The Master Guide to Understanding Opioid Addiction
Drug overdoses are now the leading cause of death for Americans under 50 years old. And the lion's share of these deaths is due to opioid addiction and abuse.
In 2015 alone more than 33 thousand people lost their lives due to an opioid overdose according to the National Institute on Drug Abuse (NIDA).Get Help Today
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And as the CDC recently reported, the problem isn't getting any better. Emergency visits involving the drugs jumped by a whopping 30% across the entire country in 2016 and continue to rise even still.
Although these powerful pain relievers do have a place in legitimate medicine today, prescription opioids are notorious for being highly addictive, especially prone to abuse, and particularly dangerous when misused.
Plus, becoming addicted to these drugs can often lead to abusing deadly illicit opioids like heroin.
If you or someone you know is struggling with an addiction to opioids, the very first step is understanding the problem. The more you know about this devastating disease, the better equipped you'll be to overcome it.
And that's what this guide is for. It covers everything from what opioids are and how an addiction begins all the way to overdoses, withdrawals, and what it takes to kick this substance use disorder for good.
Overcoming opioid addiction is possible. And when you know the ins and outs of this deadly disorder, it's more attainable than ever.
What Are Opioids?
Opioids belong to a class of drugs known as analgesics - a fancy word for pain relievers.
Doctors will typically prescribe these drugs for moderate to severe pain that's either chronic (constant) or acute (brief but severe). Some of the most common prescription opioids are OxyContin, Codeine, Fentanyl, and Vicodin (these four drugs are also the most commonly abused prescription drugs today).
Patients who are in pain due to cancer, back problems, surgery, or other types of injuries might go on opioids to help them live more of a regular life. And when used properly, these medications can be an absolute life-saver for some.
But opioids are also classified as narcotics. That means that these drugs tend to not only blunt the senses but can also produce an elated mood and feelings of bliss at high dosages. At even greater dosages they can produce stupor, coma, and even death.
And equally importantly, opioids are also highly addictive due to the rapid onset of tolerance, the intensely pleasurable high, and the brutal withdrawals that prevent those in its grasp from being able to quit.
Opioids also encompass illicit drugs like heroin and opium.
The opioid epidemic, which is reported to kill around 116 Americans every single day, is fueled by both prescription and illicit opioids.
The body naturally produces chemicals that are similar to these opioids. These chemicals are called endorphins, and they're meant to help regulate pain. Without endorphins, we wouldn't be able to keep our cool or find help in times of extreme physical stress.
Endorphins are also responsible in part for experiencing pleasure. A runner's high, the pleasure involved in eating particularly spicy food, UV light, and even childbirth have all been associated with the release of endorphins according to How Stuff Works.
Certain cells in your brain, spinal cord, and gastrointestinal tract have specialized structures known as opioid receptors. These receptors are designed to match up with the naturally occurring endorphins to block pain and produce pleasure.
Opioids fit into these same receptors and activate them without the help of endorphins. They essentially hijack your body's natural system and produce effects like pain relief and pleasure on-demand.
Unlike natural endorphins, however, opioids can cause a host of negative side effects. Dangerous levels of respiratory depression, constipation, nausea, vomiting, and tolerance can all come about from using these drugs.
Opioids vs. Opiates: What's The Difference?
You may have heard people use these two terms interchangeably in the past. However, there's a distinct difference between the two.
While both of these kinds of drugs do have narcotic pain-relieving effects, opiates are naturally derived from the opium poppy. The sap of this plant organically contains these psychoactive chemicals and can actually be gathered right from the poppy itself.
The four types of naturally occurring opiates are:
- Morphine (Arymo ER, Kadian, MorphaBond ER, MS Contin)
- Codeine (Pyregesic-C, Tylenol w/Codeine, Brontex, Phenergan, Vanacof)
Opioids, on the other hand, are either synthetic (entirely man-made) or semi-synthetic (part man-made and part organic from the poppy).
Some of the most popular synthetic opioids are:
- Fentanyl (Abstral, Actiq, Duragesic, Fentora)
- Tramadol (ConZip, Ultram)
- Methadone (Dolophine, Methadose, Diskets)
- Meperidine (Demerol HCl)
The most common semi-synthetic opioids include:
As the epidemic has continued to escalate and get more attention from the media and government agencies though, the term “opioid” is now generally used to refer to all natural, semi-synthetic, and synthetic opioids.
For the purposes of this guide and to maintain clarity throughout, the term opioid will be used this way to refer to both opioids and opiates.
The short answer here is that they certainly can be.
One of the most alluring aspects of abusing prescription opioids is the fact that these pills are actually legal, as opposed to street opioids like heroin - a Schedule I narcotic according to the DEA.
