Opioid Addiction and Recovery

Opioid addiction has risen to epidemic levels in North America and beyond. In the U.S. alone, drug overdose is now the number one cause of unintentional death. The CDC also puts the total financial cost of the prescription opioid crisis in the U.S. at $78.5 billion per year, which includes the costs of healthcare, lost productivity (for those who can no longer work), addiction treatment, and costs associated with the criminal justice system. It is a major public health emergency.

It’s important to understand that addiction is not the fault of an addict. In the case of opioids in particular, a number of other factors come into play. According to the Global Commision on Drugs Policy, “The current opioid crisis was spurred by a broad expansion of medical use of opioids, which began in the 1990s as a legitimate response to the under-treatment of pain, but which was soon exploited by the unethical behavior of pharmaceutical companies eager to increase their revenue.”

 Opioid Addiction and Recovery

In other words, many drug companies, in an effort to make more money, strongly encouraged doctors to prescribe opioids. This is one of the reasons there has been such a dramatic spike in opioid addiction.

Many opioids are prescription drugs prescribed by doctors for pain relief. This is often to help people with severe, debilitating pain, such as those suffering from advanced stages of cancer, or those with bone disease or neurological illnesses. In addition to pain relief, opioids in these classes affect the brain’s pleasure center. Someone who takes them who isn't in pain will often feel elated, followed by a sense of deep relaxation and/or drowsiness.

The main ingredient in such opioids is oxycodone, a chemical that is powerful, effective, and highly addictive. For example, a lot of people who were legitimately prescribed an opiate like OxyContin at first, become addicted to it over time. Unfortunately, addiction to an opioid can be very dangerous, in part due to the danger of overdose.

According to the National Institute on Drug Abuse, approximately 20% of all drug treatment admissions are opioid-related. In other words, one in five individuals getting help for drug addiction are there because they got addicted to some form of opioid, including prescription painkillers like Percocet, OxyContin, and Vicodin.

It’s also common and important to know that many of those who were initially addicted to a prescription opioid like Vicodin, switch to heroin once it becomes difficult or impossible to get the prescription opioid. In fact, roughly 80% of people who use heroin first misused prescription opioids. Others switch to fentanyl, a powerful synthetic opioid.

How do you know whether you’re addicted to an opioid?

As stated, prescription painkillers (opioids) are some of the most frequently prescribed drugs in America, making them some of the most available to abuse. High levels of addiction can be credited to the combination of their euphoric effect and how quickly dependence can happen. An estimated 4.7 million people are addicted to prescription painkillers in the U.S.

Most people become addicted to prescription opioids after using them for a medical reason. For example, you may have needed an oxycodone like Percocet or OxyContin to help you recover from a surgery. This can make it confusing when it comes to understanding whether you are addicted to an opioid.

The first step of addiction comes in the form of tolerance. This is when your body becomes used to the effects of a drug. In time, tolerance leads to dependence, which is when you need a higher dose of the drug to get the same result you got before (to get the same high).

A common sign someone has developed a prescription opioid addiction is “doctor shopping,” or switching healthcare providers to get more or higher doses of the substance -- this is because of the dependence. The person often becomes obsessed with getting access to the substance and may falsify prescriptions and/or use multiple pharmacies in an attempt to get more of it.

Another sign of opioid addiction is using the drug in a way other than it was prescribed or intended. For example, since OxyContin is a time-released substance, abusing it can take the form of crushing pills to inhale the powder, or mixing the powder with water to inject it with a syringe. This speeds up its release, giving the user a sudden euphoric high. However, this kind of use can also result in coma or even death. Mixing OxyContin with alcohol is another extremely dangerous combination that can result in death. Never, ever mix opioids with alcohol.

The final step is addiction, which is when you cannot control your need for the opioid. You can't stop using no matter what you try (even if you know it’s wrong or impacting your life in a negative way).

Common signs you’re addicted to an opioid include:

  • Constantly thinking about how you’re going to get more (especially so you don’t run out)
  • Using different doctors to get your opioid (doctor shopping)
  • Fighting with friends and family over your use (including denying you have a problem)
  • Borrowing, begging, stealing, or engaging in other illegal activities in order to get the drug
  • Experiencing physical withdrawal symptoms when you try to stop using the drug, including flu-like symptoms like nausea, vomiting, coughing, joint, muscle, and bone aches

This last point is important because it is part of the reason it’s so critical to get support when you’re recovering from an opioid addiction. Addicts will often undergo withdrawal when they stop taking the drug. For example, people who suddenly stop taking a prescription opioid on which they’ve become dependent can experience muscle and bone pain, depression, diarrhea, and insomnia if they aren’t properly tapered off the drug with medical detox.

