Signs of Opioid Addiction
Families wondering if their loved one is addicted to opioids should look for physical signs, including:
- Small, pinpoint pupils
- Nausea & Vomiting
- Nodding-off or suddenly falling asleep
- Wearing long sleeves to cover up track marks or a heroin abscess
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
- Sweating and chills
- Increased body temperature
- Racing heart
- Muscle and bone pain
- High blood pressure
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.
|Medication||Brand Name||Function||Side Effects||Uses|
|Buprenorphine (without Naloxone)||Subutex, Sublocade||Fights cravings and withdrawal symptoms||Headache, nausea, constipation, sleep problems|| |
Used during detox or long-term given at a clinic
|Buprenorphine + Naloxone||Suboxone, Zubsolv||Fights cravings and withdrawal symptoms||Headache, nausea, constipation, sleep problems||Used long-term, taken at home daily as a film that dissolves under the tongue|
|Naltrexone||Vivitrol, Revia, Depade||Discourages relapse by blocking opioid effects||Non-addictive, no serious side effects||Vivitrol - Injection given in a doctors office monthly (most effective) |
Revia/Depade - taken at home daily as a pill
|Methadone||Dolophine, Methadose||Fights cravings and withdrawal symptoms||Headache, nausea, constipation, sleep problems||Used 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
Counseling for Opioid Addiction
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.
“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.
“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.
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