And in the mind of many people, if a drug is legal, it's got to be safer to use and abuse than street drugs.
This notion, however, is not necessarily true.
When used properly and according to a legitimate prescription, clinical opioids can be quite safe and incredibly helpful. But when abused, they can actually become just as deadly as street drugs like heroin. And in some cases, they can even be more dangerous.
Fentanyl, for instance, is a synthetic prescription opioid that's anywhere from 50 to 100 times more powerful than morphine. Heroin, for comparison, is only about 2 to 5 times as strong as morphine.
In fact, when you look at the hard numbers, prescription opioids like fentanyl and drugs like Vicodin regularly kill more people than heroin.
In 2016 alone, more than 17 thousand people lost their lives due to a prescription opioid overdose. Compare that to about 15.5 overdose deaths caused by heroin. It seems, then, that just because a drug is legal doesn't mean it's safe.
And to make things even more complicated, prescription drug abuse regularly leads to using illicit street drugs like heroin. Around 80% of heroin addicts say that their drug habits started with abusing prescription opioids. And 94% said they made the switch because this deadly street drug was both cheaper and easier to get their hands on.
Even now as opioid prescriptions are dropping, death rates still continue to rise. And that's because so many addicts are dropping their prescription drug addiction and turning instead to heroin.
The Opioid Epidemic: How Bad Is It?
You've more than likely heard about the health epidemic raging across the country today. More people are dying from drug overdoses than automobile accidents, guns, and even certain types of cancers. And at the heart of it all is the dramatic rise in opioid-related deaths.
But how bad has the problem gotten, really? Let's take a look at some stats to help put this deadly trend into perspective.
In 2016 alone:
- Over 42 thousand people died from an opioid overdose.
- 2.1 million Americans were considered to be addicted to opioids.
- 11.5 million people misused prescription opioids.
- The opioid epidemic caused an economic burden of $504 billion in the United States
- Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
- Between 8 and 12 percent develop an opioid use disorder.
- An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
- Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states.
- The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017.
- Opioid overdoses in large cities increased by 54 percent in 16 states.
And within Colorado itself, opioid abuse has become a serious problem - especially when it comes to prescription drugs.
In fall of 2017, the President declared the opioid epidemic to be a National Public Health Emergency under federal law. This declaration has opened up the door to new waves of funding for agencies designed to combat the problem as well as reduce certain restrictions.
However, experts tend to agree that this is only a small first step towards truly dealing with the problem and much more needs to be done.
Over the past several decades, a lot has changed in how opioids are prescribed and how addiction is being treated. For example:
- Prescribing guidelines have become much tighter.
- Addiction medications for treating opioid dependency have become more advanced.
- Overdose treatments have become cheaper and more accessible.
- The approach to treating the opioid epidemic has taken on a harm reduction philosophy rather than an abstinence-based approach.
Since the start of the epidemic, numerous public figures have lost their lives due to the raging opioid epidemic. Here are just a few:
- Heath Ledger
- Phillip Seymour Hoffman
- Tom Petty
- Carrie Fisher
- Chris Penn
And while the death of a celebrity can be shocking, the opioid epidemic has affected the lives of so many more.
To hear just some of these stories and how this devastating addiction has impacted individuals firsthand, take a look at the White House's The Crisis Next Door. This site includes a number of personal stories from Americans whose lives have changed forever because of the opioid epidemic.
Below is just one of these heart-breaking stories from Lauri, a Wisconsin mother of two.
According to NIDA, addiction is defined as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”
Addiction isn't so much about being physically dependent, then. It's more about the behaviors associated with your drug use - like whether or not they're compulsive, persistent, and most importantly, destructive.
Contrary to popular belief, anyone can become addicted to opioids. It isn't just people living on the streets or individuals who come from a life of crime and substance abuse. Homemakers, high-school athletes, business professionals, doctors, laborers, anyone is at risk - especially those who suffer from chronic pain.
Addiction does not discriminate.
And no matter how you become addicted, at the start of it all lies a single instance of opioid abuse.
How Are Opioids Abused?
Nearly all forms of addiction start with abuse. Misusing these substances, even once, can send you into a tailspin that can quickly turn into a serious substance use disorder.
But what is “abuse” really - especially when it comes to legal prescription drugs?
Since opioids come in both legal (prescription medications) and illegal forms (street drugs), what constitutes abuse depends on the type of drug.
For street drugs, abuse is simple: using them at all is considered to be abuse. Whether you snort it, shoot it, or smoke it and even if you only do it once, you're still abusing it simply because it's illegal.
Prescription opioids, on the other hand, are a bit trickier. Abusing these drugs can take a variety of forms. Essentially, using these drugs in any way they weren't meant to be used constitutes abuse.
