Opioid painkillers are some of the most commonly prescribed medications in the United States. Some individuals need these medications for short-term use to handle the pain of surgery and post-operative recovery. Others receive opioid painkiller prescriptions for chronic pain resulting from injuries or degenerative conditions. Unfortunately, over-prescription of opioids and poor understanding of the risks of opioid addiction among the public have coalesced into an ongoing crisis, and accidental drug overdoses have become the leading cause of accidental death in the United States.
Opioid addiction is extremely difficult to overcome primarily due to the severity of withdrawal symptoms. Withdrawal usually appears within 12 hours of the last dose of opioids, beginning with uncomfortable but relatively moderate symptoms until eventually escalating to excruciating and even life-threatening levels.
Opioids create a powerful biochemical dependency. Opioid medications and synthetic opioids like heroin attach to the opioid receptors in the brain, causing a surge of dopamine and pleasurable feelings of relaxation and euphoria. However, the brain cannot maintain this type of biochemical relationship with these drugs and eventually develops a tolerance to opioids. The person using the opioids will then start to feel diminishing returns if he or she keeps using the same dosing size and schedule. This inevitably encourages abuse as he or she will need more and more of the drug to feel the desired effects.
If an individual develops an opioid addiction and goes for too long without another dose, withdrawal symptoms manifest within one day, escalating in severity and potentially reaching life-threatening levels. The most commonly reported symptoms during the initial phases of opioid withdrawal include:
- Muscular aches and joint pain
- Sleep problems, such as insomnia
- Runny nose
- Cravings for opioids
For a milder addiction, these symptoms may persist for several days and gradually worsen. People struggling with more severe opioid addictions generally report milder symptoms for the first few hours or days after a dose’s effects fade, and then they can quickly escalate to much worse symptoms such as:
- Abdominal cramps
- Nausea and vomiting
- Rapid heart rate
- More intense cravings for opioids
These symptoms often push those experiencing them to try to locate more opioids as soon as possible. If left unchecked, these symptoms can lead to potentially fatal medical events.
A severe opioid addiction can cause withdrawal to manifest much sooner than 12 hours after the last dose, and those symptoms will escalate in severity very quickly. If left unchecked, an individual experiencing severe withdrawal symptoms may start having convulsions, vivid hallucinations, lash out irrationally and unpredictably at others, or experience cardiovascular difficulties due to irregular or rapid heart rate.
Opioid addiction is incredibly powerful, and it is neither safe nor feasible to attempt to overcome opioid withdrawal without assistance. Even for milder addiction cases, opioid withdrawal can be incredibly dangerous. Thankfully, there is assistance available for opioid addiction treatment that can ease the pain of withdrawal and offer an easier transition into rehab and recovery.
Medically Assisted Detox
The detox process involves removing the last of the drugs in a patient’s body and preparing the patient for rehab. Drug addiction of any kind can lead to malnutrition, dehydration, and dangerous vitamin deficiencies that can cause debilitating physical and psychological effects. Substance abuse treatment centers that offer medically assisted detox services rely on several medications to ensure the safe removal of drugs from a patient’s body with a minimal appearance of withdrawal symptoms.
One commonly used medication is clonidine, a sedative that can help reduce symptoms of anxiety, lower heart rate, and ease muscle tension. While clonidine can help with these physical symptoms, it does not reduce cravings.
Substance abuse treatment providers generally look to opioid replacement therapy to handle cravings. Two of the most commonly used medications are methadone and suboxone. Methadone is a synthetic opioid capable of providing pain relief and blocking opioid receptors, but it also carries a risk of abuse and addiction since it is still an opioid. Suboxone is quickly becoming the preferred alternative to methadone as it offers more effective results with a much lower risk of addiction.
What Is Suboxone?
Suboxone is actually a combination of two commonly used opioid treatment medications: naloxone, often sold under the brand name Narcan and capable of reversing the symptoms of opioid overdose, and buprenorphine, a mild opioid that does not cause increasingly potent effects with higher doses, essentially eliminating the risk of replacing one addiction with another.
Maintenance Treatment And Relapse Prevention
Suboxone is one of the most popular choices among substance abuse treatment professionals for managing cravings for opioids. Suboxone effectively prevents the user from experiencing the euphoria of other opioids like OxyContin and heroin by blocking opioid receptors, rendering the drugs impotent and discouraging future use. Doctors often prescribe Suboxone as a maintenance prescription during and after rehab; the patient takes this medication to ward off cravings and minimize withdrawal symptoms, taking incrementally smaller doses until he or she no longer requires the medication.
Potential Risks Of Some Opioid Use Disorder Treatments
Most opioid replacement therapy is just that: replacing one opioid for a less harmful alternative. However, most types of opioid replacement medication carry a risk of abuse and addiction. Unless patients follow prescribing doctors’ directions to the letter, they risk potentially replacing a previous addiction with a new one for the medication intended to help them overcome addiction in the first place.
Medical research holds promise for individuals in this position, however. The Food and Drug Administration recently approved the first non-opioid medication for use in treating opioid withdrawal symptoms and cravings. Lofexidine is an oral tablet capable of diminishing the typical withdrawal symptoms experienced in opioid addiction. However, it only received approval in May of 2018, so the potential long-term efficacy of this drug remains unclear.
Medical Treatment As Part Of Comprehensive Opioid Addiction Treatment
Ultimately, medical assistance is a crucial component of any opioid addiction treatment plan, but it is not the only method required for overcoming opioid addiction. Anyone struggling with any type of opioid addiction requires comprehensive treatment that fully addresses all aspects of his or her addiction, not just the physical symptoms of withdrawal.
Many people struggling with addiction face psychological trauma, co-occurring mental health disorders, and physical ailments like infectious diseases and malnutrition from years of drug abuse. These individuals need complete treatment plans that fully cover all aspects of their addiction, and medical assistance during the detox process and beyond is a crucial component of any effective treatment plan. Medical assistance is also important beyond rehab. The shock of returning to regular day-to-day life is incredibly difficult for anyone freshly finished with rehab, and cravings can become a daily contention even after maintaining sobriety for many months. Suboxone prescriptions can play a crucial role in the maintenance work of living sober after rehab. Proper medications combined with the relapse preventing techniques learned during rehab generally offer the best chances of achieving lifelong sobriety after opioid addiction.
Reach out to us for a deeper dive into this difficult and complex topic. There’s certainly a lot more to discuss.