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Last Updated: August 24, 2021
Opioids are strong pain relievers that include oxycodone (OxyContin) and hydrocodone (Vicodin). These drugs can be effective and safe when you use them for short periods of time to relieve pain. But if you take too much or stay on them for too long, you can become dependent on them. Over the past decade, our understanding of opioid use disorder (OUD) has evolved. We now know that most individuals who continue to abuse opioids do so not so much for the narcotic ‘high’ but, rather, to prevent the discomfort and misery that begins as soon as the opioid wears off. Simply stated, they abuse to avoid withdrawal. Opioid use disorder symptoms include a constant urge to use these drugs, trouble stopping them, and needing to take larger amounts to get the same effects.
Opioid use disorder has reached epidemic status in the United States, affecting more than 2 million people. Overdose deaths due to opioid use have risen steadily, reaching nearly 50,000 a year. Getting on an opioid use disorder treatment can prevent an overdose and reduce your dependence on these drugs.
Opioid Use Disorder Therapies
Once you have become dependent on opioids, stopping them cold turkey could lead to withdrawal symptoms such as:
- Fast heart rate
You’ll need help from a doctor or an addiction specialist to slowly and safely wean your body off of opioids. Depending on the dose you were on and how long you took opioids, it could take months or years for you to fully recover.
Opioid use disorder treatment often involves a combination of medication and counseling. Some medication-assisted treatment (MAT) programs are inpatient, meaning that you live at the center while you get treatment. This type of intensive program may be best if you also have another substance use disorder, such as alcohol use disorder.
Other programs are outpatient. You live at home but visit the center often–sometimes every day. Outpatient programs may be in a hospital, a community mental health center, or another setting.
Medication for opioid use disorder reduces cravings and prevents withdrawal symptoms. It lets you focus on the factors that cause you to use opioids.
A few types of medication for opioid use disorder are available, and they each work in slightly different ways. Your doctor will help you choose the one that’s right for you.
Methadone is one of the most common opioid use disorder treatments. It strongly activates the same receptors in your brain as opioids do. But because its effects are less intense and longer-lasting than opioids, methadone reduces cravings and withdrawal symptoms. This treatment is very effective, but you can only get it at a special methadone clinic. Risks include dangerous heart rhythms and overdose.
Buprenorphine (Sublocade, Suboxone, Subutex) is a newer treatment. It also activates opioid receptors in your brain. Plus, it blocks other opioids, so if you do take an opioid while you’re on buprenorphine, you won’t feel any effects. This medication can cause side effects like heart rhythm problems and overdose. Taking buprenorphine together with another drug called naloxone reduces the risk of overdose.
Naltrexone (Vivitrol) works differently from the other two medications. Instead of activating opioid receptors in your brain, it blocks them. So if you do take opioids, you won’t feel a high and won’t be able to overdose. However, you can still accidentally overdose on naltrexone. Taking the long-acting injection form is less likely to cause an overdose.
It can 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 keep adjusting the dose until it manages your cravings and withdrawal symptoms.
There is no ideal length of time to stay on medication for opioid use disorder. Once you’re stable, your doctor may begin to taper you off the drug by slowly reducing the dose over a period of weeks to months. But because there is a real risk of relapse, you may need to stay on medication for many years to fully control your opioid dependence.
The second part of opioid use disorder treatment is therapy. Cognitive behavioral therapy (CBT) helps you change the thoughts that may have contributed to you abusing opioids, or that may be preventing you from reaching recovery. CBT also motivates you to change, and helps you stick to your treatment program. It is most effective when you combine it with medication.
Education is another part of opioid use disorder treatment. Your therapist will teach you strategies to manage your pain and emotional distress without turning to opioids.
Another way to get therapy is through a self-help program like 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 has groups that meet across the country. NA can help you change the way you think about opioids, and realize that it is possible for you to change.
Opioid use disorder therapies don’t work overnight. You have to stick with them to see results. After you get through your first treatment program, you’ll need to be vigilant to ensure that you stay off drugs. This may involve counseling or other emotional support, education on how to treat pain without opioids, and careful monitoring for signs of relapse.
Opioid use disorder may feel 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 drugs. Be patient, be persistent, and lean on the doctors and therapists who are trying to help you.