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The Truth About Opioid Addiction

By Dr. Brian Wind Ph.D.
4 FAQ

JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field and their own personal recovery.

  • Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310652/

  • Co-pay Savings Program: VIVITROL. Vivitrol; Alkermes Inc. Retrieved 8/25/21, from https://www.vivitrol.com/co-pay-savings-program

  • Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction science & clinical practice, 4(2), 39–47. https://doi.org/10.1151/ascp084239

  • Dydyk AM, Jain NK, Gupta M. Opioid Use Disorder. [Updated 2021 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553166/

  • Evans, C. J., & Cahill, C. M. (2016). Neurobiology of opioid dependence in creating addiction vulnerability. F1000Research, 5, F1000 Faculty Rev-1748. https://doi.org/10.12688/f1000research.8369.1

  • Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: implications for treatment. Science & practice perspectives, 1(1), 13–20. https://doi.org/10.1151/spp021113

  • McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525. https://doi.org/10.1016/j.psc.2010.04.012

  • (2017, July). What is Cognitive Behavioral Therapy? American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

  • (2020, December 15). Buprenorphine Sublingual and Buccal (opioid dependence). MedlinePlus.Gov; U.S. National Library of Medicine. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine

  • (2021, May 14). Buprenorphine. SAMHSA; U.S. Department of Health and Human Services. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine

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All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.

More than 70% of overdose deaths involve opioids. Learn why drugs like heroin, oxycodone and fentanyl are so deadly and what you can do to get help.
Opioid Addiction Topics
  • Opioid Addiction
  • Signs of Opioid Addiction
  • Opioid Withdrawal
  • Opioid Addiction Medication
  • Counseling for Opioid Addiction
  • Opioid Articles

Opioid Addiction

Prescription Opioids
Street Opioids

Signs of Opioid Addiction

Families wondering if their loved one is addicted to opioids should look for physical signs, including:

  • Small, pinpoint pupils
  • Itching
  • Nausea & Vomiting
  • Nodding-off or suddenly falling asleep
  • Wearing long sleeves to cover up track marks or a heroin abscess

Opioid Withdrawal

Agitation, anxiety and irritability are common when addicts cannot access opioids and begin to experience withdrawals.

The most common opioid withdrawal symptoms include:

  • Nausea and vomiting
  • Diarrhea
  • Insomnia
  • Sweating and chills
  • Anxiety
  • Increased body temperature
  • Racing heart
  • Muscle and bone pain
  • High blood pressure
Post Acute Withdrawal Syndrome (PAWS)
Some opioid addicts develop PAWS, where the milder withdrawal symptoms linger for weeks or even months after getting sober – especially cravings, sleep disruption, anxiety, exhaustion and “brain fog.”

Opioid Addiction Treatment

Treatment for opioid addiction starts by addressing physical withdrawal symptoms, usually using medications. Once stabilized and comfortable, the underlying issues that lead to opioids use are addressed with various forms of therapy and sometimes with continued medications.

Opioid Addiction Medication

You don’t need to come to treatment knowing what opioid medication you need. (That’s the doctor’s job). But, there are FDA-approved options worth considering.

MedicationBrand NameFunctionSide EffectsUses
Buprenorphine (without Naloxone)Subutex, SublocadeFights cravings and withdrawal symptomsHeadache, nausea, constipation, sleep problems

Used during detox or long-term given at a clinic
Subutex - pill
Sublocade - monthly injection

Buprenorphine + NaloxoneSuboxone, ZubsolvFights cravings and withdrawal symptomsHeadache, nausea, constipation, sleep problemsUsed long-term, taken at home daily as a film that dissolves under the tongue
NaltrexoneVivitrol, Revia, DepadeDiscourages relapse by blocking opioid effectsNon-addictive, no serious side effectsVivitrol - Injection given in a doctors office monthly (most effective)
Revia/Depade - taken at home daily as a pill
MethadoneDolophine, MethadoseFights cravings and withdrawal symptomsHeadache, nausea, constipation, sleep problemsUsed long-term, given at a clinic daily (no longer recommended)

There’s not one “right” medication for every opioid addiction.

  • If you’ve been in-and-out of rehabs with little lasting sobriety, using Suboxone for six-month or more might be a good option, but must be tapered down with a doctor.
  • If you’ve not been able to take Suboxone properly in the past, Sublocade monthly shots might be a better fit.
  • Vivitrol is my recommendation for your first time in treatment because it’s non-addictive, although Vivitrol is expensive without insurance ($1000 per monthly shot).

Also, many patients stay sober without continuing medications after rehab. That is always an option.

Opioid Maintenance Therapy

Usually, these programs use Suboxone. Drugs like Suboxone allow opioid addicts to function normally and prevent relapse as the person creates a life in recovery.

Doctors work with the patient to slowly lower their dose without sending the patient into withdrawals that could lead to relapse. Suboxone (or other Buprenorphine medications) can be used for years, but my recommendation is 12 months or less.

How Opioid Medications Work

Full Agonist

Methadone is no longer recommended because it fully activates the opioid receptor. Buprenorphine is safer.

Partial Agonist

Buprenorphine (Suboxone) doesn’t fully activate the opioid. Cravings are satisfied, but without the high.

Antagonist

Naltrexone (Vivitrol) blocks the opioid receptors, so using opioids make you sick not high.

Counseling for Opioid Addiction

The two psychological techniques proven to help people overcome opioid addiction are Cognitive Behavioral Therapy and Dialectical Behavioral Therapy delivered as group and one-on-one sessions.

Cognitive Behavioral Therapy (CBT)

CBT involves changing the thoughts and behavior patterns associated with opioid abuse. It breaks down negative, untrue or unhelpful thoughts that dominate our minds before we make the decision to use drugs and offers healthy tools to replace the need to use.

icon

“I feel like a failure. Getting high will make me feel better.”

CBT teaches us to recognize destructive thoughts early to prevent a negative spiral of thoughts and feelings. We learn to focus on positive, helpful thoughts instead.

icon

“I get so nervous before my annual review, I need something to take the edge off.”

CBT teaches us that simple actions change the way we behave. Tools like breathing exercises and meditation help us calm our nerves without having to resort to drugs.

Dialectical Behavior Therapy (DBT)

DBT works from the same fundamentals as CBT with an emphasis on mindfulness and acceptance.

Stress and discomfort are a part of life. Learning to deal with these feelings sober is essential to recovery. The best way to do this is to calm your mind and bring yourself back to the present.

CBT and DBT aren’t specific to opioid addiction. The same techniques and ideas are used for recovery from other substance issues like alcoholism and meth addiction, as well as other psychological problems like depression and anxiety.

Opioid Treatment Centers

Most people choose a treatment center based on their insurance.

  • Medicare – Only hospital-type settings are usually covered, so it’s best to start your search by calling the number on the back of your Medicare card.
  • Medicaid – Only certain centers in your state will accept Medicaid. For example, Tenncare Drug Rehab in Tennessee. Call the number on the back of your Medicaid card for your local options.
  • No Insurance – It’s tough, but not impossible. Try FindTreatment.gov using the free or sliding scale filters and ask around at local recovery meetings.
  • With Insurance – The centers listed below are in-network with Tricare, Tirbal and all private insurances like Blue Cross, Aetna, Cigna and United.
Tennessee
4.5 (149)

Opioid Rehab Tennessee

Listed as a top 2 rehab in the country by Newsweek, Addiction Center and the BBB.

Kentucky
4.8 (172)

Heroin Rehab Kentucky

The highest-rated in-network heroin rehab on Google.

The Top 5 Opioid Addiction Articles

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Opioid Articles

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