Treatment of Opioid Dependence: What to Expect?

There are many types of prescription opioids including: codeine, fentanyl, hydrocodone, oxycodone, oxymorphone, and morphine. Even heroin is considered an opioid, which is why heroin addiction is considered an opioid addiction. Heroin is an illegal and highly addictive opioid that has no sanctioned medical use.

The prescription opioids are commonly sold under brand names like OxyContin, Percocet, Palladone, and Vicodin.

Several opioids are taken in pill form, while others are taken as lozenges or even lollipops. There are also opioids that are administered intravenously, via a skin patch, or with a suppository.

When a person takes opioids for an extended period of time, whether for pain relief or for recreational purposes, there is a risk of developing opioid dependence.

Opioid dependence, also known as opioid addiction or opioid use disorder (OUD), is a chronic condition characterized by a physical and psychological dependence on opioids.

When someone becomes dependent on opioids, their body develops a tolerance to the drugs, which means they need increasingly higher doses to achieve the desired effects.

Dependence is when the body has become accustomed to the presence of opioids, causing withdrawal symptoms whenever the person reduces their intake or tries to quit opioids.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides criteria for diagnosing opioid use disorder, which include:

Taking opioids in larger amounts or for a longer period than intended.

Persistent desire or unsuccessful efforts to cut down or control opioid use.

Spending a significant amount of time obtaining, using, or recovering from the effects of opioids.

Craving or a strong desire to use opioids.

Ongoing opioid use leading to failure to fulfill major obligations at work, school, or home.

Continued opioid use despite persistent or recurring social or interpersonal problems caused or exacerbated by opioid use.

Giving up or reducing important social, occupational, or recreational activities because of opioid use.

Recurrent use of opioids in situations where it is physically hazardous.

Continued opioid use despite the knowledge of persistent or recurrent physical or psychological problems likely to be caused or exacerbated by opioids.

Tolerance, as defined by a need for increased amounts of opioids to achieve the desired effect or a diminished effect with continued use of the same amount.

Withdrawal, as manifested by the characteristic opioid withdrawal syndrome or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

Opioid dependence can also happen alongside opioid addiction, which is a condition that is characterized by compulsive drug-seeking behavior and difficulty in controlling opioid use. An addicted person will keep taking opioids even when they are already experiencing the consequences.

Both opioid dependence and addiction are a serious health concerns that can have severe consequences, including overdose and death. The withdrawal symptoms of opioids can sometimes be life-threatening, which is why proper treatment is needed.

Opioid withdrawal symptoms can vary in intensity and duration depending on factors such as the type of opioid used, the duration and amount of opioid use, and individual differences. The most common opioid withdrawal symptoms include:

Flu-like symptoms: These can include muscle aches, joint pain, sweating, chills, and a runny nose.

Gastrointestinal symptoms: Nausea, vomiting, diarrhea, and abdominal cramping are commonly experienced during opioid withdrawal.

Insomnia: Difficulty falling asleep or staying asleep is a common symptom. Sleep disturbances can contribute to other withdrawal symptoms.

Anxiety and restlessness: Feelings of anxiety, restlessness, irritability, and agitation are frequently reported.

Mood changes: Opioid withdrawal can lead to mood swings, depression, and a general sense of unease or dysphoria.

Dilated pupils: The pupils may become larger than usual (dilated), which is known as mydriasis.

Increased heart rate and blood pressure: During withdrawal, heart rate and blood pressure may rise temporarily.

Yawning and teary eyes: Frequent yawning and tearing up can be observed during the withdrawal process.

Goosebumps and chills: The skin may become covered in goosebumps, leading to a feeling of chills or coldness.

Opioid withdrawal can be a challenging and uncomfortable process. This is only one of the reasons why seeking medical assistance and support from healthcare professionals is absolutely crucial for managing symptoms and ensuring a safe detoxification.

Dangerous withdrawal symptoms aside, there are other reasons why you need to consider seeking treatment if you have an opioid addiction or dependence.

Treatment not only addresses withdrawal symptoms but also the other risks caused by opioid misuse, including overdose and addiction. Simply put, going through treatment can save your life by preventing fatal outcomes.

Opioid dependence is often a manifestation of an underlying medical condition, mental health disorder, or chronic pain. Treatment allows people to recognize and address the root causes of their opioid use and develop healthier coping mechanisms to manage pain or mental health concerns.

It is common for opioid dependence to co-occur with mental health disorders such as depression, anxiety, or post-traumatic stress disorder (PTSD). Treatment interventions address both the addiction and underlying mental health conditions that are contributing to the person’s substance abuse.

It can even improve your physical health. Prolonged opioid use can have detrimental effects on your health, affecting every part of your body. It can lead to respiratory problems, cardiovascular issues, hormonal imbalances, and many other physical problems. Treatment helps mitigate these health risks while promoting your overall well-being.

