Rehab for Opioid Use: What to Expect

Detoxification, commonly referred to as detox, is the process of removing opioids or other substances from the body while managing withdrawal symptoms. It’s an essential first step in the treatment of opioid dependence or addiction.

Contrary to popular belief, opioid dependence is not actually the same as opioid addiction, although they are related to one another. Addiction, as we mentioned earlier, is the compulsive use of harmful substances. On the other hand, dependence is when you have taken a certain substance for a significant period of time, to the point where your body has adjusted to its constant presence.

If you are drug dependent and you suddenly quit or reduce your intake, you will go through a withdrawal phase, which is often described as painful or uncomfortable. In some cases, the withdrawal effects can even be dangerous or life-threatening.

A proper detox process keeps the patient safe and comfortable while their opioid intake is gradually lowered by medical professionals. This is called tapering. A gradual tapering of the opioid medication may be used during detox to reduce the severity of withdrawal symptoms. This approach involves decreasing the dose of the opioid medication over time until it can be safely discontinued.

Detoxification is typically conducted in a supervised medical setting, such as a hospital, detox center, or outpatient clinic. Healthcare professionals monitor the individual’s vital signs and symptoms to ensure their safety and comfort.

Medications may be used to help keep cravings and withdrawal symptoms under control during this time.

Keep in mind that detox alone is not a comprehensive treatment for opioid addiction. It addresses the physical dependence on opioids but does not address the underlying psychological and behavioral aspects of addiction.

To achieve lasting recovery, individuals usually need to transition from detox to ongoing addiction treatment, which may include counseling, therapy, and support groups.

This comprehensive approach, often referred to as medication-assisted treatment (MAT), has been shown to be effective in helping individuals achieve and maintain recovery from opioid addiction.

Opioid withdrawal symptoms can be quite uncomfortable and distressing. They occur when someone who has been using opioids for a prolonged period suddenly reduces their dose or stops using them altogether.

The severity and duration of withdrawal symptoms can vary depending on factors such as the type of opioid used, the duration of use, the dosage, and individual differences. Common opioid withdrawal symptoms include:

Flu-Like Symptoms: Opioid withdrawal can feel like a severe case of the flu. Symptoms may include muscle aches, joint pain, and general malaise.

Nausea and Vomiting: Nausea is a common withdrawal symptom, often accompanied by vomiting. These symptoms can contribute to dehydration.

Diarrhea and Abdominal Cramps: Opioid withdrawal can lead to gastrointestinal symptoms like diarrhea, abdominal cramps, and frequent bowel movements.

Yawning and Runny Nose: Excessive yawning and a runny or stuffy nose are often observed during opioid withdrawal.

Sweating: Profuse sweating, even in cool conditions, is a typical symptom.

Restlessness and Agitation: Many individuals experience restlessness, anxiety, and irritability during withdrawal.

Insomnia: Difficulty falling asleep or staying asleep is a common withdrawal symptom, leading to fatigue.

Dilated Pupils: Opioid withdrawal can cause pupils to become larger than usual.

Goosebumps and Skin Sensations: Some people report having “goosebumps” on the skin, along with sensations like crawling or itching.

Increased Heart Rate and Blood Pressure: Withdrawal can lead to an elevated heart rate and increased blood pressure.

Mood Changes: Emotional symptoms such as depression, anxiety, and mood swings are common during opioid withdrawal.

Drug Cravings: Strong cravings for opioids are often experienced during withdrawal, which can make it challenging to stay clean.

Opioid withdrawal may last anywhere from a few hours to several weeks. It’s different for everyone. And while some of these opioid withdrawal symptoms are not life-threatening, going through them is another thing entirely. It’s an unpleasant situation, which is why many people would rather stay addicted.

Medically supervised detoxification and withdrawal management can help these individuals safely manage their symptoms and increase the likelihood of successful recovery from opioid addiction. If you or someone you know is struggling with opioid addiction or withdrawal, it is advisable to seek professional medical assistance and support.