This may include:
- Double dosing
- Taking the drugs at the wrong time of day
- Taking them with other substances like alcohol or benzodiazepines
- Administering them in an improper way (i.e., crushing, snorting, injecting, etc. when they're meant to be swallowed)
- Sharing them with others
- Using other people's prescriptions (even if you have the same condition)
- Selling, buying, or stealing prescription opioids.
It's worth remembering, though, that just because you're abusing a prescription opioid doesn't mean you're at less of a risk of becoming addicted as someone abusing an illicit one.
Both forms of abuse can and regularly do lead to addiction in tens of thousands of people a year.
With opioids (and with almost any other addictive drug), continued abuse of these drugs creates a shift in the natural functioning of the brain. And a lot of that change has to do with a particular chemical known as dopamine.
Dopamine is widely regarded as the “pleasure” chemical. When you eat a delicious meal, complete a goal, or even have sex, the enjoyment you get out of that activity is largely because of the release of dopamine.
And this chemical is connected to how we learn too. The more dopamine a certain activity releases, the more we are driven to engage in it.
The problem is that this system of reward and learning is hijacked by addictive substances like opioids. Rather than performing certain activities and getting a natural rush of this pleasure chemical, drugs like heroin and OxyContin trigger this release artificially and on-demand.
Added to that, the levels of dopamine released are also much higher than normal too. In fact, some drugs have been known to release as much as 10 times the amount of dopamine as more natural activities.
Over time, the brain gets so dependent on getting a dopamine rush from the drug that it stops being able to produce it on its own. As a result, using and abusing opioids eventually becomes the only way to feel any sort of pleasure - and indeed the only way to feel “normal” at all.
The brain also goes through physical changes over the course of an addiction. As NIDA reports:
Brain-imaging studies from people addicted to drugs show physical changes in areas of the brain that are critical for judgment, decisionmaking, learning, memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of an addicted person.
As you can see, then, addiction isn't just a matter of willpower; it's an actual physical disease.
Is Dependence The Same As Addiction?
One of the most common misconceptions when it comes to opioids and addiction, in general, is that physical dependence is the same as addiction.
This is not true.
These two terms describe two distinct conditions. Sometimes they overlap, true, but they aren't one and the same.
Physical dependence, for example, happens when the body gets so used to opioids being in the system that it actually can't function normally without it. This is accompanied by a growing tolerance - the need for a higher and higher dosage in order to achieve the same effect.
As a result of increasing tolerance, people dependent on opioids will also suffer from uncomfortable physical and mental symptoms when reducing their dosage. These symptoms are called withdrawals.
The presence of these two characteristics, tolerance and withdrawal, are the hallmarks of physical dependence.
However, just because someone is physically dependent on opioids doesn't mean they are addicted. Physicians increase patient dosages all the time because of tolerance. And just because some people may feel sick after weaning off of these drugs doesn't mean their behaviors were compulsive, persistent, and destructive.
An addiction of any kind can make life as a whole significantly harder. Just some of the possible consequences of an addiction include:
- Alienating and destroying the trust of friends and family
- No longer getting enjoyment out of old hobbies or activities you used to enjoy
- Running into financial problems because of your addiction
- Having problems with the law which can have permanent consequences (including jail time)
- Being unable to perform at your job or at school work
When it comes to opioids specifically, there are a number of other long-term consequences (both physical and psychological) that may come about as a result of this type of addiction too.
- Physical Effects
- Chronic constipation
- Weakened immune system
- Liver and kidney damage (due to both opioid toxicity and fillers)
- Skin abscesses and infected injection sites
- A greater sensitivity to pain (called hyperalgesia)
- A much higher risk of contracting blood-borne diseases like HIV, Hepatitis, and Tuberculosis)
- Psychological Effects
- Impotence and lowered libido
- Mood disorders like anxiety or depression
- Deterioration of the brain's white matter (due to decreased respiration)
- Inhibited decision-making abilities
- An inability to regulate behavior
- A decreased ability to handle stressful situations
As you can see, opioid addiction isn't just about becoming a slave to your drug habit. Instead, the detrimental effects of a substance use disorder leech into nearly every facet of your life. And ultimately, they change who you are today and who you'll become for the rest of your life.
Overdosing on Opioids
Undoubtedly one of the most terrifying outcomes of opioid abuse and addiction is the risk of an overdose.
While the high from drugs like heroin and OxyContin can be pleasantly sedating, this characteristic in particular can end up costing you your life.
That's because opioids have a three-pronged effect on your body's ability to breathe according to Scientific American's interview with Bertha Madras, a professor of psychobiology at McLean Hospital and Harvard Medical School.
