Opioid Addiction and Treatment

Opioid addiction is a medical condition that creates long-term changes to the brain. Early intervention can help you avoid some of the long-term health conditions associated with opioid addiction treatment in Richmond. McShin partners with leading doctors in Richmond, VA and the surrounding areas to offer clients the best medical care for opioid treatment. 

Breaking free from the cycle of prescription drugs, heroin, or fentanyl use requires more than willpower. Medications, counseling, and other treatments can help you recover. 

What are opioids?

Opioids are a drug type that includes strong prescription pain relievers like oxycodone, hydrocodone, fentanyl and tramadol. Heroin is also an opioid.

A health care provider may prescribe an opioid to you if you have been injured or have had surgery. Opioids are used to reduce the pain from cancer and other severe health conditions. Some providers prescribe them for long-term pain management.

When taken for a short time, prescription opioids for pain relief are generally safe as prescribed by your healthcare provider. However, the misuse and addiction of these drugs are still potential risks.

Treating Opioid Addiction

Treatment Plan

When a patient starts addiction treatment with a clinician, they often sign an agreement about what to expect during treatment. This may include treatment goals, medications, treatment schedule and counseling plan.

 The treatment plan will also include the following:

• Regular visits to a treatment facility

• Medications such as methadone, buprenorphine, and naltrexone are often used to treat opioid addiction.

• Patient compliance with treatment

• Considerations for reoccurrence of use and other safety concerns.

Patient Participation

Patients who participate in treatment and recovery tend to do better. Addiction is a chronic disease, and treatment will be ongoing. Given the complexity involved in treating a patient, it is recommended that the patient and doctor agree on a treatment plan before beginning treatment. Patients should expect to be treated with respect and have their concerns listened to when starting or changing treatment plans.

Patients must disclose all other medications they are taking and if they drink alcohol regularly. This is very important because certain medications and regular alcohol use can cause major problems with certain treatment medications.

 A patient’s responsibilities include:

• Making all scheduled appointments

• Agreeing to a drug-testing program on a regular basis

• Medications must be taken as prescribed to work effectively.

• Using only the drugs that you have been prescribed

• Encouraging family and friends to be involved

• To avoid the temptation to use a substance again after a period of not using it, people may take steps to avoid certain people, places or situations.

Types of Opioid Treatment

When people with addictive disorders go to the emergency room, they often require an evaluation to determine what specific treatment is needed. Many hospitals provide this assessment and then connect patients to the appropriate program. Some general hospitals don’t admit patients solely for withdrawal or substance abuse treatment unless there is another factor present, such as a significantly different medical problem.

Opioid addiction can be treated with a variety of therapies, including both outpatient therapy and inpatient programs. Some treatment programs employ medications to help patients make the transition from physical dependence on opioids. McShin partners with doctors that will prescribe your medication while you attend our residential program or reside in our recovery housing. 

Counseling

Counseling is an important part of a treatment plan, and it is usually required with all medications. It should be done with a qualified clinician or health professional who will play an important role with the care team. Counseling enables patients to address issues such as family problems and social isolation that may contribute to their addiction.

 Here are some examples:

• Improving self-esteem and feelings of self-worth

• Stressful situations at work or home

• Spending time with people who are under the influence of drugs or alcohol

People may also find it beneficial to join self help support groups. Counseling is also available for friends and family of those dealing with addiction. Remember that friends and family can be affected by an individuals actions.

Detox and Withdrawal Management

The term “opioid withdrawal” refers to the wide range of symptoms that occur after stopping the use of opioid drugs. The length and severity of withdrawal will depend on how long a person has been taking opioids and which drugs they took. While usually lasting three to five days, withdrawals can last as long as ten days if not treated. 

Although withdrawal from opioids can cause very troubling symptoms, such as vomiting, cramps, and sweating, it is not a life-threatening condition. The recommendation for people trying to stop taking drugs is to use medications to control withdrawal rather than quitting “cold turkey.” Forgoing prescribed medication-assisted treatment programs or attempting to quit “cold turkey” can lead to stronger cravings and continued use. 

Evidence supports the use of withdrawal management on its own or with counseling as one component in a comprehensive treatment plan for opioid use. In combination with counseling and other support, maintenance medication is recommended for treating opioid addiction.

