Opiates are outranked only by alcohol as humanity's oldest and most persistent drug problem. Despite efforts of the legal and medical communities, more than one million people in the United States are opiate addicts. Advances in treatment and therapies are now offering a glimmer of hope to people. Opiate detox has come a long way.

Dozens of opiates and related drugs have been extracted from the seeds of the opium poppy or synthesized in laboratories. The poppy seed contains morphine and codeine, among other drugs. Synthetic derivatives include hydrocodone (Vicodin), oxycodone (Percodan, OxyContin), hydromorphone (Dilaudid) and heroin (diacetylmorphine). Some synthetic opiates or opioids with a different chemical structure but similar effects on the body and brain are propoxyphene (Darvon), meperidine (Demerol) and methadone. Physicians prescribe these drugs to treat and control pain.

Opiates enhance the effects of endorphins and enkephalins by acting at nerve receptors for these natural body chemicals. They suppress pain, reduce anxiety, and can produce euphoria at high doses. Most opiates are taken by mouth, smoked or snorted, although intravenous use delivers the quickest high.

An addiction to opiates consumes a person's life. Despite the risk of serious physical or psychological damage, addicts continue to use the drugs. Some cannot hold a job and turn to crime to pay for their habit. Heroin has long been the favorite drug of addicts because it is several times stronger than morphine and reaches the brain quickly when injected into a vein. Opiates do not have serious side effects, but can cause constipation and depress breathing. Addicts often ignore their health and the use of needles can result in infectious diseases, like HIV and hepatitis.

For some addicts, detoxification is the beginning of treatment. Detoxification is the controlled and medically supervised withdrawal from the drug. The symptoms of withdrawal can be agitation, anxiety, tremors, muscle aches, hot and cold flashes, nausea, vomiting and diarrhea. These withdrawal symptoms are not dangerous, rather they are extremely unpleasant and uncomfortable. The intensity of the reaction depends on the dose and speed of withdrawal. Short-acting opiates tend to produce more intense but briefer symptoms. The effect of a single dose of heroin last four to six hours and the reaction to withdrawal lasts for about a week. Withdrawal symptoms are an unfortunate part of opiate detox and should be expected.

No single approach to detoxification is guaranteed to work for all addicts. Many heroin addicts are switched to methadone, a synthetic opiate, which can be taken by mouth or injected. Then the dose is slowly reduced over about a week. Clonidine is a drug often used to shorten the withdrawal time and relive physical symptoms. The decision to undergo opiate detox should be made in conjunction with a physician.