craving for opiates, lassitude, and depression 4
- Other symptoms that may occur during opiate withdrawal are agitation, irritability, muscular jerks, abdominal pain, diarrhea, burning sensations, "gooseflesh," and itching 5
Fever in Opiate Withdrawal
- While the studies do not directly mention fever as a symptom of opiate withdrawal, they describe the withdrawal syndrome as similar to a flu-like illness, which often includes fever 3
- The flu-like symptoms associated with opiate withdrawal may imply that fever can be a part of the withdrawal syndrome, although it is not explicitly stated in the studies
Treatment of Opiate Withdrawal
- Clonidine hydrochloride has been shown to rapidly suppress the signs and symptoms associated with opiate withdrawal, including those similar to flu-like illnesses 6, 7
- Other treatments, such as doxepin, may also alleviate symptoms of opiate withdrawal, but may have more adverse effects than clonidine 4