Opioid Addiction and Treatment

Article originally published on MedlinePlus. Bethesda (MD): National Library of Medicine (US); Opioid Addiction Treatment; [updated 2019 Oct 8; cited 2022 Aug 10]; Available from: https://medlineplus.gov/opioidmisuseandaddictiontreatment.html

Summary

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your health care provider. However, opioid misuse and addiction are still potential risks.

What are opioid misuse and addiction?

Opioid misuse means you are not taking the medicines according to your provider’s instructions, you are using them to get high, or you are taking someone else’s opioids. Addiction is a chronic brain disease. It causes you to compulsively seek out drugs even though they cause you harm.

What are the treatments for opioid misuse and addiction?

Treatments for opioid misuse and addiction include:

  • Medicines
  • Counseling and behavioral therapies
  • Medication-assisted therapy (MAT), which includes medicines, counseling, and behavioral therapies. This offers a “whole patient” approach to treatment, which can increase your chance of a successful recovery.
  • Residential and hospital-based treatment

Which medicines treat opioid misuse and addiction?

The medicines used to treat opioid misuse and addiction are methadone, buprenorphine, and naltrexone.

Methadone and buprenorphine can decrease withdrawal symptoms and cravings. They work by acting on the same targets in the brain as other opioids, but they do not make you feel high. Some people worry that if they take methadone or buprenorphine, it means that they are substituting one addiction for another. But it is not; these medicines are a treatment. They restore balance to the parts of the brain affected by addiction. This allows your brain to heal while you work toward recovery.

There is also a combination drug that includes buprenorphine and naloxone. Naloxone is a drug to treat an opioid overdose. If you take it along with buprenorphine, you will be less likely to misuse the buprenorphine.

You may safely take these medicines for months, years, or even a lifetime. If you want to stop taking them, do not do it on your own. You should contact your health care provider first, and work out a plan for stopping.

Naltrexone works differently than methadone and buprenorphine. It does not help you with withdrawal symptoms or cravings. Instead, it takes away the high that you would normally get when you take opioids. Because of this, you would take naltrexone to prevent a relapse, not to try to get off opioids. You have to be off opioids for at least 7-10 days before you can take naltrexone. Otherwise you could have bad withdrawal symptoms.

How does counseling treat opioid misuse and addiction?

Counseling for opioid misuse and addiction can help you:

  • Change your attitudes and behaviors related to drug use
  • Build healthy life skills
  • Stick with other forms of treatment, such as medicines

There are different types of counseling to treat opioid misuse and addiction, including:

  • Individual counseling, which may include setting goals, talking about setbacks, and celebrating progress. You may also talk about legal concerns and family problems. Counseling often includes specific behavioral therapies, such as
    • Cognitive-behavioral therapy (CBT) helps you recognize and stop negative patterns of thinking and behavior. It teaches you coping skills, including how to manage stress and change the thoughts that cause you to want to misuse opioids.
    • Motivational enhancement therapy helps you build up motivation to stick with your treatment plan
    • Contingency management focuses on giving you incentives for positive behaviors such as staying off the opioids
  • Group counseling, which can help you feel that you are not alone with your issues. You get a chance to hear about the difficulties and successes of others who have the same challenges. This can help you to learn new strategies for dealing with the situations you may come across.
  • Family counseling/ includes partners or spouses and other family members who are close to you. It can help to repair and improve your family relationships.

Counselors can also refer you to other resources that you might need, such as:

  • Peer support groups, including 12-step programs like Narcotics Anonymous
  • Spiritual and faith-based groups
  • HIV testing and hepatitis screening
  • Case or care management
  • Employment or educational supports
  • Organizations that help you find housing or transportation

What are residential and hospital-based treatments for opioid misuse and addiction?

Residential programs combine housing and treatment services. You are living with your peers, and you can support each other to stay in recovery. Inpatient hospital-based programs combine health care and addiction treatment services for people with medical problems. Hospitals may also offer intensive outpatient treatment. All these types of treatments are very structured, and usually include several different kinds of counseling and behavioral therapies. They also often include medicines.

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Related Issues

Specifics

  • Buprenorphine (Substance Abuse and Mental Health Services Administration)
  • Methadone (Substance Abuse and Mental Health Services Administration)
  • Naloxone (Substance Abuse and Mental Health Services Administration)
  • Naltrexone (Substance Abuse and Mental Health Services Administration)

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