Medications are an important component of opioid addiction treatment, often referred to as medication-assisted treatment (MAT). MAT combines medication with counseling and behavioral therapies to provide a comprehensive approach to opioid addiction recovery. The primary medications used for opioid addiction treatment include: methadone, buprenorphine, naltrexone, and suboxone.

Methadone is a long-acting opioid agonist that helps reduce withdrawal symptoms and cravings. It’s typically administered daily in a specialized clinic under supervision. Methadone maintenance therapy is one of the most established forms of MAT and has been used for several decades.

Buprenorphine is a partial opioid agonist that can reduce cravings and withdrawal symptoms without producing the same intense high as full opioid agonists. It can be prescribed by qualified healthcare providers, making it more accessible to some individuals compared to methadone.

Naltrexone is an opioid antagonist that blocks the effects of opioids. It is available in both oral (daily pill) and extended-release injectable formulations (Vivitrol), which can be administered monthly. Naltrexone is unique in that it doesn’t produce physical dependence, but it’s crucial for patients to be opioid-free for a certain period before starting naltrexone to avoid precipitating withdrawal.

Finally, Suboxone is a combination medication containing buprenorphine and naloxone (an opioid antagonist). Naloxone is added to buprenorphine to deter misuse, as it can precipitate withdrawal if the medication is injected or abused.

These medications are often used in combination with counseling and therapy to address the psychological and behavioral aspects of addiction. The choice of medication and the specific treatment plan should be tailored to the individual’s needs and circumstances, including the severity of their addiction, previous treatment history, and medical considerations.

Just like detox and medication-assisted treatment, counseling and behavioral therapies also play a crucial role in opioid rehab. These therapies address the person’s mental and emotional needs.

Cognitive-Behavioral Therapy (CBT) is one of the most widely used therapeutic approaches for OUD. It helps patients identify and change unhealthy thought patterns and behaviors related to drug use.

CBT can help people develop coping strategies to deal with cravings and triggers and improve their problem-solving skills.

Dialectical Behavior Therapy (DBT) combines elements of CBT with mindfulness techniques. It helps recovering individuals regulate their emotions, tolerate distress, and improve interpersonal skills, all of which can be beneficial in overcoming addiction.

Meanwhile, Contingency Management (CM) is a behavior-based therapy that uses positive reinforcement to encourage abstinence from opioids. Patients receive rewards or incentives for achieving specific goals, such as passing drug tests or attending counseling sessions. This approach can be highly effective in motivating individuals to stay drug-free.

Speaking of motivation, Motivational Interviewing (MI) is a client-centered counseling approach that helps individuals explore their ambivalence about change and find their own motivation for recovery.

Therapists using MI aim to evoke self-motivational statements from clients and guide them toward making positive decisions regarding their substance use.

Another common therapy is the 12-Step Facilitation Therapy. This therapy is based on the principles of self-help groups like Narcotics Anonymous (NA) and Alcoholics Anonymous (AA).

It encourages individuals to engage in 12-step programs, which emphasize surrendering to a higher power, admitting powerlessness over drugs, and seeking support from a community of peers in recovery.

On top of these examples, rehab centers may also use individual therapy, group therapy, and family therapy, depending on the patient’s needs.

Rehab programs can be done in an inpatient or outpatient setting. One is not necessarily better than the other. It’s all a matter of finding the right fit for the specific patient.

Different rehab centers may offer different treatment services and therapies. The best treatment programs are the ones that are personalized to fit the patient’s needs. Combining counseling and behavioral therapies with medication-assisted treatment when appropriate can significantly increase the chances of successful, long-term opioid addiction recovery.

Treatment is an addicted individualʼs best option if they want to recover. Beating an addiction not only requires eliminating the physical dependence, but also addressing the behavioral factors that prevent them from wanting to get better. Simply quitting may not change the psychological aspect of addiction. Some people quit for a while, and then take drugs or alcohol again, only to overdose because they did not detox properly. Recovery involves changing the way the patient feels, thinks, and behaves.