Opioid Addiction Treatment & Medications

The opioid crisis that has been ravaging the U.S. over the past decade has made the addictive power of opioids painfully clear.1 In 2018, around 1.7 million suffered from opioid use disorders relating to prescription painkillers, while more than 650k people that year had heroin use disorders.1 If you are abusing painkillers and/or heroin, you don’t have to continue down the devastating path of opioid addiction. With treatment you can reverse course and continue to live your life free of the burden of addiction.

This article will help you recognize the signs of opioid addiction, the types of treatment that can help, and medications that may be used to aid in recovering from opioid use disorder.

Types of Opioid Use Disorder Treatments

S. Kingtstown RI Outpatient

There are many types of opioid use disorder treatments that can benefit people who are struggling with opioid abuse and addiction. They include:

  • Medical opioid detox. This is the preferred first step in the recovery process for many people because of the severe discomfort associated with opioid withdrawal. During opioid detox, you will receive medical supervision and medications to relieve your symptoms so you can stay as safe and comfortable as possible as you withdraw from opioids. Medical support through detox may be offered in both outpatient and inpatient settings.2
  • Inpatient/residential rehab. People who want and need a great deal of support and a sober living environment may attend an inpatient or residential rehab program. While residing at the rehab center, you receive and participate in a variety of treatments, such as individual counseling, group therapy, and self-help groups like Narcotics Anonymous (NA). You may also receive life skills training and vocational support during your stay.3
  • Partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). These are forms of intensive outpatient treatment where you live at home and travel to rehab for intensive treatment. These programs are designed to provide more support than traditional outpatient therapy and sometimes serve as a step-down form of care after inpatient rehab. The exact schedule can vary by facility. A PHP is more intensive and usually requires attendance 5-7 days a week for several hours per day, while an IOP usually requires fewer days per week and fewer hours per day of treatment. You participate in treatments that are similar to those found in inpatient rehab.4-6
  • Outpatient treatment. This is a form of treatment that can be used as a step-down from other types of programs or as a stand-alone form of treatment for people who do not require a high level of supervision and care and those with a lot of social support. Outpatient treatment can take place during the day or evening and may only require attendance for a few hours per week. You typically participate in individual and group counseling and 12-step or other support groups.7,8
  • Sober living homes. These are drug- and alcohol-free residences designed to support people in the initial phases of recovery after they have completed treatment. They often require or strongly encourage participation in therapy and/or 12-step or other groups and rely on the support of others in the residence to promote recovery. Most homes require residents to adhere to house rules, pay rent, and participate in household chores.9
  • Medication-assisted treatment (MAT). This form of treatment, which may be initiated in an inpatient or outpatient setting, involves a combination of counseling and medication. Despite myths that medication substitutes one drug addiction for another, research has shown MAT to be effective in reducing illicit opioid use.10
  • Mutual help groups. Groups like Narcotics Anonymous (NA) and Smart Recovery are often utilized in rehab programs and are available outside of treatment facilities as well. Many people utilize these programs after attending rehab as part of their aftercare, although attendance completion of formal treatment is not a requirement for participation. Groups emphasize mutual support and giving back to others.

Opioid Addiction Medications

Doctor with patient

MAT for opioid use disorder involves the use of medications to achieve remission, that is, the disappearance of symptoms of OUD. Remission is a key component of recovery, where a person overcomes their substance use disorder and regains their health and social functioning. Full recovery generally includes behavioral therapy and counseling.

Some medications may be initiated during withdrawal to ease symptoms and then continued after detox to support recovery, while others may not be started until detox is complete.11

Three medications are currently approved by the FDA for the treatment of opioid use disorder. They are:12

  • Methadone.
  • Buprenorphine.
  • Naltrexone.

Methadone

This long-acting opioid agonist medication binds to opioid receptors in the brain and produces mild opioid effects, similar to those produced by the body’s so-called natural opioids, endorphins.11 It may be used during acute opioid withdrawal to alleviate symptoms, and it may also be maintained long-term as a tool to aid in recovery and prevent relapse since it blocks the effects of illicit opioids and decreases cravings and urges to use other opioids. Methadone has also been associated with a reduced risk of overdose.  Methadone, which is taken orally, can only be dispensed and administered in a specially regulated opioid treatment program (OTP) and the acute inpatient hospital treatment setting.11,13

While methadone does have some abuse potential, it is considered safe and effective when used as prescribed. To reduce the potential for abuse and ensure dosage compliance, methadone patients are required to take their medication under direct supervision in an OTP or acute inpatient hospital treatment setting. Patients who have been stable on methadone for a period of time (and have shown progress and proven, consistent compliance with the medication dosage) may be given the option to take a limited number of doses home.13

Buprenorphine

This alternative to methadone is a partial opioid agonist, which means it does not fully activate the opioid receptors. It strongly attaches to the opioid receptors and blocks other opioids from attaching to them. Like methadone, it reduces withdrawal symptoms and relieves cravings, but unlike methadone it has a “ceiling effect”; once you take a certain amount, further doses won’t produce more opioid effects. This increases the safety and reduces the abuse and overdose potential of this medication.11

Buprenorphine is a safe and effective medication to use during detoxification from opioids. Before patients can begin using buprenorphine, they must already be in opioid withdrawal and have abstained from opioids for anywhere from 12-36 hours, depending on the opioid used. Taking buprenorphine too early can cause acute and sometimes severe withdrawal symptoms to begin immediately, so it is important to follow the guidelines provided at the time of initiation.14

Like methadone, buprenorphine may be used long-term to stave off cravings and support a person when making the necessary life changes to achieve recovery. How long a person stays on buprenorphine will vary according to the needs and desires of the patient, and stable patients can continue on it indefinitely as long as it is beneficial.14

Buprenorphine is a more convenient option than methadone for many people because it can currently be prescribed and dispensed in some doctors’ offices as well as the offices of other qualified healthcare providers and doesn’t require patients to visit an OTP.2,14 Some forms of buprenorphine don’t require daily administration. For example, there are monthly injections (Sublocade) and even implants that are placed under the skin to deliver buprenorphine for 6 months (Probuphine).15,16

Some medications (Suboxone, Zubsolv) combine buprenorphine with naloxone, the opioid overdose reversal drug.17 The addition of naloxone helps to prevent diversion and abuse of buprenorphine.11

Naltrexone

As an MAT drug, naltrexone works in a different way than methadone and buprenorphine. An opioid antagonist, naltrexone attaches strongly to opioid receptors and displaces opioids from those receptors. In doing so, naltrexone blocks the euphoric effects of opioids; if you’re on this medication and you use opioids, you won’t get high.12

Naltrexone does not cause opioid effects, so it has no abuse potential and is not addictive. There is also no withdrawal syndrome associated with this medication, however, it can precipitate withdrawal in those who have recently used opioids.18

You therefore need to wait until your body is clear of all opioids, including buprenorphine and methadone, to receive this medication. For people with OUD, this means they must wait a period of approximately 14 days from last opioid use.11

Naltrexone is available as a daily pill or as a monthly extended-release injection (Vivitrol).18

Treatment for Opioid Addiction with AdCare

Adcare Hospital in Worcester MA

AdCare provides inpatient rehab, outpatient programs, and telehealth treatment for those who need help for opioid abuse and addiction. We utilize medication-assisted treatment for patients who are interested and who are good candidates for this approach to recovery. MAT medications offered at AdCare include:

  • Methadone (used primarily during medical detox).
  • Buprenorphine (Sublocade).
  • Buprenorphine/naloxone (Suboxone).
  • Naltrexone (Vivitrol).

We can help you understand your opioid addiction treatment options when you call us at .19