First, these drugs inhibit signals sent to the diaphragm, an organ that pushes air out of the lungs and lets you take in more oxygen. Second, they interfere with a person's ability to detect the buildup of carbon dioxide (a waste product of respiration). And finally, they actually suppress activity in the brain that directly controls your breathing rate.
In the end, it impacts every system in your brain and body that prevents you from suffocating. It isn't any wonder, then, why opioid overdoses are so incredibly deadly. And in order to ensure the best chances of recovery from an overdose, it's vital that you're able to first recognize the signs.
The first step in getting life-saving help during an overdose is spotting the symptoms.
And while you may think that surely you can tell when someone is in trouble after taking too many opioids, the fact remains that every second counts.
In many cases, overdose victims aren't getting essential oxygen to their brain. In as little as one minute without oxygen, brain cells begin dying off. And every second without air after that increases the risk of permanent damage, coma, and death.
Being able to spot the signs immediately, then, can end up being a literal lifesaver. According to MedlinePlus, here's what to watch for:
- Airways & Lungs
- No breathing
- Shallow breathing
- Slow and difficult breathing
- Eyes, Ears, Nose, & Throat
- Dry mouth
- Extremely small pupils, sometimes as small as the head of a pin (pinpoint pupils)
- Discolored tongue
- Heart & Blood
- Low blood pressure
- Weak pulse
- Extremely pale face
- Feels clammy to the touch
- Bluish-colored nails and lips
- Stomach & Intestines
- Vomiting or gurgling noises
- Spasms of the stomach and intestines
- Nervous System
- Inability to speak
- Uncontrolled muscle movements
The first and possibly most important thing to remember in the case of an overdose is that time is of the essence here. Don't wait; don't hesitate; don't delay. Every second without emergency medical help is a second closer to permanent and life-threatening damage.
So, if you suspect someone is overdosing on opioids, contact medical help immediately.
There are two ways to do so. The first is obviously to call 9-1-1. Operators will likely send an ambulance equipped with life-saving tools/medicines and will transport the victim to the nearest hospital.
Do not attempt to drive the victim yourself unless told to do so by an operator. Oftentimes waiting for an ambulance will have a better outcome than trying to make it to an emergency room on your own.
The second option is calling the national Poison Help hotline at 1-800-222-1222. The difference with this hotline is that it does not have to be an emergency when you call. Operators here are available 24/7 too.
In the end, the absolute best thing you can do in the case of an overdose is to get in touch with a medical professional as soon as you can. Remember: every second counts!
Polydrug Abuse & How It Impacts Toxicity
While taking large doses of opioids by themselves is certainly dangerous on its own, when you mix these drugs with other substances, the outcome becomes even more fatal.
And even though it sounds like a disaster waiting to happen, many people combine opioids with a variety of other substances in order to create a more powerful high. The sedative effects may become less pronounced, the anxiety and pain relief might be more potent, and the euphoria can turn into an even more pleasurable state.
But the benefits of doing so certainly do not outweigh the risks - namely an increased chance of overdose.
This risk is especially high when opioids are combined with other depressants like alcohol, barbiturates, or certain anti-anxiety meds. When you mix these types of drugs together, the respiratory depression effects tend to overlap, making it even easier lose consciousness and, essentially, stop breathing altogether.
Benzodiazepines in particular are a huge threat today. NIDA reports that more than 30% of opioid overdoses also involve benzos like Xanax and Ativan. Plus, studies have found that the overdose death rate among opioid patients receiving benzos was a whopping 10 times higher than for people taking prescription painkillers along.
And given that these drugs are already quite dangerous on their own, developing another addiction on top of opioids is incredibly dangerous.
As such, if you suspect someone is abusing both opioids and benzos (or any other drug for that matter), it's important that you help them understand the risks before it's too late.
How Long Do Opioids Stay In Your System?
Maybe you're wondering whether or not you can pass a drug test after getting clean. Or perhaps you're finally fed up with the constant struggle with addiction and want to know how long it takes to start going through withdrawals. No matter what your reasoning, knowing how long it takes to fully flush all traces of opioids out of your system is valuable info.
But even so, it's important to remember that there aren't any hard and fast rules for how long it takes to rid a body of a drug. And that's because (cliché as it is) every body is different. Genetics, metabolism, body type, addiction history, addiction duration, and countless other factors all have an influence on how long your body retains a drug.
So judging how long until you're totally clean is a bit of a toss-up. That being said, there are some general estimates of the amount of time certain opioids stay in the body. These are listed below along with how long various the tests can detect them. The half-life of each drug (how long it takes for half of the molecules to be broken down by the body) are also listed.
Oxycodone (Half-life of around 3 hours)
- Urine: Detectable up to 3 to 4 days.