Other physical signs and symptoms of opioid abuse include:

  • Euphoria (feeling high)
  • Drowsiness, sometimes to the point of nodding off
  • Slowed or shallow breathing
  • Nausea and vomiting
  • Flushed or itchy skin
  • Constipation
  • Headache
  • Dry mouth
  • Sweating
  • Slurred speech
  • Confusion or poor judgment

The National Institutes of Health warns against a common belief that prescription opioid medicines are “safer” than illegal drugs like crystal meth or cocaine. In reality, when prescription medications like OxyContin or Percocet are abused and not taken as prescribed, they pose serious and potentially deadly health risks.

What are the risks of opioid addiction?

One of the biggest risks that come along with opioids is death by overdose. Because the drugs suppress a person's ability to breathe, users can actually die from drug-induced suffocation. This is part of why it’s so important to only take opioids like these as prescribed by a doctor (i.e. not upping your dose on your own).

Alcohol Rehab

As stated, another major risk involves combining opioids with alcohol. For example, taking certain long-acting forms of hydrocodone like Vicodin along with alcohol can cause rapid release of the drug, resulting in high blood levels that can be lethal. Again: Never mix alcohol or any other drugs with opioids of any kind.

Other organs vulnerable to damage through the abuse of opioids include the heart, liver, lungs, kidneys, intestinal tract, and circulatory system. A number of birth defects are also linked to the use of these drugs by pregnant women.

Finally, the psychological and emotional impacts of opioid addiction are just as far-reaching as the physiological effects. It’s common for this kind of addiction to affect nearly every part of a person’s life. Opioid addicts may have problems at school, work, or in the home since they will often sacrifice time or energy in getting the drug instead of concentrating on important life tasks. They can start to spin out of control, eventually finding that their entire life starts to revolve around getting, having, and using the drug.

This kind of addiction also tends to severely strain the person’s relationships, causing difficulties with friends, spouses, and family members. A great number of addicts have or develop financial problems, as they spend more and more money on the substance. They may eventually get into legal trouble.

It’s important to understand that for an addict, consuming the opioid is compulsive. It's not something within their control (even if it started out that way). Addiction is not something to be ashamed of, and no one is “bad” or “wrong” for having developed an addiction. The important thing is to get help, especially since the cost of not getting it is potentially deadly.

What is an opioid addiction treatment center?

An opioid addiction treatment center is an institution – usually a rehab facility – that specializes in helping clients overcome opioid addictions. Rehab, short for rehabilitation, is about support and recovery from addiction. Opioid rehab centers can offer either or both inpatient and outpatient services, and they all keep treatment confidential.

Depending on how severely a person is addicted to opioids, an inpatient drug rehab center may be the best option. This is in large part because the first step at an inpatient opioid rehab center is medical detox, or safely ridding the body of opioids in a medical way. Those who’ve been using opioids heavily are in need of professional help to rid their body of the substance since they’ve built up a tolerance and are likely to experience serious withdrawal symptoms.

Without such structured support, undergoing the opioid detox process can be intense, painful, and sometimes deadly. Part of the point of going to an inpatient opioid rehab treatment facility is so that medical professionals can help. They’re trained and prepared to manage symptoms, keeping patients safe and comfortable as they undergo detox and withdrawal. 

What is treated at an opioid addiction treatment center, and how does it work?

Opioid addiction centers treat those recovering from:

  • Addiction to prescription painkillers (opioids) like:
    • Morphine
    • Codeine
    • Oxycodone (Percocet, OxyContin, Percodan)
    • Hydrocodone (Vicodin, Lortab, Lorcet)
    • Methadone
    • Fentanyl (Duragesic)
    • Pethidine (Demerol)
    • Hydromorphone (Dilaudid)
    • Propoxyphene (Darvocet/Darvon)
  • Heroin

 Opioid addiction treatment centers tend to treat clients in three phases:

  1. Intake
  2. Detoxification (detox)
  3. Addiction therapy and Recovery (ongoing self-care and support)

1. Intake

During intake, a rehabilitation professional asks questions to get a better understanding of the patient’s situation and whether they’re a good fit for the opioid treatment center. They usually get a family history (including history of addiction), more information on the person’s situation (how long they’ve been using opioids, progression, etc.), and payment information.

Federal law requires inpatient rehab centers to keep patient information private, so opioid addiction rehab centers keep treatment confidential.

While many rehab facilities offer treatment courses of 28 days, for opioid addiction treatment, stays of 60 or 90 days are often recommended.

2. Detox (including medically-assisted detox)

Due to the specific nature of opioid addiction, opioid addiction treatment centers are specially equipped to handle medically-assisted detox or helping ease someone’s experience of detox and withdrawal by providing a substitute drug.

When someone uses an opioid like OxyContin, Vicodin, or heroin for an extended period of time, the body adjusts. The drug becomes physiologically required in order to function properly, and when its presence is removed, the body goes into withdrawal. Without proper care, opioid detox and withdrawal can be painful and even fatal. With the right care, it is a much more comfortable process.

