Opioids include a wide range of narcotic drugs, such as heroin, oxycodone, codeine, morphine, hydromorphone, and methadone. These drugs bind to endogenous opioid receptors in the brain to produce effects, such as pain relief, sedation, and in cases of abuse, euphoria 1. These feelings of intense pleasure can serve as positive reinforcement for users to continue abusing opioids, a pattern which can lead to addiction 1.
Opioid addictions are among the most difficult to overcome. After quitting or dramatically reducing opioid use, many users begin experiencing withdrawal symptoms 1. These symptoms are extremely unpleasant and can drive a person to return to opioid abuse in order to alleviate them. Therefore, it is extremely important that someone with an opioid use disorder gets help as they progress through the stages of detox and withdrawal.
Individuals who complete a medically supervised detox program after a prolonged period of opioid abuse are more likely to be successful in their recovery than individuals who drop out of treatment 2. However, quitting opioid use is not easy, which is why many clinics offer detox medications and other support options to make the detox and withdrawal processes as comfortable as possible 2. In particular, opioid detox medications can help individuals suffering from an addiction by reducing cravings and managing uncomfortable withdrawal symptoms 2.
This article will cover the following information:
- Medications used for detox.
- Types of detox programs.
- Benefits of medically assisted detox.
- Opioid abuse treatment.
- How to find a detox or treatment program.
Benefits of Detox
Detox simply helps addicts get away from their addictions long enough to seek help.Read More
In most cases, opioid withdrawal syndrome is not fatal 3. However, the process can be extremely uncomfortable and may cause some medical complications. One significant danger arises when a person attempts to detox from opioid abuse or goes through a period of withdrawal and then relapses 3. During withdrawal, the body’s tolerance for the drug decreases significantly, which means that the user requires lower doses to achieve a high than they once did. If a person with a history of opioid addiction returns to using a high dose that he or she used in the past, it could lead to an overdose and possibly even death 3.
To minimize the risks of relapse and overdose, individuals struggling with opioid abuse should seek professional detoxification treatment and recovery throughout the withdrawal process. In a professional care setting, opioid detox and withdrawal can be treated with several different medications in order to manage unpleasant symptoms.
Some opioid detox and opioid withdrawal medications include 1,2,3:
- Methadone: Methadone, which is a long-acting opioid agonist, is the most common FDA-approved medication used in opioid detox. It works to alleviate withdrawal symptoms and ease cravings by interacting with the same receptors in the brain that the abused opioids do, without eliciting the same euphoric rush or high. In some cases, it may also be used as maintenance therapy to manage severe, long-term opioid dependence.
- Buprenorphine: Previously marketed as Subutex, buprenorphine is a partial opioid agonist used to treat the symptoms of opioid withdrawal and alleviate cravings. Buprenorphine is commonly prescribed as a combination formula with naloxone (i.e., Suboxone), a drug that blocks the effects of opioids, to deter abuse of the detox medication.
- Clonidine: While clonidine does not reduce opioid cravings during drug detox, it can reduce autonomic withdrawal symptoms such as agitation, rapid heart rate, and sweating. It is not generally used alone since it isn’t effective at treating some of the other common withdrawal effects such as bone and muscle pain, insomnia, or gastrointestinal distress.
- Naltrexone: Naltrexone can be used in combination with clonidine to speed up the opioid detox process. It is also used to help discourage relapse in individuals who are receiving opioid addiction treatment.
- Antidepressant medications: Antidepressants that cause a sedative effect, such as trazodone and imipramine, may also be used to augment the management of opioid withdrawal symptoms.
- Insomnia medications: Many individuals going through opioid detox and withdrawal experience insomnia. Doctors may prescribe sleep medications, such as benzodiazepines, as needed, but since they have a high potential for abuse, the patient must be monitored closely.
Types of Detox Programs
Detoxification from opioid abuse can occur in a number of settings. Some people prefer to go through detox or withdrawal at home; however, this is extremely difficult and should only be done with the support of a strong social system. The Substance Abuse and Mental Health Services Administration (SAMHSA) states that an inpatient or hospital setting is the preferred location for opioid detox due to the distressing withdrawal symptoms 1. The various types of detox programs include:
- Inpatient detox program: An inpatient drug detox program provides a patient with 24-hour medical and psychiatric care while the opioid is eliminated from the body. This setting is ideal because you are separated from triggers and drug temptations.
- Hospital setting: At a hospital setting, you will receive around-the-clock care but staff may not be as experienced in treating addiction.
- Outpatient detox program: During outpatient detox, you will report to a clinic each day to receive a detox medication and receive counseling but will return home afterward.
- Outpatient care through a doctor’s office: While working with a doctor, you will receive regular medical evaluations and medication, as needed.
If you or someone you care about needs help overcoming opioid addiction, there is help available.
Benefits of Medically Assisted Detox
Detoxing at home can be painful and many users relapse to alleviate the unpleasant withdrawal symptoms. Attempting to detox in your old using environment can leave you vulnerable to triggers or stressors. There are a number of benefits of going through detox under medical supervision rather than attempting to detox on your own. When you go through medically assisted detox at a residential facility, you will benefit from:
- A reduced risk of relapse.
- Mitigated withdrawal symptoms.
- Decreased opioid cravings.
- Immediate attention for any medical complications.
- A safe and controlled environment away from temptation.
- Care for any psychological symptoms or conditions.
- Supportive staff members who can help you transition to a drug rehabilitation facility.
Opioid Abuse Treatment
The road to recovery from opioid addiction is long and challenging. However, with the right level of care and support, you can be successful in achieving and maintaining sobriety. Detoxification from opioid abuse is the first step.
Following detoxification, it is crucial that you transition into a formal substance abuse treatment program that can address the underlying causes of your drug abuse. Trained addiction specialists will help you learn to identify triggers for relapse, avoid them, and utilize healthy coping skills. This type of comprehensive opioid addiction treatment can help you maintain your sobriety in the long-run.
There are many different types of opioid addiction treatment programs, such as:
- Inpatient treatment: You will reside at the facility anywhere from 28 to 90 days, depending on the program and your individual needs. You will participate in individual counseling, group therapy, skills building, and more.
- Outpatient treatment: Many patients prefer the freedom to continue participating in their daily routines while receiving addiction treatment. Outpatient programs, which allow you to live at home, meet as much as 5-8 hours per day, five days per week or as little as 1-2 hours per day twice per week.
- Luxury facilities: While you are going through treatment, luxury facilities provide you with extra care including nutrition advice, relaxation activities, and spa amenities.
- Executive facilities: Similar to luxury programs, these programs focus on comfort and amenities but also provide you with the ability to continue working throughout recovery from opioid abuse.
- Holistic treatment: Holistic health refers to treating your mind, body, and spirit. Holistic treatment programs believe in addressing all areas of a person in order to help you be as healthy as possible.
- 12-step programs: Free, fellowship programs, such as Narcotics Anonymous (NA), are structured support groups that help participants progress through various aspects of recovery while providing strong social supports.
- Non-12-step programs: Like 12-step programs, non-12-step programs offer social support but utilize scientific and evidence-based approaches to addiction recovery. Examples of non-12-step programs include SMART Recovery and Secular Organizations for Sobriety (SOS).
- Substance Abuse and Mental Health Services Administration. (2013). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol (TIP 45).
- Kleber, H. D. (2007). Pharmacologic treatments for opioid dependence: Detoxification and maintenance options. Dialogues in Clinical Neuroscience, 9(4), 455-470.
- U.S. National Library of Medicine. (2016). Opiate and opioid withdrawal.
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment: Overview, Essential Concepts, and Definitions in Detoxification.