The Truth About Opioid Addiction

Opioid addiction is a brain disease diagnosed when the drug is continued even though it is causing harm – including relationship, job or legal issues. Addiction to opioids happens regardless of whether the drugs were prescribed by a doctor or acquired illegally on the street.

What is an opioid?

Opioids describe prescription and illegal drugs used for pain relief.

These drugs are made from the opium poppy plant or recreated synthetically to impact specific opioid receptors in the brain.

Yes. In the simplest definition, a disease is something that changes cells in a negative way. Drug addiction changes how cells in the brain communicate, which re-wires how a person thinks, feels and behaves.

Opioid addiction changes the brain in three fundamental ways:

1. Tolerance – With repeated use of opioids, the brain adjusts to the flood of dopamine, which is what causes the feelings of pleasure. These brain cells are turned down, which means you need more of the drug to feel the same desired effect. It also makes life without the drug less pleasurable.
2. Dependence / Withdrawal – The body becomes so used to opioids that it needs them to feel normal. If opioids aren’t present, brain chemistry is off balance resulting in withdrawal symptoms like nausea, sweating and anxiety.
3. Cravings – The brain is conditioned to desire opioids, even though the individual knows they are harmful and unhealthy. Opioid cravings are extremely powerful and can occur even after years of abstinence.

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

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

Opioids, especially heroin and fentanyl, are notorious for withdrawal symptoms. Patients describe cold-turkey opioid withdrawal as feeling like every bone in your body is breaking, but symptoms are much more manageable at a medical detox center.

The most common opioid withdrawal symptoms include:

How long do opioid withdrawal symptoms last?

Opioid withdrawal can begin in as little as a few hours after the last dose and typically clear up within 4-7 days. Most people feel significantly better within a week.

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.

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.

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

Opioid maintenance therapy uses weaker opioids to satisfy the brain’s craving for the drug without getting you high.

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

Opioid medications pacify opioid receptors in the brain that are used to being activated by drugs. Each medication works slightly differently.

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.

“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.