TREATMENT FOR NARCOTIC AND OPIOID PAINKILLER ADDICTION
DETOXIFICATION & WITHDRAWAL
Narcotic and opioid painkiller addiction leads to real changes in certain areas of the brain. Prescription drug addiction alters the circuits responsible for mood and “reward” behaviors. In addition, long-term prescription drug abuse affects virtually all the systems in the body. Cutting off the supply abruptly leads to opioid withdrawal symptoms.
Symptoms of opioid withdrawal include:
Craving for drugs
Someone with an established narcotic addiction will usually do almost anything to try to avoid the intensely unpleasant process of withdrawal, which is a major reason for relapse and continued abuse.
Opioid withdrawal can last hours, days or weeks, depending on how long and how much a person has used the drug of choice. After the intense initial symptoms subside, some physical and mental discomfort may persist for weeks.
MEDICATIONS FOR OPIOID WITHDRAWAL
There are medications that are used to prevent symptoms of opioid withdrawal during detox, easing the person out of physical dependence.
The most commonly-used are listed below:
Methadone is a long-acting opioid drug. It activates the same opioid receptors as narcotics, effectively eliminating withdrawal symptoms. Providing the correct dose of methadone prevents opioid withdrawal symptoms and eases drug craving but it does not provide the euphoria. The dose can be slowly tapered off, freeing the person from physical dependence without withdrawal symptoms. Methadone is the most effective known treatment for narcotic addiction.
Buprenorphine and Naloxone (Suboxone) is a newer combination drug that helps for detox from prescription opioid addiction. Buprenorphine activates opioid receptors, reducing drug craving and preventing withdrawal. Naloxone helps prevent misuse of the medication.
MAINTENANCE THERAPY AFTER DETOX
Experts say psychological and social factors are the main drivers that push people with addiction back to using. Stress and situations that remind the brain of the drug’s pleasure are common triggers. Most people who go through detox and short-term counseling will relapse to prescription drug abuse.
Studies show that the chances of beating narcotic addiction are better with long-term maintenance therapy with either methadone or buprenorphine paired with naloxone (Zubsolv, Bunavail, Suboxone). This is often called Medication Assisted Treatment (MAT). These drugs are used during the maintenance phase of treatment. People on these drugs are still opioid-dependent, but they are often freed from their destructive drug addiction. They can return to work, drive without impairment, and function normally in society. Naloxone has also been combined with oxycontin (Targiniq ER ) to deter abuse by snorting or injecting the drug. A person can still become addicted by taking it orally, however.
Methadone is the best-studied, most effective method of recovery from narcotic addiction. Suboxone, while newer, has gained wide acceptance as maintenance therapy.
Some people have a high rate of relapse when maintenance therapy is stopped, and so they remain on the medicines for decades. In others, maintenance therapy is tapered off over months to years. It is important to work with your doctor and therapists to determine what is best for you.
Naltrexone (ReVia, Vivitrol) is an opiate receptor-blocking medication used in maintenance therapy for narcotic addiction. Unlike methadone and Suboxone, naltrexone does not activate receptors at all, so it does not reduce opioid withdrawal or craving. However, because naltrexone blocks opiate receptors, a person won’t get high if he or she uses drugs while taking the medicine. The drug is usually ineffective by itself, because people can simply stop taking it and get high shortly after.
COUNSELING AND 12-STEP PROGRAMS
Narcotics Anonymous (NA) is an international network of community-based meetings for those recovering from drug addiction. Modeled after Alcoholics Anonymous (AA), NA is a 12-step program with a defined process for overcoming narcotic addiction.
NA is an abstinence-based program. In principle, NA is opposed to the use of maintenance therapy. Methadone Anonymous is a 12-step program that acknowledges the value of methadone or Suboxone in recovery from narcotic addiction.
Most experts and treatment centers recommend participation in a 12-step program or other form of counseling. Therapy can take place as an outpatient, or in a residential facility.
Alternatives to 12-step programs include:
Cognitive behavioral therapy
Family and couples therapy
RECOVERY SUPPORT SERVICES
Recovery support services are provided through community-based programs by behavioral health care providers, peer providers, family members, friends and social networks, the faith community, and people with experience in recovery. Recovery support services help people enter into and navigate systems of care, remove barriers to recovery, stay engaged in the recovery process, and live full lives in communities of their choice. These services foster health and resilience (including helping individuals be well, manage symptoms, and achieve and maintain abstinence); increase housing to support recovery; reduce barriers to employment, education, and other life goals; and secure necessary social supports in their chosen community.
Recovery Support Services may include:
Employment services and job training;
Case management and individual services coordination, providing linkages with other services (e.g., legal services, Temporary Assistance for Needy Families, social services, food stamps);
Housing assistance and services;
Transportation to and from treatment, recovery support activities, employment, etc.
Peer-to-peer services, mentoring, and coaching
Self-help and support groups (e.g., 12-step groups, SMART Recovery®, Women for Sobriety)
Life skills training
Spiritual and faith-based support;
Parent education and child development support services