Another reason to pursue treatment is to reduce and prevent criminal behavior. Substance use disorders, including opioid dependence, can drive people to engage in illegal activities to sustain their addiction. Treatment reduces the need to engage in criminal behavior, lowering the burden on law enforcement and the criminal justice system.

Opioid dependence tends to get in the way of a person’s relationships, employment, and responsibilities. Treatment interventions, such as medication-assisted treatment (MAT) combined with counseling and support services, can help individuals regain control over their lives, rebuild relationships, and reintegrate into society.

Treatment for opioid dependence even has an impact on the economy since drug abuse places a heavy burden on families and society as a whole. Without opioid dependence, people can regain their productivity and save up on healthcare costs. This minimizes the social and economic consequences of addiction.

It’s safe to say that treatment for opioid dependence has the potential to save lives. It can improve a person’s physical and mental health, reduce criminal behavior, restore their sense of self-worth, and even generate economic benefits for society at large.

Before we go into detail about what you can expect when you seek treatment for opioid dependence, we’re going to give you an overview of the whole process.

Of course we need to take note that every rehab center will be different in its approach. They may offer different treatment programs to address opioid addiction and dependence, so it’s worth looking at various rehab centers to see what their approach is.

Aside from that, the exact treatment approach may also vary from one person to another because the best treatment programs are personalized to suit the patient’s specific needs. Everyone is different. Even if you use the same opioids and take the same dosage as somebody else, your symptoms may be different from theirs.

When it comes to the treatment of opioid dependence, there are several approaches available. The specific course of treatment can vary depending on individual circumstances, preferences, and medical advice.

With that out of the way, most treatment programs will begin with a comprehensive evaluation and assessment of the patient by a healthcare professional. They will evaluate the patient’s medical history, substance use patterns, physical health, and any co-occurring mental health conditions. This assessment helps determine the most appropriate treatment options.

For those who are physically dependent on opioids, they may have to go through a medically-supervised detoxification process. Medical detox helps your body eliminate opioids while managing withdrawal symptoms. Medical professionals may administer medications to ease withdrawal discomfort and ensure your safety during this phase.

Medication-Assisted Treatment or MAT is a common approach for opioid dependence. It involves the use of FDA-approved medications to help reduce cravings, manage withdrawal symptoms, and promote recovery.

The three primary medications used for MAT are: methadone, buprenorphine, and naltrexone. All three of these medications can help suppress withdrawal symptoms or reduce cravings by blocking the effects of opioids. These medications are often combined with counseling and behavioral therapies for better outcomes.

Alongside medication, counseling and behavioral therapies play a crucial role in treating opioid dependence. They help address the psychological and social aspects of addiction, allowing patients to recognize unhealthy thought patterns and triggers that keep them addicted.

This helps them develop healthy coping mechanisms that will support their long-term recovery. Common forms of therapy include individual counseling, group therapy, cognitive-behavioral therapy (CBT), motivational interviewing, and contingency management.

Because opioid addiction is a chronic condition, long-term maintenance treatment may be necessary for sustained recovery. This may involve ongoing medication use, counseling, and regular follow-up appointments with healthcare providers to monitor progress, adjust treatment as needed, and provide support.

If you or someone you know is seeking treatment for opioid dependence, it is recommended to consult with healthcare professionals or addiction specialists who can provide personalized guidance and support throughout the treatment journey.

Methadone treatment, also known as methadone maintenance treatment (MMT), is a widely used approach to help people with opioid dependence or addiction. Methadone is a synthetic opioid medication that is primarily used to reduce withdrawal symptoms and cravings associated with opioid addiction.

Methadone works by binding to the same opioid receptors in the brain that are affected by drugs like heroin or prescription opioids. However, methadone has a longer duration of action, which helps prevent withdrawal symptoms and reduces drug cravings without producing the euphoric effects associated with other opioids.

This medication is typically administered orally in liquid form on a daily basis. In some cases, it may be provided as a dissolvable tablet or a wafer. The dosage of methadone is determined based on the person’s specific needs and may be adjusted over time. Healthcare providers will try to find the optimal dosage that effectively manages withdrawal symptoms and cravings without causing sedation or other adverse effects.

The primary goal of methadone treatment is to stabilize individuals who are dependent on opioids and help them lead functional lives while reducing or eliminating the use of illicit opioids.

Methadone treatment is considered a form of MAT, meaning it is used in combination with counseling, behavioral therapies, and other support services to address the complex nature of opioid addiction.

This treatment program, much like other outpatient rehab programs, is often conducted in specialized clinics under the supervision of healthcare professionals. Patients visit the clinic regularly to receive their methadone dose and participate in counseling or other supportive services.