- Blood: Detectable up to 24 hours.
- Saliva: Detectable up to 1 to 4 days.
- Hair: Detectable up to 90 days.
Heroin (Half-life of 2 to 6 minutes)
- Urine: Detectable up to 1 to 4 days.
- Blood: Detectable up to 3 minutes.
- Saliva: Detectable up to 12 hours.
- Hair: Detectable up to 90 days.
Morphine (Half-life of 1.5 to 7 hours)
- Urine: Detectable up to 72 hours.
- Blood: Detectable up to 6 to 12 hours.
- Hair: Detectable up to 90 days.
Hydromorphone (Half-life of 4 hours)
- Urine: Detectable up to up to 72 hours.
- Blood: Detectable up to 24 hours.
- Saliva: Detectable up to 48 hours.
- Hair: Detectable up to 90 days.
What Is Withdrawal & What Does It Look Like?
Withdrawal - it's easily one of the most frightening words for anybody that's actually been through it. For most opioid addicts, it conjures up memories of grueling muscle aches, near constant disorientation and anxiety, knee-buckling nausea, and unpredictable hot flashes.
It's been described as having the worst flu you can possibly imagine - but ten times worse.
As painful as it might be, withdrawal is a necessary step in tackling any addiction. And it's one of the first.
Over the course of addiction, the body has built up a massive amount of tolerance to opioids. And that tolerance is caused by a number of physical changes that happen throughout the body. Certain chemicals become stronger, special cells grow or die off, and in the end, an addicted body is far different on a physical level than a non-addicted one.
But when you stop using a drug suddenly, the body struggles to revert back to its former self. And that re-adjustment period is what causes the uncomfortable state of withdrawal.
And with the right help from a professional detox service, it doesn't have to be nearly as painful as going it alone.
Detoxification is the body's way of clearing itself of all the chemicals and toxins that have built up over the course of an addiction. These chemicals include, of course, the drugs themselves but the process also encompasses more than that.
The main struggle of detoxification is getting through the symptoms of withdrawal without turning back to using again. And with opioids, that can be especially tough. Some studies have even found that the relapse rate with opioids like heroin can end up being as high as 91% (59% of which occur within the first week).
And when you take a look at the numerous and painful withdrawals associated with these drugs, it isn't hard to imagine why many are so quick to turn back to drug abuse for relief.
According to Mental Health Daily, some of the most common opioid withdrawals include:
Physical Withdrawal Symptoms
- Body aches
- Dilated pupils
- Flu-like symptoms
- Runny nose
- Crying spells
- Mood swings
- Sleep changes
- Suicidal thoughts
In most cases, the body will fully break down most opioids within 7 to 10 days. For especially long-acting opioids like methadone, detox can actually end up lasting for weeks at a time. However, most other drugs in this category will usually take between one and two weeks before patients start more normal.
In general, the opioid withdrawal timeline can be broken down into three stages: acute, protracted, and PAWS.
- Acute - The first stage of opioid withdrawal usually begins within the first few hours for short-acting drugs (like heroin) and within the first 30 hours for longer-acting ones (like methadone). Once symptoms begin, they'll usually persist and become increasingly intense for the next 72 hours (can be around 10 days for methadone).
According to MedlinePlus, symptoms during this stage may include:
- Muscle aches
- Increased tearing
- Runny nose
- Protracted - Once symptoms peak at around 3 days in for most opioids, the intensity of your symptoms will slowly begin to decrease. This marks the beginning of the protracted phase which can last anywhere from 4 to 7 days. You may also notice new symptoms appearing including:
- Abdominal cramping
- Dilated pupils
- PAWS - Finally, you may also experience Post-Acute Withdrawal Syndrome, also known as PAWS. This stage of withdrawal usually consists mostly of psychological symptoms that can end up lasting for weeks, months, or even years at a time. Not much is known about PAWS and why some people get it while others don't, but studies have shown that expert assistance and aftercare can help make this condition more manageable.
Some symptoms you may experience during PAWS could include:
- Pessimistic Thoughts
- Psychosocial Dysfunction
- Obsessive- Compulsive behavior
- Impaired Interpersonal Skills
- Feelings of Guilt
- Autonomic Disturbances
- Impaired Concentration
- Lack of Initiative
- Inability to Think Clearly
- Emotional Overreactions or Numbness
- Memory Problems
- Sleep Disturbances
- Stress Sensitivity
- Physical Coordination Problems
- Increased Sensitivity to Pain
- Panic Disorder
- Sleep Disorder
- Generalized Anxiety Disorder
What Are The Different Ways of Detoxing?
There are three main ways of going through detox: home, medicated, and holistic.
