How Is Opiate Addiction Treated?
Opioids and opiates have ravaged the United States for decades.
Today, we’ll be highlighting the most effective, evidence-based approach to opiate addiction treatment.
In 2017, the year when the opioid epidemic was declared a national emergency, 1.7 million people in the US reported a substance use disorder related to prescription opioid painkillers. Over 650,000 reported heroin use disorder. Note that these two are not mutually exclusive.
Before we explore the most efficient route to recovery from opiate addiction or opioid addiction, we’ll glimpse at each class of drug in turn. While the words are sometimes used interchangeably, opiates and opioids are not the same.
What are Opiates?
Unlike opioids, opiates are derived from natural sources, the seeds of the opium poppy.
Opiates are narcotic analgesics, the most popular being heroin and morphine.
Sedative narcotics, opiates function by suppressing activity in your central nervous system. This class of drug also changes the way your brain interprets pain as it binds to your naturally-occurring opioid receptors.
The opium plant has a long history of recorded use, dating back to at least 1,500 BC.
The number of heroin users in the United States has remained relatively stable over recent years, with roughly one million Americans using the drug each year, almost one-fifth of these as first-time users. The number of first-time users has more than doubled in the past ten years. Of these one million heroin users, more than 600,000 are diagnosed with heroin use disorder, an alarmingly high percentage.
Opiates, then, are ruthlessly efficient analgesics, but they only mask symptoms without in any way curing the condition. Instead, the drugs alter your consciousness by producing intense euphoria.
What are Opioids?
Opioids are synthetic or semi-synthetic narcotic analgesics. The active ingredients of opioids are man-made, with the drugs not occurring in natural form. When you take opioids, the drug interacts with your body’s opioid receptors. The medication numbs the body and mind.
Common opioids include:
Use short-term, opioids can effectively reduce pain. This class of drug can also lessen anxiety in some patients.
When used as intended, opioids change the way you perceive pain. If abused, opioids bring about euphoric feelings, but it’s only a fleeting high. Side effects of nausea and drowsiness are commonplace. The transient nature of the high is what causes people to use more and more opioids as they chase what they will never re-attain.
Tolerance to opioid drugs rapidly builds, so you’ll need increasingly more of the drug to achieve the same effects. Dependence and opioid addiction can easily follow.
Opiates and Opioids
- Heroin (opiate): Heroin is a Schedule I narcotic, classified by the federal government as having no accepted medical use. Sometimes, and in limited applications, pharmaceutical-grade heroin – diacetylmorphine – is used by doctors in Canada and parts of Europe. Heroin in the United States is available exclusively on the black market, online and offline.
- Morphine (opiate): Morphine occurs naturally in the seeds of the opium poppy plant. The drug is used principally for pain relief. This drug falls under schedule II, meaning it has some medical use but the potential for dependence and abuse. You can only obtain morphine on prescription.
- Buprenorphine and methadone (opioids): Buprenorphine and methadone are both FDA-approved for treating opioid withdrawal and opioid use disorder. They work by targeting the same receptors in your brain that opioids target.
- Fentanyl (opioid): Fentanyl is the strongest opiate-based painkiller available. This drug is 50 times more potent than morphine. This drug is potentially deadly if used outside a medical setting, typically for pain relief in terminal cancer patients. More and more dealers in the United States are cutting heroin with fentanyl, leading to a dramatic increase in overdose rates.
- Hydrocodone and oxycodone (opioids): Both of these semi-synthetic opioids are used for treating both acute and chronic pain. Similar structurally to morphine, they are classified in schedule II for their medical benefits alongside high potential for abuse and dependence. This runs counter to the myth propagated by big pharma that triggered the opioid epidemic.
Opiate Addiction Treatment: What Works Best?
An analysis of current research shows that treating opioid use disorder and heroin use disorder pharmacologically can be beneficial, and can also reduce some of the attendant risks of withdrawal.
Medication-assisted treatment for opiate addiction improves retention in treatment programs, while also bringing about some social benefits with reduced criminal activity and less transmission of infectious diseases.
The other chief advantage of MAT is the way some medications can be used to alleviate many of the adverse withdrawal symptoms associated with heroin detox and withdrawal. Medications can be used for:
Medications appropriate for use treating opiate addiction can be categorized as follows:
- Agonists: Activate your opioid receptors fully
- Partial agonists: Activate your opioid receptors mildly
- Antagonists: Block your opioid receptors while interfering with the rewarding effects of opioids
Medication is personalized for each client, and from the above three groups, these are the drugs most frequently used for treating opiate addiction:
- Methadone: This is an extremely slow-acting opioid agonist. Patients take oral doses of methadone so it takes a while to take effect. Used since the 1960s for treating heroin addiction, methadone is administered in a controlled setting via outpatient treatment programs.
- Buprenorphine: Buprenorphine helps to reduce the cravings associated with heroin withdrawal. The drug does not deliver the high of heroin, and nor does it trigger the same negative side effects. Suboxone is a form of buprenorphine that also contains naloxone. Approved by the FDA in 2002, generic versions of the drug gained FDA approval in 2013. This widened access to the medication. Six-month implants of buprenorphine were FDA-approved in 2016. Monthly injections are also available. This form of delivery removes the barrier of daily dosing.
- Naltrexone: Naltrexone is an opioid antagonist that interferes with the way opioids act. Naltrexone is neither sedating nor addictive. FDA-approval for an injectable form (Vivitrol) means there’s less hassle involved with taking the medication.
Medication can be used to great effect when treating opiate addiction, and these treatments can be delivered either in residential rehab or through an intensive outpatient program, assuming that you have a suitably supportive home environment.
Medication is only one arm of treatment, though. MAT will be accompanied by a range of behavioral therapies and psychotherapies. Once the toxins are gone from your body and you’re stable, the proper work of recovery can begin.
CBT (cognitive-behavioral therapy) can be highly effective if you are addicted to opiates. You’ll learn how to better identify the triggers that lead you to crave heroin. You will also discover how to formulate and implement healthy coping strategies. You should feel stronger in your recovery as a result of practicing CBT, and you should minimize your chances of relapse.
Another modality that can be equally effective is contingency management. Here, healthy behaviors are rewarded using a points-based system.
Beyond these basics, there are other forms of therapy that can work depending on your circumstances and your addiction. DBT, for instance, is a highly specific form of CBT that can also work with heroin use disorder.
How can you go about seeking opiate addiction treatment, then?
Getting Help with The District Recovery Community
Are you addicted to opiates? If so, it’s not surprising given the high potential for abuse and addiction this substance brings with it.
Maybe it’s your loved one dependent on heroin, and you’re looking to help them move beyond the chains of addiction.
Either way, here at The District Recovery Community, we’ll help you or your loved one with personalized treatment for opiate addiction.
Reach out to our friendly team at TDRC and we’ll outline the various suitable options for treatment, from partial hospitalization programs through to intensive outpatient programs. If you have a mental health condition co-occurring alongside heroin addiction, we have dual diagnosis treatment ideal for addressing both issues simultaneously.
Whatever form of treatment you require, we can make it happen. All you need to do is call 844.287.8506.