Opiate addiction has definitely been on the rise in recent years. For whatever reason, people are turning more and more to both prescription painkillers, as well as to street drugs like heroin (this is at least partially driven from people who get addicted to prescription opiates).
How opiate addiction can start
Opiate addictions can start when people least suspect it. Just about any accident, injury, or illness could be the thing that pushes us into a situation where we are experiencing chronic pain and are in need of medication.
Usually it will be a doctor that prescribes opiates to us, but in some cases a friend or family member will innocently give us a prescription medication (almost never a good idea to begin with) and thus we might get started on opiates that way. Once the ball is rolling, most people will start actively seeking out their drug of choice in order to avoid withdrawal. Whether this means gaming multiple doctors or buying heroin off the streets, people will go to many lengths in order to maintain their state of being. Avoiding withdrawal is a powerful motivator.
Opiate addiction symptoms
Most addicts will go out of their way in order to hide an addiction from the world. But eventually it will start to show through, both in their behavior and in their attitude. The signs of opiate addiction are really more behavioral than they are physical. Some of the symptoms of opiate addiction might include:
* Obsessing over medications.
* Obsessing over doctor appointments and the need to get more medicine.
* Being restless, irritable, and angry when not getting enough opiates.
* Being preoccupied with getting more drugs.
* Lying about how much they have used or where they got the medication.
* Lying to doctors or faking injuries or illnesses in order to get more medicine.
* Self inflicted injury in order to get medication.
There are other symptoms as well but this just gives you a general idea. Keep a careful watch for these opiate addiction signs and you can probably detect this fairly early in a loved one’s behavior. Different addicts will have different ways of coping with addiction and attempting to deal with their life while keeping their using hidden. Any unusual behavior might point to active addiction.
Treating opiate addicts
There are a number of different options for treating opiate addicts. The problem with them is that they are all pretty much guaranteed to fail if the addict does not want to get clean. There is no way to change a person’s mind from the outside…the healing process starts from within. Specifically, it starts with an internal decision to make a major change in your life. Without this huge decision, without this total level of surrender, there can be no lasting changes when it comes to addiction.
Therefore, the best treatment for an opiate addict is the one that the addict is more willing to engage with. If they are resistant to the idea it is not going to work anyway, period. They have to want it for it to be effective.
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It would be nice if there were a shot or a magic pill that could make people change at this fundamental level, but right now there is no such thing. The motivation still has to come from within, and it is still the determining factor in recovery success.
Long term help for the opiate addict
Getting some help in the short run is great. Going to a 28 day program or even shorter can, and does, help opiate addicts to recover. But the success rates of such programs remain quite low, and really the problem is not stopping….it is staying stopped. Therefore, if an addict has tried and failed with short term solutions already, then they should shift their strategy towards longer term solutions.
There are a couple of routes you could go with this. One is to find long term treatment, where a person checks in and lives for a period of months or even years. Halfway houses are an example of this strategy. Another long term approach might be to find a therapist to work with on an outpatient basis, though this strategy is a lot less intensive and might not work for everyone. Finally, drug maintenance can also be a long term strategy, though I would caution that this probably needs to be combined with other strategies in order to be effective.
Many opiate addicts in particular are addicted to Oxycontin. This is a powerful medication that contains a very powerful synthetic opiate and is only available with a prescription. But of course there is a huge black market for the substance because it is so addictive.
Addicts use Oxycontin in many different ways. Usually it is crushed up and snorted but it can be taken via just about any conceivable route other than smoking it. Many people who found themselves taking this prescription opiate for their pain find it very difficult to just stop taking it cold turkey, because their body has become used to the pleasurable effects that the drug produces.
Oxycontin has a high abuse potential because it is a powerful opiate medication. Therefore Oxycontin addiction remains fairly common.
Another popular prescription medication that has a lot of abuse potential is Vicodin. This is actually Hydrocodone and the general opinion is that it probably gets over prescribed in the United States. When over the counter medications such as Tylenol or Motrin may have sufficed in the past, doctors are more quick to prescribe Vicodin instead, and patients are more quick to request it. This is unfortunate because the drug has the potential to be addicting, and in most cases a lessor pain medicine would have actually worked.
Another big problem with Vicodin addiction is that the opiates contained in this medication are almost always packaged with acetaminophen. This can be really hard on the liver when an addict starts to abuse Vicodin, because they are getting way to much acetaminophen into their system.
Opiate dependence is sometimes both detoxed with Suboxone, as well as to use this medication for long term drug therapy maintenance. Suboxone is a pill that contains 2 different medications in it: one is a synthetic, partial opiate, and the other is an opiate blocker called Nalaxone. The Nalaxone is in the pill so that it the pill cannot be melted down and injected, thus lowering the abuse potential of the medication.
Some opiate addicts take Suboxone for a long term drug maintenance in order to avoid street drugs or other opiates. It can also be particularly useful for opiate addicts who are suffering from chronic pain conditions that cannot be controlled with non-addictive medicines. Most people who use Suboxone for long term drug therapy take it twice a day, and this helps control cravings for opiates as well as to medicate their body for any pain issues they may have.
It is certainly not for everyone but it has definite application for a select group of opiate addicted users. In addition, the drug is fairly expensive and in some situations this can be cost prohibitive for some people, depending on how they are funded or whether they have insurance or not.