Home - The cheapest and most convenient way of detoxing is by doing it at home on your own. Some people purchase different detoxification kits that supposedly help flush the system of the drug quicker. Others opt for a more herbal approach and supplement their diet with various home remedies and unproven techniques.
But no matter what at-home detox approach you take, they all have one thing in common: they're much less effective and far more dangerous than using a professional program. Though the withdrawals from opioids aren't necessarily fatal on their own, the complications that can result (dehydration, malnutrition, cardiac events, self-harm, etc.) can end up putting your life in jeopardy without proper help.
It should go without saying, then, that at-home detox is strongly discouraged.
This is one approach to professional detoxification. These types of programs follow a protocol that is heavily reliant on using medications to treat some of the nastiest withdrawals opioids have to offer.
While the convenience of treating everything with a pill is hard to argue against, there are a couple of things that make a purely medicated approach something worth reconsidering. First of all, many of these medications are actually quite addictive on their own. Suboxone, one of the most widely used medications for treating opioid withdrawal, has actually become a substance of abuse itself. And weaning off of it is no picnic either.
Added to that, these medications often come with a host of their own side effects too. And when you combine those with the symptoms of withdrawal you're already being bruised and battered by, it can be a bit overwhelming to say the least.
A holistic professional detox program takes a different approach to getting clean. While many of these programs do end up using medications throughout detoxification, the main focus of a holistic program is to support the body while it naturally flushes the dangerous toxins out of the system.
Many times these programs incorporate nutrition-rich meal plans and exercise regimens to help keep your body in optimal condition. This can make detox less painful, quicker, and ultimately more successful in the end.
Plus, one of the best parts of a holistic program is the fact that you don't have to deal with any lingering addiction to medications or any nasty side effects. It's a more natural approach that many consider to be superior to medicated opioid detox.
Getting Professional Help At A Rehab Facility
While detoxification is a necessary step of getting clean, it certainly isn't the only step you'll need to take. Once you've fully cleansed the body of opioids, you'll then need to go through rehabilitation.
There are primarily three different types of opioid rehabilitation programs to choose from: inpatient, outpatient, and intensive outpatient.
An inpatient program usually last for at least 30 days and requires all patients to actually live on the program campus. This helps control the patients' access to drugs (thereby reducing the risk of relapse). And added to that, it also can help them focus entirely on their recovery without the added pressure of their normal daily obligations or environments.
Inpatient is considered to be the most effective approach to rehab.
Contrary to inpatient, an outpatient program let's recovering addicts come to meetings and treatment sessions several times a week while carrying out their normal lives. Patients sleep at home and can maintain a job while attending sessions that are just a few hours long during some evenings. Programs usually last for several months.
It's a more flexible approach for patients who don't need the same level of care as more serious addicts.
An IOP offers the flexibility of outpatient programs with the intensity of inpatient ones. People in IOPs are able to eat, sleep, and work like normal but attend meetings in the evenings, just like outpatient programs. However, these meetings are usually longer and happen much more frequently throughout the week. They also last for several months, like outpatient programs.
Unfortunately, an alarming number of people falsely believe that detox alone is all you need to recover from an opioid addiction. This belief is not only wrong, but it's also quite dangerous. The truth of the matter is that while detoxification helps cleanse the body of a substance use disorder, rehabilitation helps cleanse the mind.
And after all, the majority of the characteristics that make up an addiction occur because of compulsive drug-seeking behaviors, not because you're physically addicted.
In fact, rehabilitation is so important that NIDA points out medical detox “is only the first stage of addiction treatment and by itself does little to change long-term drug use.” When it's combined with rehab, however, the chances of recovery are far higher.
One of the most notable benefits of partnering with a rehabilitation program is the fact that these programs can offer medical help that can actually end up saving your life during recovery.
The process of detoxification can be complicated. Patients who have been struggling with addiction often aren't in the best health once they finally decide to get professional help. Their immune system may be compromised, they may be malnourished, and in general, their body may not be able to handle recovery on its own without help.
This can lead to a heightened risk of experiencing life-threatening complications. Malnutrition, dehydration, abnormal heartbeat, and more can all be quite common during this stage of recovery. And if you don't have a medical professional by your side, that can lead to a serious threat to your safety.
But the life-saving power of a rehab center isn't just confined to preventing complications. Rehabilitation provides treatments and strategies that make relapse far less likely. And when it comes to opioid addiction, relapsing can and often does lead to life-threatening overdose.
To explain, opioids are notorious for building up tolerance incredibly quickly - sometimes within hours of first using. But tolerance with this type of drug also drops much quicker than most people might expect.
That means that if an opioid addict remains clean for a week but then relapses using the same dosage that got him high before, it might be far too much for their body to handle. And as a result, they may end up suffering from an accidental overdose.
