Opioids are a class of drugs, including prescription pain medicines like oxycodone, as well as illicit drugs, including black-market fentanyl and heroin.
Opioid Addiction Treatment
Opioid addiction is a massive problem in the U.S., and the opioid epidemic has led to more than 800,000 American deaths since the 1990s.
For anyone struggling with an addiction to opioids, treatment is available, but they have to be willing to seek it out. Treatments include medication-assisted treatment using Suboxone and other FDA-approved medicines, as well as behavioral therapy and participation in support groups.
Understanding Opioid Addiction
Addiction to any substance is complex. Addiction is a disease, and it affects someone’s brain and behavior, as well as their physical health.
When you first use opioids, it’s a choice. Then, because of how the drugs affect your brain and its reward system, eventually, your use becomes out of control and compulsive. Your entire focus might be on how you’re going to get more opioids and continue to use them because your brain has been hijacked.
These effects occur because opioids and other addictive substances flood your brain and body with artificially high levels of feel-good chemicals, triggering that reward response.
There’s also an element of dependence that often occurs with opioid addiction.
Dependence means that if you suddenly stop using the substance you’re addicted to, your brain and body will struggle to return to a sense of balance without it. You may experience symptoms of withdrawal like flu-like symptoms and extreme cravings.
Medically Supervised Detox
The first step for many people who are dealing with opioid addiction, also known as an opioid use disorder, is a medically supervised detox. During this time, you receive medical support, including medications, to help reduce drug cravings and withdrawal symptoms.
This is one of the most essential parts of treatment because without detoxing from substances completely, you can’t then begin the rest of your treatment program.
Medications used to help treat an opioid use disorder include:
- Buprenorphine: This medication acts in the brain like an opioid but reduces cravings for the problematic drug to reduce or alleviate withdrawal symptoms. Buprenorphine, when combined with naloxone, can prevent possible misuse. Someone should wait until they’re experiencing mild or moderate opioid withdrawal to begin medication with buprenorphine in it.
- Methadone: This is like an opioid in the brain that helps someone feel normal but not high, and withdrawal doesn’t occur. Methadone can be started at the beginning of withdrawal.
- Naltrexone: This medication blocks opioid effects on the brain, so you can’t get high on them while you’re on naltrexone. It can reduce the risk of relapse, but it doesn’t eliminate cravings.
These are generic drugs, and they’re available in brand-name versions, such as Suboxone, which is a combination of buprenorphine and naloxone.
Sometimes there’s a fear that medication-assisted treatment is replacing one addiction with another, but that’s not the reality. These medications are specifically approved for the treatment of opioid use disorders, and the person receiving them is carefully supervised. Medications can be life-saving for people with opioid use disorder.
Medications also improve many other outcomes related to addiction.
Rehab and Behavioral Therapy
After someone has fully and safely detoxed, they can begin the next stage of their addiction treatment program, which can look different for everyone. No two people are the same, so their treatment plan has to reflect their individual needs.
Addiction treatment programs can occur on an inpatient, residential basis, or on outpatient basis.
Some people go through a continuum of care, so they start with a high level of inpatient treatment, and as they’re ready, they move into lower treatment levels that provide them with more accountability for their recovery.
Cognitive-behavioral therapy, or CBT, is most often used for treating opioid addiction.
CBT is a form of psychotherapy that helps with the treatment of not only substance use disorders but also mood disorders like depression, anxiety disorders, and a range of other disorders. Psychotherapy is also known as talk therapy.
When someone participates in a CBT program, they learn how to change the negative thought patterns that lead them to engage in problematic behaviors. They also learn how to include healthy coping skills in their lives.
Specific goals of CBT for substance abuse can include bringing awareness and correcting maladaptive patterns of behavior, and putting coping skills that are healthy into use while avoiding triggers.
When someone receives treatment for an addiction, co-occurring disorders have to be addressed too.
Co-occurring disorders might include another mental health disorder, like depression or bipolar. If that co-occurring disorder isn’t treated and managed, a person is at a higher risk of relapsing.
Addiction recovery is something that’s a lifelong commitment. A person who’s in recovery from opioid addiction has to continue to work on it, and this can start with an aftercare plan if they attend a formalized rehab program.
An aftercare plan for opioid addiction might include referrals for local counselors and resources in a person’s community.
It also often includes participation in a support group like a 12-step program and continuation of medication-assisted treatment as needed.
Even after someone completes an addiction treatment program, there’s always a risk of relapse because addiction is considered a chronic disease. With any chronic disease, relapse can occur if a change is needed in the treatment plan.
For example, if someone has type 2 diabetes and it’s well-controlled initially with medication, but then the patient stops using it as directed, or the medication no longer works, then they might relapse. The same can happen with a substance use disorder.
A relapse doesn’t mean someone’s failed. It means that their treatment plan and program need to be revisited, and perhaps tweaks need to be made to reflect their current needs.
Finally, an important part of any addiction treatment program is also social support, whether that’s from friends, family, or other people in recovery. This is what helps a person as they’re navigating their new life without opioids and provides them with a sense of outside accountability.