Interestingly, methadone itself is a controlled substance, meaning it has a potential for misuse and addiction. Its distribution and administration are strictly regulated to ensure its appropriate use.

Methadone treatment is often considered a long-term approach, and some individuals may continue the treatment for months or even years. The duration of treatment varies depending on individual needs and progress. However, this treatment has been shown to be effective in reducing opioid use, lowering the risk of overdose, improving social functioning, and reducing criminal activity among individuals with opioid addiction.

That said, methadone treatment is not suitable for everyone, and the decision to pursue this form of treatment should be made in consultation with a healthcare professional experienced in addiction medicine.

Opioid medical detox, also known as opioid detoxification or withdrawal management, is a process designed to help addicted individuals safely and comfortably discontinue the use of opioids.

It typically involves a combination of medical supervision, medication, and supportive care to manage the physical and psychological symptoms of opioid withdrawal.

Just like medical detox for other substances, it involves gradually lowering the person’s drug intake while their withdrawal symptoms and cravings are managed by medical professionals. It is designed to keep the person safe and healthy as they recover from their opioid dependence.

Withdrawal symptoms during opioid detox can be challenging and uncomfortable. Medical staff provide supportive care and administer medications to alleviate symptoms such as nausea, vomiting, diarrhea, muscle aches, anxiety, and insomnia. The goal is to help the individual through the acute withdrawal phase and ensure their safety.

Healthcare providers may administer methadone, buprenorphine, or naltrexone to help stabilize the individual and minimize their discomfort.

Opioid detox can also have psychological effects, including anxiety, depression, irritability, and cravings. Mental health professionals or counselors may be involved in providing emotional support and counseling to address these aspects and help the patient cope with the challenges of withdrawal.

Opioid detox is typically conducted in an inpatient or outpatient medical setting under the supervision of healthcare professionals. This allows for close monitoring of vital signs, symptom management, and adjustment of medications as needed.

Medical detox is typically the first step in a comprehensive treatment plan for opioid addiction. Once the acute withdrawal phase is managed, the individual is often referred to further treatment options, such as residential rehab, outpatient therapy, or ongoing medication-assisted treatment. These programs aim to address the underlying causes of addiction and provide support for long-term recovery.

We’ve mentioned the three most commonly used medications for opioid addiction treatment. Now let’s take a closer look at each of them.

Methadone is a long-acting opioid agonist that activates the same opioid receptors in the brain as other opioids but in a controlled manner. It helps reduce withdrawal symptoms and cravings without producing the euphoric effects of other opioids.

Methadone is usually dispensed through specialized clinics and requires daily administration under supervision.

Buprenorphine is another medication used for opioid dependence. It is a partial opioid agonist that also binds to the opioid receptors in the brain but has a ceiling effect, meaning it produces diminishing returns in terms of opioid effects beyond a certain dosage.

It helps reduce withdrawal symptoms and cravings and can be prescribed by qualified healthcare providers who have received a waiver to do so. Buprenorphine is available in various formulations, including sublingual tablets, dissolvable films, and long-acting injections.

Finally, naltrexone is an opioid antagonist that blocks the effects of opioids by binding to the opioid receptors and preventing other opioids from attaching to them. It does not produce any opioid effects itself.

Naltrexone can be administered orally or through an extended-release injection (Vivitrol) that lasts for about a month. It is typically used after detoxification from opioids to help prevent relapse.

These medications are most effective when used as part of a comprehensive treatment approach that includes counseling, behavioral therapies, and support services.

Behavioral therapies play a crucial role in the treatment of opioid dependence. They are often used in combination with medication-assisted treatment (MAT) to address both the physical and psychological aspects of addiction. Here are some commonly used behavioral therapies for opioid dependence:

Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors associated with drug use. It focuses on developing coping skills, managing cravings, and preventing relapse. CBT can be provided in individual or group settings.

Contingency Management (CM): CM is a rewards-based therapy that reinforces positive behaviors such as abstinence from drug use. It involves providing incentives, such as vouchers or privileges, for meeting treatment goals, such as attending counseling sessions or providing drug-free urine samples.

Motivational Interviewing (MI): MI is a client-centered therapy that aims to enhance an individual’s motivation to change their drug use behavior. It involves building a therapeutic relationship and using techniques to explore and resolve ambivalence about quitting opioids.

Dialectical Behavior Therapy (DBT): DBT combines elements of CBT with mindfulness practices. It focuses on teaching individuals skills to manage emotions, tolerate distress, and improve interpersonal relationships. DBT can be particularly helpful for individuals with co-occurring mental health conditions.

The exact methods used may vary from person to person. Just like with medical detox, these therapies are most effective when delivered by trained professionals with expertise in addiction treatment.

Look for a rehab near you today if you or someone you love is struggling with addiction or opioid dependence. The road to recovery begins today.

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.