That's why it's so incredibly important that you use only the programs that are most likely to lead to a full recovery. And that means checking into rehab.
How Does A Quality Rehab Program Reduce the Likelihood of Relapse?
Outline ways rehab helps: 1-on-1 counseling, group talk, behavioral therapy, other treatments (mention neurofeedback)
- 1-on-1 Counseling - Speaking with a counselor and getting to the root of your addiction is a critical part of recovery. It could be a past trauma that led you to abuse drugs, a co-occurring mental disorder, or an infinite number of other causes. But before you can stay sober for the long-run, you simply must learn how to cope with this core problem in healthier ways. And 1-on-1 counseling will help.
- Group Talk - What most people think of when they imagine rehab, group talk is an essential part of any recovery program. Not only will these meetings help build up a social support network (which can be immensely helpful during recovery), they'll also put your own problems with addiction into perspective.
- Behavioral Therapy - Behavioral therapies like Cognitive-Behavioral Therapy are evidence-based techniques for helping you overcome cravings, avoid triggers, and maintain sobriety when you're out in the real world after rehab. The techniques you'll learn from these therapies will help you regain self-control and take your life back from opioid addiction.
- Other Treatments - There are a variety of other treatments and therapies you'll go through over the course of your rehab program. These may include yoga sessions, meditation classes, art therapies - it really does just depend on the individual program.
One exciting new treatment is called Neurofeedback Therapy. This cutting-edge treatment resembles a highly sophisticated video game. An EEG program will monitor your brain signals while you observe certain images and direct your brainwaves to the desired type of activity. Essentially, you'll train your brain to start thinking in more productive (and less addictive) ways.
Which Medications Are Used for Opioid Withdrawal?
Detox and rehab programs will use a number of different medications to help patients get through the worst of their opioid withdrawals and maintain sobriety.
Below are just some of the most popular ones used today.
- Anti-inflammatory pain relievers (for muscle aches)
- Anti-nausea medications
- Antidiarrheal medications
- Sleep aids like melatonin or valerian root
- Anti-anxiety medications like benzodiazepines
- Gabapentin (Neurontin) for reducing the intensity of withdrawals
In addition to these drugs, there are also two other types of medications in particular that have had the best results when it comes to treating opioid addiction: Opioid Replacement Therapies and Naltrexone.
Opioid Replacement Therapies, also known as ORTs, are some of the most effective medications in use today for cutting down on the intensity of opioid withdrawals.
The only two FDA approved ORTs are buprenorphine and methadone.
When taken properly, these medications can essentially eliminate the incredibly painful withdrawals associated with opioid detox. Plus, these medications can even block the effects of opioids if a patient so happens to relapse while on them. And that can make it all the more likely that they'll continue their recovery.
So, what's the secret behind these apparent wonder drugs? They're actually opioids themselves.
Methadone, the oldest treatment of the two, is a full opioid agonist. That means that it fully stimulates the opioid receptors in the body, though to a much lesser degree and over a longer time period than other opioids.
Buprenorphine (marketed as Suboxone and Subutex) is the newest addition to the ORT family and has in some ways replaced the use of methadone. Rather than being a full-agonist like methadone, buprenorphine is only a partial agonist. And that means it stimulates these cells to an even lesser degree.
What's the benefit of that? There's less potential for abuse. And that can mean quite a lot when dealing with people whose every cell is screaming at them to start using again at any chance they get.
Suboxone and methadone are undoubtedly some of the most promising ways to get opioid addicts through treatment and help them stay clean for the long-run. But as much hope as they might bring to the addiction community, there are still some major setbacks to these drugs. And the biggest by far is the risk of abuse and addiction.
As opioids themselves, both of these drugs stimulate the body and brain's opioid receptors to some degree. It's often far less than their other opioid counterparts like heroin and oxycodone, but even still, these cells are still being activated.
And over time, that can make it incredibly hard to wean off of these drugs completely.
Beyond that, these drugs can also be used in conjunction with other opioids in order to maintain their addictive habits. For instance, someone may use Suboxone during the week to push off withdrawal symptoms so they can maintain a job and have some semblance of a normal life. But when the weekend arrives, they can ditch the drug in favor of something harder like heroin.
If ORTs are necessary for overcoming an addiction, many addiction experts advise against long-term use, also called a "maintenance plan." Instead, recovering addicts should use them to get through the worst of the withdrawals and then quickly taper them off of these drugs to prevent dependence problems.
While buprenorphine and methadone are both considered to be at the forefront of the fight against opioid addiction, there's a new player that's quickly gaining traction - and it's called naltrexone.
