Understanding Opioid Abuse, Addiction, and Treatment

Opioids are some of the most addictive drugs in the United States. In 2021, an estimated 2.5 million people over the age of 18 in the U.S.–and 16 million worldwide–had an opioid use disorder.[1]

Opioid abuse has become such a widespread issue that it has been declared a nationwide crisis. An estimated 187 people in the U.S. die every day as a result of opioid overdoses–most of which involve illicit opioids like fentanyl.[2]

In this article, you will learn:

• The most commonly abused opioids
• Symptoms of opioid overdose
• Signs of opioid addiction
• What to expect during opioid withdrawal and detox
• Where to find opioid addiction treatment

If you or someone you love are struggling with opioid addiction, please reach out to Ascend Recovery Centers today to discuss your treatment options and get started with a confidential, risk-free assessment.

Commonly Abused Opioid Drugs

There are many different types of opioids–both prescription and illicit. Many people get addicted to opioids after they are prescribed by a doctor. An estimated 21-29% of people who take prescription opioids for chronic pain abuse them, and 8-12% develop an opioid use disorder.[3]

Up to 86% of heroin users report abusing prescription opioids before progressing to more potent drugs like heroin.[4]

Some of the most widely abused opioids are:

• Oxycodone (OxyContin, Percocet)
• Hydrocodone (Vicodin, Norco)
• Morphine (MS Contin, Kadian)
• Codeine (Tylenol with Codeine, Empirin with Codeine)
• Hydromorphone (Dilaudid)
• Meperidine (Demerol)
• Tramadol (Ultram, ConZip)
• Buprenorphine (Suboxone, Subutex)
• Methadone
• Heroin
• Fentanyl (Duragesic, Sublimaze)

Fentanyl is an opioid that is approximately 50 times stronger than heroin and 100 times stronger than morphine. While it has legitimate medical uses, such as treating breakthrough cancer pain, illicit fentanyl has become a major problem across the country. Sold in the form of a powder, fentanyl is often found mixed with heroin or counterfeit prescription pills. Being so potent and readily available, fentanyl is a leading cause of opioid overdose.

Opioid Overdose

Rates of opioid overdose have continued increasing over the last two decades, primarily due to the rise of illicit and dangerous opioids like heroin and fentanyl. In 2022, an estimated 83,000 people died as a result of an opioid overdose death.[5]

Symptoms of opioid overdose are:

• Respiratory depression
• Pinpoint pupils
• Loss of consciousness
• Bluish lips and nails
• Slow or irregular heartbeat
• Cold, clammy skin
• Unresponsiveness
• Seizures
• Vomiting
• Inability to wake up

Emergency medical services should be called as soon as an overdose is suspected. Naloxone (Narcan) is an opioid overdose reversal medication that can be administered to restore breathing under medical assistance. You can purchase naloxone without a prescription over the counter in any U.S. state.[6]

Signs of Opioid Addiction

Opioids work by binding to opioid receptors in the brain and throughout the body. These receptors are found in areas of the brain responsible for regulating pain and emotions. When opioids attach to these receptors, they inhibit the transmission of pain signals and activate the brain’s reward system, leading to feelings of euphoria and pleasure.

The euphoric effects of opioids are a result of increased dopamine levels in the brain. Dopamine is a neurotransmitter associated with pleasure and reward. When opioids stimulate the release of dopamine, it reinforces the behavior of opioid use, creating a powerful craving for more of the drug.

Repeated opioid use can lead to tolerance, where higher doses are needed to achieve the same effects. This tolerance can quickly escalate into dependence, where the brain adapts to the presence of opioids and requires them to function normally. Physical dependence is characterized by withdrawal symptoms that occur when opioid use is reduced or stopped abruptly. These symptoms can be intensely uncomfortable and often drive individuals to continue using opioids to avoid withdrawal.

In addition to physical dependence, opioids can also cause psychological dependence, where individuals crave the euphoric effects of the drug and may compulsively seek out and use opioids despite negative consequences.

Healthcare professionals may diagnose someone struggling with opioid addiction as having an opioid use disorder (OUD). As outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptoms of opioid use disorder are:[7]

1. Taking opioids in larger amounts or over a longer period than intended.
2. Persistent desire or unsuccessful efforts to cut down or control opioid use.
3. Spending a great deal of time obtaining, using, or recovering from the effects of opioids.
4. Craving or strong desire to use opioids.
5. Recurrent opioid use resulting in failure to fulfill major role obligations at work, school, or home.
6. Continued opioid use despite having social or interpersonal problems caused by drug use.
7. Giving up or reducing important social, occupational, or recreational activities because of opioid use.
8. Repeated opioid use in situations where it is physically hazardous.
9. Continued opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.
10. Tolerance
11. Physical dependence and withdrawal

Experiencing 2-3 symptoms indicates a mild OUD while 4-5 symptoms indicate moderate and 6 or more symptoms a severe OUD. If you or a loved one suffers from any of the above-listed symptoms, please contact our caring admissions team at Ascend Recovery Centers for a substance abuse assessment.

Opioid Withdrawal

Abruptly stopping opioids after a period of regular use can result in withdrawal symptoms. Symptoms can appear just hours after the last dose and may last for a week or two. Opioid withdrawal is often described as flu-like and can include symptoms like:[8]

• Nausea
• Vomiting
• Diarrhea
• Abdominal cramping
• Muscle aches
• Dilated pupils
• Goosebumps
• Sweating
• Runny nose
• Yawning
• Insomnia
• Restlessness
• Anxiety
• Irritability
• Increased heart rate
• High blood pressure
• Tremors
• Chills
• Fatigue
• Drug cravings

These symptoms are generally not life-threatening; however, they can be so excruciatingly painful that people who attempt to detox on their own are often unsuccessful and end up continuing their drug use as they seek symptom relief. As a result, the best way to detox is to do so under close medical supervision.

