What is opioid addiction?

Opioid addiction is a complex coupling of drives: the drive to feel the euphoric effects of the drug and the drive to avoid the withdrawal symptoms caused by the drug use. Opioids, such as some prescription pain medications or heroin, attach to the highly sensitive opioid receptors in the brain, which stimulate the release of natural brain chemicals such as endorphins and dopamine which produces the pleasurable feelings. After repeated exposure in the brain to the exogenous opioids a physical dependence occurs causing severe withdrawal symptoms. The complexity continues as an person with the opioid addiction develops patterns of staving off the withdrawal symptoms by using more of the drug.

Opioid use often begins as a choice or as a prescribed treatment from a doctor, but frequent use can cause the brain cells to change the way they work. The brain is re-set to think that the drug is necessary for survival. Opioid addiction is characterized by the repeated daily use to “stay well” with intermittent use at higher level to feel the euphoric effects. The need to satisfy cravings or avoid withdrawal can be so intense that people who want to stop taking opioids find this difficult to do. They may find themselves doing things they would not ordinarily do in order to obtain more of the drug they crave. For this reason, even though opioid addiction is a medical condition and not a moral failing, it can drive behavior.

How long does a Recovery Program take?

The duration of your recovery is individually determined, and there are many sources of information to guide you. It is recommended that counseling extend beyond the medication period. Remember, if you think it’d be taking too much time to do it right, just think how long it will take to do it over again.

What about pain management?

The notion of pain medication using narcotics for people that have an opioid addiction is complicated, and for most people the answer is no. Giving up the pain medications to control pain and learning to live life without using is a difficult adjustment, but for others they find that the pain meds are related to the experience of their pain and notice remarkable improvements. If you have a pain condition, please call or come in person to talk to our counselors. There is help and we have seen hundreds of people take control of their lives.

 

What is Medication Assisted Treatment (MAT)?

MAT is substance abuse treatment that integrates the use of agonist medications like methadone and partial agonist medications such as buprenorphine. Methadone and buprenorphine are long acting synthetic opioids that move slowly in the body. This slow action eliminates withdrawal symptoms for 24 to 48 hours, thus empowering people with opioid addictions to engage in positive lifestyle activities without the compulsion to use pills or heroin. Our system helps with medication management while offering medical supervision and counseling support. This combination accounts for our success rates, which are among the best in the nation.

Does one get addicted to methadone and buprenorphine?

Methadone and buprenorphine are narcotic analgesics and with repeated exposure, physical dependence occurs. Physical dependence to a drug is a part of addiction, but that is not the whole story. Addiction is characterized by compulsive use of the drug, and that simply does not happen with Methadone and buprenorphine. The MAT patient is no more an addict than the diabetic who is dependent on insulin. They do not seek out the drug in the absence of withdrawal symptoms or pain; their lives do not revolve around use of the drug.

What is Methadone?

Methadone is a long acting synthetic opioid*. It was first used in the maintenance treatment of drug addiction in the mid-1960s, by Drs. Vincent Dole and Marie Nyswander of Rockefeller University. In the United States alone, there are more than 1,200 Methadone maintenance programs with an estimated staff of 20,000; serving more than 200,000 patients annually. Methadone is widely employed throughout the world, and is the most effective treatment for opioid addiction.

*We use the term opioid and opiate interchangeably to describe the class of drugs and medications including: Lortab, Vicodin, OxyContin, Darvicet, Percocet, Morphine, Codeine, Heroin, Oxycodone and Hydrocodone.

What is Buprenorphine?

Buprenorphine is the active ingredient in Suboxone, which is a partial opioid agonist, that when taken once daily, blocks other opioids from attaching to receptors in the brain. This treatment can help you stop misusing opioids. Treatment, including counseling, can help you rebuild your life.

 

How does Methadone work?

Methadone is an opiate agonist which has a series of actions similar to those of morphine and other narcotic medications. People who are addicted to opiates, will experience withdrawal symptoms if the concentration of opiates in the body falls below a certain level. In methadone treatment, patients are given enough methadone to ward off opiate withdrawal symptoms, but not enough to induce narcotic effects. In proper doses, methadone does not create euphoria, sedation or analgesia. At a therapeutic level methadone has no adverse effects on motor skills, mental capability or employability.