Naltrexone is an especially unique opioid addiction treatment because rather than being an opioid agonist that stimulates the special receptors in your body, this drug actually blocks them off (i.e., is an antagonist).
This creates several effects. First, it essentially makes it impossible to feel the euphoric and sedative effects of opioids if you end up relapsing (since the receptors are blocked off completely). And when you take away these pleasurable aspects of getting high, there really isn't much of a reason to start using again.
Secondly, it can also be quite helpful in eliminating the intense cravings associated with opioid addiction and making environmental triggers far less powerful. Studies have even found that naltrexone can even be just as effective as Suboxone.
And best of all, naltrexone has no potential for abuse. Since it is only blocking opioid receptors without stimulating them, there is no high associated with this drug. And thus, it is not habit forming - an enormous benefit over ORTs like methadone and buprenorphine.
Plus, naltrexone is also easily administered through a brand called Vivitrol. Vivitrol comes in the form of an easy-to-use once-a-month shot. No having to remember to take your pills every day or trying to get on a specific schedule. Just one dose a month and you should notice a significant decrease in the intensity of your cravings. It's that easy.
With its ease of use and low risk of abuse, Naltrexone is undoubtedly an incredibly powerful tool in the fight against opioid addiction.
What If You Can't Afford Professional Help?
Once you've recognized the signs of being an addict and have gotten past the denial that is so common, it's time to get help for your opioid problem. Professional treatment is without a doubt the most effective way of attaining sobriety. But what happens when you think you can't afford it?
Cost of treatment is actually one of the biggest barriers to getting help for an addiction. According to the 2016 National Survey on Drug Use and Health (NSDUH), as many as 17.7 million adults needed substance abuse treatment but didn't receive it.
Now, 16.9 million of these individuals were in denial about their addiction, but around 800,000 knew they needed treatment. Of those 800,000 people, almost one third didn't get the treatment they needed because of costs or perceived costs.
The price of treatment, it seems, is a major barrier for many. But luckily, checking into rehabilitation is now more cost-effective than ever.
Due in part to the raging drug epidemic happening today, the individual costs of treatment are much more affordable than they've been in the past.
The most exciting change has to do with insurance. Years ago many health insurance providers didn't cover addition treatment at all and patients would have to foot the entire bill on their own.
However, thanks to the Affordable Care Act, all insurance providers are now legally mandated to help cover treatment costs. The amount of coverage still varies from company to company of course. Some patients might even end up not having to pay anything at all.
Beyond insurance, many facilities have also begun offering flexible payment plans and financing options. Sliding scale costs, month-to-month payments, and other cost-reducing measures can make getting the help you need significantly more affordable than it's been in the past.
There are also a variety of free and low-cost treatment options when it comes to getting help for your opioid addiction - even if you don't have private insurance.
First, you can apply for federally-funded healthcare like Medicaid or Medicare to help subsidize the costs. These programs are usually based on income level though, and there's often quite a bit of red tape around the qualification process.
Certain large-scale religious organizations may also offer free or low-cost treatment programs. The Salvation Army, for example, helps treat more than 150 thousand addicts a year for little to no cost.
It's worth remembering, however, that free or low-cost treatment facilities may not be held to the same standards as private programs. As such, you may not receive the same quality of care. It's a tradeoff that, depending on your individual situation, may or may not be worth it.
And finally, there are also numerous support groups around the world that can help addicts get closer to attaining sobriety. These include:
- 12-step groups (like Narcotics Anonymous, Heroin Anonymous, and Pills Anonymous)
- SMART Recovery
- Women for Sobriety
- Secular Organizations for Sobriety
In the end, there have never been more free or low-cost treatment options than there are today. And that means if you really do want to recover from your opioid addiction, there are plenty of organizations that are willing to help.
AspenRidge North: You Can Recover - And We Can Help
Opioid addiction is without a doubt the most widespread and rapidly expanding health crisis the United States has ever seen. In a single year, drugs like these regularly kill more Americans than those that died in the Vietnam War or at the height of the AIDS crisis.
And the more you know about how these dangerous drugs work and what an addiction looks like, the better able you'll be to avoid them or overcome their pull if you're already addicted.
You don't have to live like a slave to your addiction. With the right professional help, you can attain sobriety. And at AspenRidge North, we can help.
Our nationally accredited rehabilitation program offers cutting-edge treatment plans that are crafted to meet your individual needs. We offer both inpatient and intensive outpatient services so no matter what level of care you're after, we have what you're looking for.
Struggling with an opioid addiction can seem hopeless. The intensity of cravings, the pain of withdrawals, and the utter lack of self-control can make it feel like there's no way out.
But with the right kind of help, you can get your life back. And at AspenRidge North, we'd love to help.
So, contact us today to begin your recovery.