Opioids are drugs such as heroin, opium, morphine, codeine, and fentanyl. They can be legal prescription medications or illegal substances. Opioids relieve pain by mimicking endorphins and enkephalins and interacting with opioid receptors in the brain and body. These interactions can depress the central nervous system, inhibit pain signals, and alter perception.
Opioids can effectively manage pain when used under professional guidance; however, because they activate the brain’s reward system, they reinforce the need to take more. This can cause an opioid addiction.
Effects of Opioids
In the short term, opioids produce euphoria and pain relief; however, they can also cause drowsiness, respiratory depression, nausea, dizziness, and skin irritation.
With prolonged use, opioids can cause impaired attention and memory, an increased sensitivity to pain, depression, and anxiety. Physically, they can cause respiratory problems, cardiovascular issues, and liver damage.
Risks of Opioids
Since opioids can be so addictive, it’s possible for users to accidentally ingest too much at once and overdose. Overdose occurs when an opioid’s depressant effects on the central nervous system cause life-threatening reactions. Overdoses usually include respiratory failure, where breathing becomes slow, shallow, or even stops completely. Without immediate medical intervention, an opioid overdose can be fatal.
If someone is overdosing, call 911 or your local emergency services number immediately. If you are qualified, administer CPR. Use Naloxone (Narcan) if available.
Detoxing from Opioids
Detox will rid your body of opioids and can be a great step towards recovery. Detox must be done under medical supervision to ensure safety.
Detox from opioids can last 4–20 days, depending on the opioid used. Quick-acting opioids like heroin typically have a shorter duration than long-acting opioids like fentanyl. Withdrawal symptoms usually appear in 8–12 hours after quitting. Symptoms include:
- Nausea and vomiting
- Anxiety
- Insomnia
- Hot and cold flashes
- Sweating
- Muscle cramps
- Diarrhea
Detox can be abstinence-based or assisted with medications such as methadone and buprenorphine. These medications are opioid receptor antagonists, meaning they attach to and activate opioid receptors in the brain to ease withdrawal symptoms. They can be used long-term if necessary.
Questions to Ask Your Provider about Medication-Assisted Treatment (MAT)
If you are considering MAT for opioid recovery, it's important to have an open discussion with your healthcare provider to make informed decisions about your treatment plan. You can ask questions like:
- What medications are available for opioid addiction?
- What are the benefits and potential side effects of each medication?
- How long should I plan to be on medication as part of my treatment?
- Can the medications be addictive themselves, and how will you monitor and manage this aspect?
- Are there any lifestyle changes I should make while on MAT?
Rehab for Opioids
After detox, you’ll begin therapy to get to the root of your addiction and learn coping skills to manage cravings. Some people with opioid addiction may need a more intensive level of care to help monitor and manage their symptoms. When talking to your doctor, consider discussing which level of care best fits your needs:
- Outpatient (OP): You’ll live at home and meet 1-2x per week with your provider and others in treatment.
- Intensive outpatient (IOP): You’ll meet 3-5x per week for several hours at a time for more intensive care.
- Partial hospitalization (PHP): You’ll meet 5-7 times a week for a full day.
- Residential: You’ll live in a rehab for 28+ days and engage in treatment with a comprehensive staff and a community of peers.
- Inpatient: You’ll live in a treatment center or hospital-like setting and have 24/7 monitoring for your safety.
Managing opioid addiction can be a complex and individualized process. Working with a licensed professional who’s experienced in opioid addiction can help guide you through the healing process. They will provide you with appropriate tools, techniques, and support tailored to your specific needs. You may engage in talk therapies such as
- Cognitive behavioral therapy (CBT) to learn how to replace unhealthy thought patterns with more affirming ones.
- Contingency management (CM) provides positive reinforcement, such as rewards or incentives, for maintaining abstinence from opioids.
- Relapse prevention counseling teaches techniques to manage addiction cravings and other symptoms.
- Motivational interviewing explores the reasons why you want to recover and use that purpose to motivate change.
Can You Relapse on Opioids?
Yes, it is possible to relapse on opioids. If this happens, talk to your doctor and seek professional treatment. You may participate in programs that focus on relapse prevention planning along with skills-building and evidence-based therapies.
Relapse isn’t a failure, but rather an opportunity to find treatment that better fits your needs and keeps you on the path to sobriety.
Questions to Ask Your Provider
If you’re looking for opioid treatment, talk to your primary care doctor. They can refer you to a substance use rehab to start your recovery. When talking to your provider, consider asking these questions:
- What are the benefits of the different types of treatment available? What are the risks?
- Are there any specific medical or psychiatric assessments I should do before starting treatment?
- What does relapse prevention planning look like?
- Is there treatment that can address any co-occurring disorders that I have?
- Does insurance cover treatment?
How Can I Find Support?
- Rehabs for Opioids
- Telehealth Provider
- Talk to a supportive friend or family member
- Talk to your primary care physician