How safe is Methadone?

Methadone is a narcotic and should be used with medical supervision. When used with medical and counseling support, methadone is very safe. Scientific studies have shown that the most significant health consequence of long term methadone treatment is a marked improvement in general health. Concerns about methadone’s effects on the immune system and kidneys and liver have been laid to rest. Methadone’s most common side effects; constipation and sweating, usually fade with time and are not serious health hazards.

How much Methadone is prescribed?

Medication levels are individually determined, due to differences in metabolism, body weight and opiate tolerance. The proper maintenance dose is one at which narcotic craving is averted, without creating euphoria, sedation or analgesia for 24 to 36 hours.

Is Methadone more addictive than heroin or other opiates?

Physical dependence and tolerance to a drug are part of addiction, but they are not the whole story. Addiction is characterized by compulsive use of the drug, despite adverse consequences. The methadone patient is no more an addict than the terminal cancer patient who is physically dependent on morphine or the diabetic who is dependent on insulin. They do not seek out the drug in the absence of withdrawal symptoms or pain; their lives do not revolve around drug use.

Will I be on Methadone Forever?

The answer for most patients is no. The Life Change Center offers several medication programs from as short as two weeks to as long as several years. A majority of patients take on a process on gradually coming off of the medication within the first year of treatment. This process is called titration. Patients that are on a titration schedule have medical supervision and counseling support throughout the entire process, increasing the likelihood of success.

 

Prescription medication and heroin addiction

Facts about heroin addictions

Heroin is:

  • An illegal depressant drug synthesized from morphine that binds to opioid receptors in the brain.
  • In Northern Nevada, heroin is typically a black sticky substance that can be injected, snorted or smoked. Yet sometimes also a white or brown powder.
  • Heroin Use

    Heroin is typically known to be injected, but can also be snorted or smoked. People using heroin report feeling euphoria, warm flushing of the skin, dry mouth, heavy arms and legs, and blurred mental functioning. These effects are followed for several hours by alternating states of feeling awake and then drowsy.

    Serious health problems can result from heroin abuse, including:

  • Liver and kidney disease
  • Bacterial infections
  • Collapsed veins
  • Pneumonia
  • Abscesses
  • Organ damage (often caused by toxic additives in street heroin)
  • Infectious diseases such as hepatitis and HIV
  • Fatal overdose is of particular concern for users of street heroin because it is impossible to know the purity of the drug or whether dangerous substances have been “cut” with heroin.

    Heroin Withdrawal

    With regular use, heroin users develop a tolerance to the drug and begin taking larger doses of the drug to feel high. Over time, the body gets used to the drug. If a heroin addict stops using, they can experience severe withdrawal symptoms, including:

  • Vomiting and diarrhea
  • Muscle and bone pain
  • Insomnia or restlessness
  • Cold flashes
  • Kicking movements
  • Heroin withdrawal symptoms can begin within hours of the last dose and typically continue for about one week. However, some heroin addicts report withdrawal symptoms that last for months and drug cravings that can be triggered by certain people, places or things even years after stopping heroin use.

    Heroin Detox

    Intense heroin cravings during withdrawal are often the cause of relapse when someone is trying to quit using heroin. To minimize heroin cravings and the pain of withdrawal, medication assisted programs administer medications such as methadone and Suboxone.

    Medically supervised heroin detox programs are designed to help heroin addicts gradually wean off drugs and prepare to work a program of addiction recovery. Going through detox without any follow-up care is a recipe for relapse. Heroin detox is just the first step in a longer process of learning new skills and addressing the issues underlying the heroin addiction.

