Treating Opioid Use Disorder With Medications

Opioid addiction is a chronic medical condition. It creates changes in your brain that make you more likely to get addicted.

It takes much more than willpower to break free of prescription drug abuse, but you can escape the cycle of detox and relapse. It may be a long-term process, but medications and counseling can improve your chances of success.

Physical Dependence and Detox

Opioid addiction leads to real changes in certain areas of your brain. Prescription drug addiction alters the circuits responsible for mood and reward behavior.

In addition, long-term prescription drug abuse affects almost all of your body’s systems. When you cut off the opioid supply cold turkey, you’re likely to get withdrawal symptoms such as:

  • Craving for drugs
  • Diarrhea
  • Large pupils
  • Yawning
  • Belly pain
  • Chills and goosebumps (the origin of the phrase "cold turkey")
  • Nausea and vomiting
  • Body aches
  • Agitation and severe bad moods

If you already have a narcotic addiction, you’ll know that a list of these symptoms doesn't capture the agony of going through them. It’s extremely unpleasant, and you’ll do almost anything to avoid it.

Opioid withdrawal lasts from hours to several days -- and sometimes weeks. It depends on how long and how much you used your drug of choice. After the intense initial symptoms subside, some physical and mental discomfort may linger for weeks.

Medications

The unpleasantness is a major reason for relapse and continued prescription drug abuse. But there are medications that can help you through opioid withdrawal and prevent symptoms. After the initial detox, you’re at risk for relapse. Experts say psychological and social factors are the main drivers that could push you back to using. Stress and situations that remind your brain of the pleasure the drug can bring are common triggers. Successful, lifelong therapy to stay opioid free usually involves long-term medication with counseling/talk therapy programs.

Methadone is the most effective treatment for narcotic addiction. It’s a long-acting opioid that affects the same parts of your as the drug you’re having a problem with does, but it doesn’t get you high. You can take it every day, but you have to go to a special clinic to get it. The correct dose prevents withdrawal symptoms and eases drug cravings.

Continued

Buprenorphine is a shorter acting drug than methadone. It hits the same receptors in your brain, but not as strongly.

It comes in several forms:

  • Tablet (Suboxone, Zubsolv)
  • Shot (Buprenex)
  • Film placed in your mouth against your cheek (Belbuca, Subutex)
  • Skin patch (Butrans)
  • Implant that goes under your skin and lasts about 6 months (Probuphine)

Naltrexone also blocks opiate receptors. Unlike methadone, it can’t ease withdrawal symptoms or cravings. But you can’t get high if you use drugs while taking it. Naltrexone works best as part of a broad recovery treatment program. You’ll start it when you’re done with detox. You can take it:

Buprenorphine is also paired with naloxone. This combination comes as a:

  • Tablet
  • Film that goes in your mouth against your cheek
  • Film that goes under your tongue

Completing detox subdues the physical effects of narcotic addiction and opioid withdrawal. But when cravings strike, they’re hard to resist. If you go through detox and short-term counseling without maintenance treatment, you’ll most likely relapse to prescription drug abuse.

Your chances of beating narcotic addiction are better with long-term maintenance therapy that includes these drugs, along with some form of talk therapy.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on December 29, 2017

Sources

SOURCES:

Carroll K.M.  American Journal of Psychiatry, 2005.

FDA. "FDA approves first buprenorphine implant for treatment of opioid dependence."

Kosten, T.R. New England Journal of Medicine, 2003.

Mattick, R.P. Cochrane Database of Systematic Reviews, 2003.

Medline Plus: "Opiate withdrawal."

Moore & Jefferson, Handbook of Medical Psychiatry, 2nd edition, Mosby 2004.

Narcotics Anonymous web site.

National Library of Medicine web site.

Van den Brink, W. Canadian Journal of Psychiatry, 2006.

National Institutes of Health: “How Do Opioids Work?”

Journal of Addiction Research & Therapy: “Addiction Relapse and Its Predictors: A Prospective Study.”

SAMHSA: “Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction.”

PubMed Health: “Buprenorphine,” “Naloxone."

National Institute on Drug Abuse: “How Do Medications to Treat Opioid Addiction Work?”

Medscape: “Opioid Abuse Treatment & Management.”

© 2016 WebMD, LLC. All rights reserved.

Pagination