Opioid Treatments for Recovery
There are several opioid treatments that will usually be used in conjunction with one another. In addition to therapy to support the recovering addict, various medications and other modalities might be used as well.
Drug therapy during detox
One of the opioid treatments that might ne used is a replacement opiate will be prescribed, such as buprenorphine or methadone. This helps support the person and evens out their mental and physical symptoms while they go through what is essentially a detoxification program to rid the body of the opioids.
Buprenorphine is the first drug to be allowed to be used in a regular doctor’s office, as compared to methadone, which must be administered in a clinical setting.
Buprenorphine is an opioid, but less addictive than other forms. It is often combined with naloxone to further reduce the risk of dependency or abuse.
Side effects are similar to those of other opioids, and can include:
• Nausea, vomiting, and constipation
• Muscle aches
• Muscle pain and cramping
• Cravings for the drug
• Irritability and upset
Probuphine is an implant of buprenorphine that steadily releases a low dose of the medication over a 6-month period. This method of use is meant to encourage recovering addicts to keep up with the treatment and prevent the potential abuse of buprenorphine due to it being an opioid.
Naloxone is a medication designed to rapidly reverse opioid overdose, and can thus save lives in the event of accidental or deliberate overdose. It is an opioid antagonist, which means that binds to the opioid receptors in the brain that feel good and get re-wired when opioids are taken. Naloxone can reverse and block the effects of other opioids.
However, there are several side effects to watch out for, including:
• abdominal cramps
• stomach pains
• body aches
• difficult or troubled breathing
• excessive, uncontrolled crying
• fast, pounding, or irregular heartbeat
Any of these should be reported to a doctor immediately.
Methadone has been used safely for decades to help heroin addicts and is now being used to aid those who are suffering from opioid addiction. It should be taken exactly as directed, on a set schedule.
Side effect to watch out for include:
• Difficulty breathing or shallow breathing
• Dizziness or fainting
• Hives or a rash
• Swelling of the face, lips, tongue, or throat
• Chest pain
• A fast or pounding heartbeat
• Mental confusion
This drug is normally used to treat high blood pressure, but can help reduce certain symptoms of opioid withdrawal. Since it is not an opioid itself, there is little to no potential for abuse.
Depending on their situation and preferences, a person may attend a residential rehab facility or an outpatient clinic and receive their medicine regularly. Over time, the dose will be lowered and there will usually be some withdrawal symptoms, but nothing to the degree or intensity of trying to go cold turkey.
Many opioid treatments focus on dealing with craving for the drug whenever they are experienced. Rehab programs divide anti-craving strategies into 3 groups:
Behavioral can include learning how to distract oneself so the urge will go away and not be acted up, making conscious decisions not to use the drug, and so on.
Cognitive focuses on positive self-talk to deal with the craving before, during and after it is experienced, helping the person feel empowered. It can help decrease “automatic” behaviors a person might have developed through their health condition or addiction, just as reaching for a pill every time they felt a twinge of pain, and coming up with different coping strategies instead.
Relaxation skills can include deep breathing, guided imagery, and visualization to reduce cravings by reducing stress. They can also help the recovering addict focus on the positive outcome, a life free from the drug they have been addicted to.
The treatment program a person follows will depend in part on whether or not they have tried to detox in the past, and why they were not successful.
Other opioid treatments for body, mind and spirit
The most successful rehab programs will often involve different methods of healing. These include better nutrition, exercise, and meditation to control pain and also drug cravings. A holistic approach that takes into account why a person might have become addicted in the first place and what they need to recover and not relapse has been shown to be the best way to treat addiction.
Pain relief from chronic pain will also be important, if that has been the cause of the addiction. Pain management through acupuncture, acupressure, and other complementary and alternative medicines (CAM) and traditional Chinese Medicine (TCM) can help. Exercise is a great natural pain reliever as well.
Good self-care is important in terms of eating, sleeping, stress management and stress-relief techniques. The recovering addict should try to formulate a routine in which they take better care of themselves so they are less likely to suffer pain, get stressed, and potentially relapse.
Opioid treatments will also depend on the reason for the pain. For example, athletes who are often injured, or dealing with a past injury, might find physical therapy useful, and supportive kinesiology taping.
Working with the doctor
The Centers for Disease Control and Prevention (CDC) have drafted guidelines with respect to prescribing opioids.
While some have complained they are too restrictive for people with severe pain, such as cancer sufferers, a lot of the pushback has been from pharmaceutical companies themselves, who stand to lose a lot of money if opioids prescribing is cut back.
Some of the most important guidelines include doctors:
• Only prescribing opioids if the expected benefits for both pain and function outweigh the risks of addiction and other side effects
• Only prescribing short-acting opioids instead of extended-release, long-acting opioids when first prescribing
• Starting by putting the patient on the lowest possible dose
• Giving a patient with acute pain the lowest possible dose of short-acting opioids, and only giving them enough pills to cover them for a reasonable period of time that they would expect to recover within
• Only prescribing long-term opioid therapy for those with chronic pain once they have set clear treatment goals for the patient.
• Only continuing prescribing in long-term cases if the goal/s are met or if there is any evidence of “clinically meaningful improvement” that would outweigh the safety risks involved with opioids
• Evaluating patients within 1 to 4 weeks of starting long-term opioid therapy, and at least every three months thereafter, to see if goals are met and the benefits outweigh the risks.