     

    Facts about prescription medication addictions

    Prescription drug abuse has swept the nation over the past decade. Prescription medications are extremely useful in treating a wide range of ailments, which can give the false impression that these drugs are somehow safe or legal to use other than as directed. Prescription drug abuse can be defined as taking a prescribed medicine:

  • That is not prescribed for you
  • In larger dosages than prescribed
  • For reasons other than the condition it is prescribed for
  • In ways other than prescribed (for example, crushed and snorted or injected rather than swallowed)
  • Most Abused Prescription Drugs

    Here are the basic facts about some of the most abused prescription drugs.

    Opiates

    Opiates, also called prescription narcotics, are generally prescribed to relieve pain. They can be swallowed, but users often snort or inject crushed pills for a faster, more intense high. These routes of administration have been linked to a number of fatal overdoses. Opiate abuse can lead to drowsiness, confusion, constipation, low blood pressure and depressed breathing.

    When trying to quit opiates, addicts often experience painful withdrawal symptoms such as muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, restlessness and involuntary kicking movements.

    Some of the most commonly abused opiates include:

  • Hydrocodone (Vicodin)
  • Oxycodone (Percodan, Percocet and OxyContin)
  • Propoxyphene (Darvon)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Diphenoxylate (Lomotil)
  • Morphine
  • Fentanyl
  • Codeine
  • Central Nervous System Depressants

    Depressants, also known as tranquilizers and sedatives, are typically prescribed for anxiety and sleep disorders. As a result of their effect on the GABA neurotransmitter, depressant abuse can slow brain function and heart rate. When used with other drugs, especially alcohol, the combination can lead to serious breathing problems and even death.

    The main categories of depressants are:

    Barbiturates

    Barbiturates treat tension, anxiety and sleep disorders. Examples include:

  • mephobarbital (Mebaral)
  • pentobarbital sodium (Nembutal)
  • Benzodiazepines

    Benzodiazepines are prescribed to treat panic attacks, acute stress, convulsions and short-term sleep problems. Examples include:

  • diazepam (Valium)
  • chlordiazepoxide HCl (Librium)
  • alprazolam (Xanax)
  • triazolam (Halcion)
  • estazolam (ProSom)
  • When an individual stops using depressants, slowed brain activity rebounds, sometimes racing out of control to cause seizures. Because withdrawal from certain depressants can be life-threatening, detox should be supervised by a physician or medical professional.

    Addicted to Prescription Drugs

    Dependence on prescription drugs is characterized by tolerance (needing more of the drug to experience the same effects) and withdrawal (physical symptoms when trying to quit using prescription drugs).

    People who are addicted to prescription drugs also become psychologically dependent, experiencing drug cravings and compulsive drug-seeking behavior. They continue to abuse prescription medications despite negative effects on their health, career, relationships and finances.

    Prescription drug addicts may find themselves stealing drugs from other people’s medicine cabinets, forging prescriptions or visiting multiple doctors to obtain more drugs. Although prescription drugs are legal when taken as prescribed for a valid medical purpose, when abused they are just as dangerous as illegal drugs.

    Opioids, such as some prescription pain medications or heroin, attach to the opioid receptors in the brain, which stimulate the release of dopamine and produce pleasurable feelings. When the opioid eventually detaches from the receptors, people experience withdrawal and cravings and have a strong need to repeat the experience. The need to satisfy cravings or avoid withdrawal can be so intense that people who want to stop taking opioids find this difficult to do. They may find themselves doing things they would not ordinarily do in order to obtain more of the drug they crave. For this reason, even though opioid dependence is a medical condition and not a moral failing, it can drive behavior.

     

    Resources

  • American Association for the Treatment of Opioid Dependence (AATOD)
  • American Psychiatric Association
  • Center for Substance Abuse Treatment (CSAT)
  • Commission on Accreditation of Rehabilitation Facilities (CARF)
  • DrugInfoNet
  • Hepatitis Information from the Centers for Disease Control (CDC)
  • Mental Help Net
  • National Domestic Violence Hotline
  • National Institute on Drug Abuse
  • National Institutes of Health (NIH)
  • National Library of Medicine
  • Mental Health America (formerly National Mental Health Association)
  • National Suicide Prevention Hotline
  • Substance Abuse & Mental Health Services Administration (SAMHSA)