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Opiate withdrawal in Tunisia: heroin, tramadol, codeine.
Opiate withdrawal is rarely fatal, but it is very hard to get through alone — and that is exactly why no one goes through it alone here. At Clinique Espoir, in Tunis, the withdrawal syndrome is treated, not endured: symptomatic treatment, or substitution treatment where it is indicated, with close follow-up. The protocol is decided after examination.
The signs of withdrawal
- Diffuse pain, cramps, shivering.
- Diarrhoea, watering eyes, yawning.
- Insomnia and dread.
- The doses keep rising, and attempts to stop alone have already failed, several times.
One of these signs alone is enough to justify a call, and the call commits you to nothing. If life is in danger — loss of consciousness, a seizure, suicidal talk — dial 190 (SAMU), then call us: we prepare for the arrival. To know what to do right now, three questions are enough to point the way.
The care at the clinic
Symptomatic treatment of withdrawal, or substitution treatment — methadone, buprenorphine — where it is indicated, with close follow-up. The withdrawal syndrome is treated, not endured. The stay follows the same path for everyone:
- Admission assessment: clinical examination, blood work-up, assessment of how severe the dependence is and screening for associated disorders — anxiety, depression, sleep, suicide risk.
- Medically supervised withdrawal: a protocol specific to the substance, vital signs checked several times a day, hydration, treatment of each withdrawal symptom.
- Stabilisation: sleep falls back into place, appetite returns, mood lifts or reveals what it was hiding.
- Work on craving, then the aftermath: motivational interviewing, cognitive behavioural therapy, a written plan for the tipping moments, and close follow-up consultations after discharge.
The detail is on the home page: the protocol, from the first day to the last, and the Opioids entry among the other substances treated.
How long?
The acute phase lasts 5 to 10 days; sleep and mood disturbances last longer and are followed during the stay, then after discharge.
These durations are indicative: they vary with how long use has gone on, the quantities, age and general health. The protocol is decided after examination.
For the family
You do not need the patient’s consent to ask for advice: a first call serves to describe the situation and gauge how urgent it is. Several substances at once is the most frequent case, and the one that must never be managed alone: the withdrawals add up and mask one another. Describe the situation over the phone; the order of priorities is a medical decision. If he refuses to hear about it, the page He refuses to come: what can you do? details what helps — and what closes the door.
Two questions people don’t dare ask
Can opiate withdrawal be done at home?
The withdrawal is rarely fatal, but very hard to get through alone: that is why attempts to stop without help so often fail. The decision is made after examination, never in advance and never alone — treatment of the withdrawal symptoms, or substitution where it is indicated, makes the crossing possible.
Will it stay confidential?
Medical confidentiality covers the entire stay. No information is passed to an employer, an administration or any third party without the patient’s written consent.
The information on this page is general and does not replace a medical consultation. No treatment, no stop and no dose change should ever be decided from this website.
Request an appointment for opiate withdrawal →
Before admission: preparing the stay, what to bring.
Other substances: alcohol · benzodiazepines · cannabis · cocaine and stimulants · pregabalin.