Medications

Because withdrawal symptoms are a major reason for the reoccurrence of use and further prescription drug abuse, medications can help prevent symptoms and aid in recovery. Once the physical symptoms of withdrawal are over, you are still at risk for reoccurrence of use. Psychological and social factors may trigger a return to drug use. Common triggers for reoccurrence of use include stress and situations that remind the recovering individual of the pleasure that drugs brought in the past. Effective, lifelong treatment for opioid addiction usually involves long-term medication and counseling or talk therapy.

Many treatment plans include medication. The type of medication chosen depends on the patient’s different situations and the treatment setting. Medications commonly used in the treatment of opioid addiction include methadone, buprenorphine, and naltrexone. These medications require a risk management plan, and counseling is recommended. Each medication has its risks and benefits and a special way of being started. It can be safely taken for years on end with no adverse effects. When used properly, these medications help patients manage addiction so they can recover. As part of the treatment process, both the clinician and the patient should review the risks and benefits of each medication together.

Buprenorphine (Suboxone)

The FDA has approved Buprenorphine as a medication used for treating opioid use disorder, and it is a proven treatment option for helping people stop abusing opioids. Buprenorphine is a partial opioid agonist that reduces the symptoms and cravings of opioid withdrawal and prevents fatal overdoses when used as directed.

Because it is a partial agonist, the drug has a ceiling effect, causing the receptors to be occupied once doses are properly calibrated. Buprenorphine has a lower risk for overdose and death than other opioids when taken as directed. It also means that people who are physically dependent on opioids will not experience euphoria when taking buprenorphine as prescribed.

For most people, initiating buprenorphine requires that they are already experiencing moderate opioid withdrawal. If you initiate buprenorphine before experiencing moderate withdrawal, it may cause severe withdrawal symptoms.

Naltrexone (Vivitrol/Revia)

Naltrexone is an opioid receptor antagonist that attaches to opioid receptors in the brain. The medication blocks the effects of opioids at these sites, thereby reducing cravings and preventing addictive behaviors such as drug use. Naltrexone comes in oral (ReVia) and long-acting injectable (Vivitrol) formulations. Both formulations are indicated for alcohol use disorder, but only the long-acting injectable formulation is indicated to treat opioid use disorder.

Naltrexone, an opioid receptor antagonist, can be prescribed to help people stop misusing opioids and may be an important part of an opioid use disorder treatment plan. The drug works by blocking the effects of opioids in your brain, reducing your cravings for these substances.

Naltrexone is usually prescribed in pill form to treat alcohol addiction, while extended-release intramuscular injectable naltrexone can be used for alcohol and opioid use disorders. Naltrexone is not an opioid, so it is not addictive and does not cause withdrawal symptoms upon cessation. Naltrexone also does not carry the risk of being abused.

As a result of the risk of precipitated and protracted opioid withdrawal, naltrexone should not be used in people actively using opioids or who have used opioids within the past seven to ten days. These people should have a urine toxicology test for opioids and/or fail a naloxone challenge test before taking naltrexone. Caution should be used in people who have acute and/or severe liver disease and people who are allergic to naltrexone. It should not be used during pregnancy.

Residential and hospital-based treatments for opioid misuse

Residential treatment programs and recovery community organizations combine housing and connection to treatment services. You live with peers who are in recovery, and you can support each other as you work toward long-term sobriety. These recovery environments tend to be very structured and often include several different kinds of counseling, recovery groups, and peer based recovery groups. 

Encouraging Someone to Seek Help

Individuals with substance use problems respond better to treatment when ready to deal with their issues. However, if you know someone who is using opioids make sure you support them non judgmentally and encourage professional care as well as self care. 

How successful is opioid treatment?

Treatment for substance use disorder can be successful in many cases but varies from person to person, depending on how severe their addiction and any complications caused by comorbidities like alcohol use or mental illness. It has been shown in studies that people with depression are more likely to develop substance use disorders. At the same time, people who use drugs like alcohol are also more likely to develop substance use disorders.

Individuals displaying both mental health and substance use disorders need integrated treatment that helps them tackle their physio-psycho-social issues all together. Environmental, family, and friend relationships are also key factors in successful recovery. 

If you or someone you know is struggling with an addiction to opioids – reach out to the McShin Foundation today by filling out our contact form or calling 804-249-1845.