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Why Medication is a Critical Part of Opioid Addiction Treatment

What is the best route for opioid addiction treatment? Several treatment options are available to you and often include medication as recommended by medical professionals.

Why Is Rehab for Opioid Addiction Important?

Opioids are an extremely addictive drug because of how they interact with your brain. Opioid drugs, such as heroin, morphine, oxycodone, and hydrocodone, influence the reward center of your brain. These drugs attach to the opioid receptors in your brain and cause a release of the chemical dopamine.1

Dopamine produces feelings of euphoria and relaxation, which leads you to crave the effects of the drug and use it at increasing dosages.

Continued opioid use and an inability to quit, even when it negatively impacts your life, are part of the criteria for diagnosing opioid use disorder (OUD). If you try to quit using opioids suddenly, you may experience unpleasant withdrawal symptoms and be unable to quit the drug without medical treatment.

Opioid use is a serious problem with over 2.1 million opioid users in the United States in 2016.2 Opioid use is considered the most lethal drug epidemic in American history, with over 47,000 deaths each year attributed to opioid use.2 Leaving a condition like this untreated can be dangerous and even deadly.

What Is Opioid Addiction Rehab?

Treating opioid use disorder is unique to other substance use disorder treatments in a few ways:3

  • Treatment often requires continuing care for a long period rather than a one-time, acute treatment approach
  • Medications used to treat OUD can be used long-term, even over a lifetime
  • Treatment medications do not just assist with alleviating withdrawal symptoms but also block the cravings and effects of opioid drugs
  • Most opioids are legal medications prescribed for pain management, and this must be considered when treating OUD

When you enter treatment for opioid use disorder, your treatment team will consider some of the things mentioned above when creating your recovery plan. If you developed an OUD after taking prescribed opioids for pain management, your plan will include non-narcotic pain management alongside your OUD treatment.

OUD treatment plans often include:2

  • Treating withdrawal symptoms
  • Opioid replacement, maintenance, or substitution therapy through medication
  • Education about opioid use
  • Cognitive-behavioral therapy
  • Motivational therapy
  • Support groups, such as Narcotics Anonymous (NA)

Opioid Withdrawal

Like with any drug, you will experience withdrawal symptoms when you quit using opioids. Some of the common withdrawal symptoms are:4

  • Depressed mood
  • Nausea or vomiting
  • Achy muscles
  • Water eyes
  • Runny nose
  • Chills
  • Sweating
  • Diarrhea
  • Yawning
  • Fever
  • Trouble sleeping

Withdrawal from opioids could be different from other substance withdrawals when it comes to pain. If you are taking a prescribed opioid for pain management, your withdrawal symptoms may include increased pain as your body gets rid of the drug that has been masking that pain.

Why Is Medication Important to OUD Treatment?

Detoxing from opioids can produce unpleasant symptoms that disrupt your everyday life and may be medically significant. Safe medications have been shown to reduce these symptoms and allow you to recover from OUD while still functioning in your job, family, and social circles.

The Federal Drug Administration (FDA) has approved three medications for treating OUD: methadone, buprenorphine, and naltrexone.5

Methadone

Methadone is a synthetic opioid agonist, which means it attaches to the opioid receptors in your brain and activates them in a way that is similar to other opioid drugs. Methadone works against the effects of a typical opioid in your body. The drug eliminates withdrawal symptoms and relieves drug cravings.

The difference between methadone and other opioid drugs is that, even though it occupies and activates the same receptors, it does so more slowly than the other harmful opioid drugs, staying at a consistent level in the body for much longer. The doses used in treatment also do not produce a euphoric effect in an opioid-dependent person.6

Buprenorphine

Buprenorphine is a partial opioid agonist, which means it functions much like methadone by attaching to the opioid receptors and activating them, but does so to a lesser degree. Buprenorphine is sometimes a safer choice than methadone when it comes to the risk of overdose and respiratory depression.

Methadone treatments may require you to visit a treatment center sometimes daily to receive your medication, but buprenorphine is available for you to take at home and even available in long-acting injections that can be managed with a monthly visit.6

Naltrexone

Naltrexone is an antagonist, meaning it attaches to the opioid receptors in the brain but does not activate them like methadone and buprenorphine. You can only receive naltrexone once you are seven days free of withdrawal and opioid dependence symptoms.4

What Treatment Is Most Effective for OUD?

Any treatment is better than no treatment. Research shows that the majority of people who engage in treatment will experience success in ceasing  or reducing drug use and improving their overall functioning.7

One study found that those taking methadone had 33% fewer opioid-positive drug tests than those in recovery but not taking methadone as part of the treatment plan. The study discovered that those in methadone treatment were 4.5 times more likely to complete treatment.7

The World Health Organization (WHO) has included methadone on its list of essential medicines because of its importance in treating OUD. Research on methadone treatment shows that it is vital to recovery because:8

  • Because it dramatically reduces the risk of overdose, it also reduces the mortality associated with OUD
  • It is associated with lower rates of relapse
  • It is associated with better compliance with policies in transitional living, parole terms, etc., which indicates that it reduces the impulsive and compulsive feelings related to OUD
  • The symptom relief that methadone provides allows your loved one to gain the most from other recovery treatments such as therapy and support groups
  • It has been connected with reduced rates of injection drug use, which lowers the risk of contracting infectious disease that can be spread via nonsterile needles including Hepatitis C and HIV

Studies of the effectiveness of buprenorphine show that it produced less intense withdrawal symptoms, longer retention in treatment, and a higher rate of treatment completion compared to other opioid agonists. No differences have been found between the effectiveness of methadone and buprenorphine.9

Naltrexone has been proven to be an effective treatment for OUD, specifically if you experience misuse with methadone or buprenorphine.9 Studies show that patients who receive naltrexone have a lower return to drug use than those without medication in their treatment.3

If you or someone you know has OUD, please call 800-891-9360(Who Answers?) to speak with a specialist who can help you find available opioid addiction treatment options.

Resources

  1. Kosten, T. R., & George, T. P. (2002). The Neurobiology of Opioid Dependence: Implications for TreatmentScience & Practice Perspectives, 1(1), 13–20.
  2. Dydyk A.M., Jain N.K., Gupta M. (2022. Opioid Use Disorder. StatPearls Publishing.
  3. Substance Abuse and Mental Health Services Administration. (2018). Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families. Treatment Improvement Protocol (TIP) Series, No. 63., Part 1, Introduction to Medications for Opioid Use Disorder Treatment.
  4. Centers for Disease Control. Module 5: Assessing and Addressing Opioid Use Disorder (OUD).
  5. United States Food and Drug Administration. (2019, February 14). Information about Medication-Assisted Treatment (MAT). United States Government.
  6. National Institute on Drug Abuse. (2021). How do medications to treat opioid use disorder work?
  7. National Institute on Drug Abuse. (2018). How effective is drug addiction treatment?
  8. World Health Organization. (2009). Methadone maintenance treatment – Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
  9. Srivastava, A. B., Mariani, J. J., & Levin, F. R. (2020). New directions in the treatment of opioid withdrawalLancet, 395(10241), 1938-1948.

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