Opioids are powerful pain relievers that include oxycodone (OxyContin) and hydrocodone (Vicodin). These medications can be effective and safe when used for short periods of time to relieve pain. But if you take too much of it or stay on it for too long, you can count on it. Over the past decade, our understanding of opioid use disorder (OUD) has evolved. We now know that most individuals who continue to use opiates do so not so much for the narcotic ‘high’ but, instead, to prevent the discomfort and misery that begins once the opioids wear off. Simply put, they abuse it to avoid withdrawal. Symptoms of opioid use disorder include a persistent desire to use these medications, difficulty stopping them, and the need to take larger amounts to get the same effects.
Opioid use disorder has reached pandemic status in the United States, affecting more than two million people. Overdose deaths from opioid use have risen steadily, to nearly 50,000 per year. Getting treatment for opioid use disorder can prevent an overdose and reduce your dependence on these medications.
Opioid use disorder treatments
Once you become dependent on opioids, stopping them may trigger withdrawal symptoms such as:
- fast heart rate
You will need help from a doctor or addiction specialist to slowly and safely wean your body off the opioids. Depending on the dose you have been taking and how long you have been taking it, it may take months or years for you to fully recover.
Treatment for opioid use disorder often includes a combination of medication and counseling. Some drug-assisted therapy (MAT) programs are inpatient, which means you live in the center while you receive treatment. This type of intensive program may be best if you also have a substance use disorder, such as alcohol use disorder.
Other outpatient programs. You live at home but visit the center often – sometimes every day. Outpatient programs may be in a hospital, community mental health center, or other location.
Opioid use disorder medication reduces cravings and prevents withdrawal symptoms. It allows you to focus on the factors that cause you to use opioids.
A few types of medications are available for opioid use disorder, and they each work in slightly different ways. Your doctor will help you choose the right one for you.
Methadone is one of the most common treatments for opioid use disorder. It strongly activates the same receptors in your brain as opioids. But because its effects are less severe and long-lasting than opioids, methadone reduces food cravings and withdrawal symptoms. This remedy is very effective, but you can get it only in a private methadone clinic. Risks include dangerous heartbeat and overdose.
Buprenorphine (Sublocade, Suboxone, Subutex) is a newer treatment. It also activates the opiate receptors in your brain. In addition, it blocks other opioids, so if you take an opioid while you’re taking buprenorphine, you won’t feel any effects. This medicine can cause side effects such as heart rhythm problems and overdose. Taking buprenorphine with another medicine called naloxone reduces the risk of an overdose.
Naltrexone (Vivitrol) works differently from the other two medicines. Instead of activating the opioid receptors in your brain, it blocks them. So if you take opioids, you won’t get high and you won’t be able to overdose. However, you can still accidentally overdose on naltrexone. Taking the long-acting injectable form is unlikely to cause an overdose.
It may take a few days or weeks for your doctor to find the dose that helps you feel better without causing too many side effects. Your doctor will continue to adjust your dose until he or she addresses your food cravings and withdrawal symptoms.
There is no ideal length of time to stay on medication for an opioid use disorder. Once you become stable, your doctor may start you off the medication by slowly reducing your dose over a period of weeks to months. But because there is a real risk of relapse, you may need to continue taking the medication for many years to fully control your dependence on opioids.
The second part of opioid use disorder treatment is therapy. Cognitive behavioral therapy (CBT) helps you change thoughts that may have contributed to your abuse of opioids, or that may be preventing you from reaching recovery. Cognitive behavioral therapy also motivates you to change, and helps you stick to your treatment program. It is most effective when combined with medication.
Education is another part of opioid use disorder treatment. Your therapist will teach you strategies for dealing with pain and emotional distress without resorting to opioids.
Another way to get treatment is through a self-help program such as Narcotics Anonymous (NA). Using the same 12-step method used in Alcoholics Anonymous (AA), NA helps people recover from substance use disorder through education, peer support, and group counseling sessions. This free program contains groups that meet across the country. Narcotics Anonymous can help you change the way you think about opioids, and realize that they can change.
Treatments for opioid use disorder do not work overnight. You have to stick to it to see results. After going through your first program of treatment, you will need to be vigilant to make sure you stay off the drugs. This may include counseling or other emotional support, education on how to treat pain without opioids, and careful monitoring for signs of relapse.
Opioid use disorder may seem like it’s taking over your life, but you can overcome it. With the right combination of treatments, it is possible to stop your dependence on these medications. Be patient, be persistent, and rely on the doctors and therapists trying to help you.