Treatment for Narcotic and Opioid Painkiller Addiction
Detoxification and 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 addicts 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). 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.
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.
September is national recovery month
Each September, SAMHSA sponsors National Recovery Month (Recovery Month) to increase awareness and understanding of mental and substance use disorders, and celebrate the individuals living in recovery. Now in its 29th year, the 2018 Recovery Month observance focuses on urban communities, health care providers, members of the media, and policymakers, highlighting the various entities that support recovery within our society.
The 2018 Recovery Month theme, “Join the Voices for Recovery: Invest in Health, Home, Purpose, and Community,” explores how integrated care, a strong community, sense of purpose, and leadership contributes to effective treatments that sustain the recovery of persons with mental and substance use disorders. The 2018 observance also aims to increase awareness and encourage audiences to take advantage of the increased dialogue around behavioral health needs and the increased emphasis on tackling our nation’s opioid crisis.
The observance will work to highlight inspiring stories that help thousands of people from all walks of life find the path to hope, health, and wellness. In addition, the materials support SAMHSA’s message that prevention works, treatment is effective, and people can and do recover.
Learn more at https://recoverymonth.gov.
(Click the image to the right to download the toolkit (PDF)).
Hep Free Hawai'i
Drug Policy Forum of Hawai'i
Harm Reduction Hawai'i
Methadone clinics in Hawai'i
Ku Aloha ola Mau
Alcohol and Drug Division (ADAD) website
Find Suboxone Providers in Hawai'i
Find Buprenorphine Providers in Hawai'i
The PATH Clinic - For pregnant & parenting women with addiction issues
808 Youth - A searchable directory of over 700 children and youth programs
Prevention Resource Center, Coalition for a Drug-Free Hawaii
See our Overdose & Naloxone page for resources.
HEPATITIS C RESOURCES
SUPPORT FOR FAMILY & LOVED ONES
SUPPORT FOR YOUTH
OTHER SYRINGE EXCHANGES IN AMERICA
NATIONAL & INTERNATIONAL HARM REDUCTION ORGANIZATIONS