Medically-assisted detox utilizes medication to ease withdrawal and aid in the overall rehab process. For example, methadone is used primarily for those struggling with heroin addiction. Some recovering heroin addicts continue to take methadone for months or even years after rehab. There is some risk of getting addicted to methadone itself, which is why treatment should be tailored and closely monitored.

Buprenorphine is one of the most popular methods of treating those recovering from addiction to prescription opioids. It has significantly fewer addictive properties than methadone and some addiction recovery specialists actually recommend staying on buprenorphine for months, years, or indefinitely. This is called maintenance therapy.

Other medications include benzodiazepines, which are anti-anxiety medications, and barbiturates, which are mild sedatives that help the mind and body stay calm as toxins are released during opioid detox and withdrawal.

3. Addiction therapy and Recovery (ongoing self-care and support)

No one plans on being an addict. The experience can be overwhelming and scary, especially since it can start to take over every aspect of life. It’s easy to feel alone and out of control, like things will never get better. Such feelings can trigger depression, anxiety and sometimes even suicidal thoughts.

In many cases, opioid addiction began in part to as an attempt to self-medicate – to treat the pain or overwhelm in a person’s life themselves. Recovery, including addiction therapy, is in part about validating the original suffering, learning to cope, and moving beyond the need for opioids to numb emotional or psychological pain.

Most opioid addiction treatment centers offer a combination of individual and group therapy. Some may also offer family therapy. In both individual and group therapy, you identify and address the root causes of opioid addiction, which may not be what you had predicted. Therapy helps address things like:

  • Healthy ways of dealing with intense emotions and thought patterns, in order to become more resourceful and resilient
  • Direction and instruction on how to work through trauma, if applicable
  • How to identify opioid addiction triggers (i.e. moments when you want to use) and what to do instead, like engaging in self-care instead of going back to substance abuse
  • Support in establishing a healthy new life, since the ideal way to ensure sobriety is to thrive

In individual therapy, you meet with a licensed mental health professional who helps you navigate the recovery process, tailoring guidance specifically to you and your situation.

In group therapy, you connect with others who've been through similar experiences and learn how to move forward without being alone. Being in a group with others who really “get” your addiction in the same way you do can lead to closer connections and a better shot at lasting sobriety. For example, many of those who end up addicted to an opiate have experienced a lot of conflict with family and friends as a result of the addiction. Dealing with the stress, shame, and ramifications of such conflict is enhanced in a community atmosphere where others are going through the same thing.

Both individual and group therapy allows those struggling with addiction to share their stories in a safe environment. Many report therapy as both enlightening and uplifting, since it gives you the opportunity to heal and grow in a truly non-judgmental setting.

What kinds of opioid treatment centers are there?

When looking at treatment options for opioid addiction, the first choice to be made is whether to go to an outpatient or inpatient rehab center.

Opiate Addiction

Outpatient opioid treatment programs offer many of the same services as inpatient rehab programs, but patients don’t stay at the facility. They live at home and come in for treatment. In general, outpatient opioid treatment centers are better suited for those whose addictions are less established, as well as those who aren’t able to leave home for some reason.

Inpatient opioid rehab facilities offer residential care, meaning all attendees live on site. The opioid rehab center takes care of all needs, including room, board, addiction therapy, medication, and specialized treatment. Inpatient rehab is recommended for those who’ve struggled with opioid addiction for a long time, those who’ve relapsed several times, or those with a dual diagnosis (people with a mental health condition as well as opioid addiction issues).

For those with jobs they don’t wish to leave for the duration of their stay at an inpatient opiate addiction rehab facility, there are also executive rehab centers. These are upscale opioid rehab facilities that allow business professionals to continue working as they go through opioid addiction treatment. Similarly, luxury drug and alcohol rehab centers offer rehab options in luxurious surroundings, often beautiful places like ocean-side resorts or mountain spa-like settings.

What happens after opioid addiction rehab treatment?

Leaving a rehab center is not the “end” of recovery. Like many things, staying sober is an ongoing commitment. Some people may choose to live in a sober living environment like a halfway house. There, alongside others who are also rebuilding their lives, you learn about yourself and build new ways of handling stress and challenge. You develop skills, explore resources, and create connections that will help you stay sober and feel a sense of belonging.

Many successful recovering opioid addicts attend 12-step and other support groups like Narcotics Anonymous (NA) indefinitely. Others may actually return to the opioid rehab facility on select weekends to get some extra support. The important thing is to determine what works for you and to do it.

Addiction can and does destroy lives. It can devastate not only your physical health, but your career, close relationships, and future. Fortunately, it’s never too late to do something about it.

Ultimately, drug rehab is a chance to turn your life around. If you or a loved one needs help getting clean, know you’re not alone. Millions of others have been through the same thing and come out on the other side stronger, safer, and more resilient.

Making the choice to end addiction is courageous. It’s also the start of a new life – one based on greater self-awareness and an expanded sense of support, community, and possibility. With the right support, you can free yourself from addiction and lead a vibrant and meaningful life. You deserve to thrive.

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