Opioid Detox and Addiction Treatment Programs

Opioid addiction treatment programs can help those struggling to detox safely, address the root causes of their opioid use, and develop the coping skills needed to maintain long-term recovery.

Medical Detox

Opioid use disorder treatment programs begin with detox. During detox, a team of healthcare professionals can prescribe medications, monitor symptoms, and provide comprehensive support as the body adjusts to the absence of opioid drugs.

Opioid withdrawal is managed using medications like methadone or buprenorphine.

• Buprenorphine – A partial opioid agonist that reduces opioid withdrawal symptoms and alleviates cravings. It may be prescribed under the brand names Suboxone or Subutex.
• Methadone – A long-acting opioid agonist that is prescribed to reduce opioid withdrawal symptoms during the detox process.
• Clonidine – An antihypertensive medication that can alleviate anxiety-related symptoms and reduce restlessness.

Additional symptom-specific medications may be prescribed depending on the client’s needs.

The goal of medical detox extends beyond cleansing your body; it also prepares you mentally and emotionally for the next phase of recovery. Detox treatment may also include group and individual therapy, support groups, and holistic treatments like yoga or meditation.

Medications for Opioid Use Disorder

One of the most effective treatment approaches for opioid addiction is medication-assisted treatment (MAT). MAT is a comprehensive approach that combines FDA-approved medications with counseling and behavioral therapy. These medications can reduce withdrawal symptoms, mitigate cravings, lower the potential for relapse, and improve treatment outcomes.[9]

Medications used to treat OUD include:

• Suboxone – Suboxone is a daily combination medication containing buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist, used to treat opioid dependence by reducing cravings and withdrawal symptoms while deterring misuse.
• Sublocade – Sublocade is a once-monthly injectable formulation of buprenorphine, a partial opioid agonist, indicated for the treatment of moderate to severe opioid use disorder in patients who have initiated treatment with a transmucosal buprenorphine-containing product.
• Vivitrol – Vivitrol is an extended-release injectable formulation of naltrexone, an opioid antagonist, used as part of a comprehensive treatment plan for opioid dependence to prevent relapse by blocking the effects of opioids.

Individuals taking these medications must be actively participating in a treatment program and remain under the guidance of a licensed physician.

Behavioral Therapy and Counseling

Opioid rehab can take place at various levels of care. Individuals with moderate to severe opioid use disorders, or those with co-occurring disorders, are best served at a residential treatment facility where they receive around-the-clock support and supervision.

After residential treatment, clients transition to lower levels of care such as a partial hospitalization program (PHP), an intensive outpatient program (IOP), and an outpatient program (OP). This continuum of care is designed to serve the evolving needs of individuals as they make progress in their recovery. It can also reinforce the important coping skills used during rehab.

The goal of rehab is to educate about addiction, diagnose and treat the underlying causes, and provide the resources, support, and tools necessary for long-term recovery. This is primarily accomplished through counseling and behavioral therapy.

• Cognitive behavioral therapy
• Dialectical behavior therapy
• Motivational interviewing
• Contingency management
• Family behavior therapy
• Individual therapy
• Group therapy
• Relapse prevention therapy

Opioid addiction treatment programs like Ascend Recovery Centers provide whole-patient care extending beyond psychotherapy. Treatment also includes:

• Individually-tailored treatment plans
• Case management
• Life skills training
• NA/AA Intergroup or SMART Recovery
• Discharge planning
• Aftercare support

From your initial assessment and intake all the way to discharge, we’ll support you every step of the way.

Find Treatment for Opioid Addiction Now

Ascend Recovery Centers is a leading provider of opioid abuse treatment. We’re setting the standard for evidence-based, whole-person care with clinically proven treatments, a multidisciplinary team of addiction specialists, and state-of-the-art facilities across the United States. In-network with many major insurance providers, we’re making quality substance abuse treatment accessible to all who need it.

Ascend Recovery Centers was founded on the premise of providing superior addiction treatment, delivered by a team of expert professionals, in the comfort of a facility that invests in the success of your long-term recovery. We recognize that addiction affects everyone differently, which is why our treatment programs are individually tailored to meet each person’s unique needs.

To learn more about our opioid rehab programs or to get started with a confidential, risk-free assessment, please contact us today!

References:

1. National Institute on Drug Abuse (NIDA): Only 1 in 5 U.S. adults with opioid use disorder received medications to treat it in 2021
2. UT Southwestern Medical Center: UTSW Q&A: Experts talk about opioid abuse, risks, treatment
3. National Institutes of Health (NIH): Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis
4. National Institute on Drug Abuse (NIDA): Prescription opioid use is a risk factor for heroin use
5. Yale Medicine: Why Is Fentanyl Driving Overdose Deaths?
6. United States Food and Drug Administration (FDA): FDA Approves First Over-the-Counter Naloxone Nasal Spray
7. American Society of Addiction Medicine: DSM-5 Criteria for Diagnosis of Opioid Use Disorder
8. National Institutes of Health (NIH): Opioid Withdrawal
9. Substance Abuse and Mental Health Services Administration (SAMHSA): Medications for Substance Use Disorders