Opiate addiction help comes in many forms
So there are a number of options for treating opiate addiction. There are therapy groups, 12 step programs, short term treatment centers, long term treatment centers, individual counseling sessions, outpatient programs, drug maintenance program, group therapy, and so on. You can even find help online and possibly look up an opiate addiction forum. The key is not that one of these works better than the others, or that there is some magic combination of things that will work. Instead, the key is that each addict is unique, and their treatment that ultimately helps them is probably going to be unique as well. Therefore, we should strive for:
1) Repeated attempts at sobriety – if they do not succeed at first then they have to come back from a relapse and try again. Try something new. Try new strategies. Do something different if you want different results.
2) Customization – a recovery program should be unique and custom fit to the individual. Right now we have more of a one-size-fits-all approach. Certain programs do not work for everyone. We need to find what works best for the individual.
3) Positive creation of a new life – emphasis is on the creation of a new life in recovery, rather than on the addiction and the baggage from the past. Moving forward, setting goals, finding new purpose in life…these are the goals of the “new recovery.”
Getting past opiate addictions and living a new life
Many people have successfully overcome opiate addictions and managed to find a new way to live. The process usually starts slowly and the addict might be pretty down at first. But there is hope for a better life if they are willing to stick it out. Eventually they will transition into a new life in recovery and their life will have meaning and purpose again for them.
Actively creating this life is the point of recovery.
I have seen this trend towards opiate addiction treatment develop over the last 5 years or so, especially with younger people, because I work in a treatment center and I end up treating these patients for opiate withdrawal. I am not sure on the exact numbers regarding opiate use these days but I can definitely tell that it has become a bigger problem.
What if I have chronic pain issues?
People who suffer from chronic pain in their body have a particularly hard time getting off of opiate drugs. This is because they have accustomed their body to a certain level of painkiller, and when they remove it, they feel even more miserable than what a typical withdrawal would produce.
Opiates might be useful in some cases for getting someone through a period of intense, acute pain. But when you are suffering from long term, chronic pain, and you also happen to be addicted to the painkillers, then you are locked into a losing battle. Eventually you will have to take more and more of the drug just to feel normal, and it will no longer dull the pain with the efficiency that it once did. In a case like this, a big part of the solution is going to be addressing the chronic pain without the use of opiates.
Doing this might take some research on your part, especially if your doctor does not seem to be well educated about addiction. You might have to shop around and find someone who is more willing to work with alternatives and is more knowledgeable about drug addiction. There are almost always alternatives to opiates if you have chronic pain, it is just a matter of experimenting enough to find something that works for you.
The decision to overcome addiction
Just like with any drug or alcohol addiction, a person has to want to change if they are addicted to opiates. No one is going to be able to force a change in this case if the person does not genuinely want to get help.
It can be easy to fall into a pattern of denial with opiates. Many people can easily justify their use to themselves in a number of ways. For one thing, a lot of people have at least some physical pain in their body that they might have started medicating with opiates, so this is one form of justification. The second form of justification is that most people who are addicted to opiates tell themselves that they believe that their body reacts differently and that they simply need more of the drug than most people do. This is part of the “uniqueness” that all addicts and alcoholics go through when they are wrestling with the idea that they have a disease of addiction.
It is very difficult to break through all of this denial because the cost of doing so is so high. The opiate user knows that they are going to have to face a mountain of reality if they have to face life without their drug. Not only will they have to deal with any physical pain and the reality of dealing with physical existence without drugging their body, but they will also have to face the fact that they have been medicating their emotional state all along and now they will have to deal with their emotions if they choose to get clean. This emotional component is actually a much bigger deal for most people than the physical aspect of things and this is why we stay addicted to drugs and alcohol in general. It is not so much the physical component that keeps us trapped, but the threat of having to face life head-on without self medicating and actually deal with our real feelings and emotions without hiding behind our drug use.
When someone is hooked on opiates (or alcohol, or other drugs), they get into the habit of being able to instantly medicate their mood–how they actually feel–by simply taking their drug of choice. If they are having a bad day, if they are upset with their boss, if they are stressed out about something in their life, they can escape any of these mental or emotional states through taking their drug. This is what people are actually addicted to….this medicating of unwanted emotional states. This is what perpetuates addiction. On some level, the opiate addict understands that this is what they are up against if they choose to get clean. They have to be miserable enough or tired enough of doing drugs in order to take on this challenging task….the task of having to deal with their raw emotions and learn how to live without medicating them.
Getting through withdrawal
Opiate withdrawal is a nightmare. Even though it is technically less dangerous than alcohol withdrawal, it is probably more miserable in terms of how a person actually feels. Symptoms can include upset stomach, vomiting, tremor, severe anxiety, and cold sweats, just to name a few. Depending on which opiate and how much of the drug a person was taking can make these withdrawal symptoms vary quite a bit in terms of intensity.
There are a couple of options for getting through withdrawal, the least appealing of which is to simply kick the stuff cold turkey in the “comfort” of your own home. Any opiate addict who has tried this can tell you that it is not fun, and this is why the addiction is so prevalent. Avoiding withdrawal perpetuates the disease.
A better option for just about anyone is to seek treatment in a drug rehab setting. At least there you have the benefit of having your withdrawal symptoms treated and addressed as you come off the opiates. Most treatment centers will give medications and slowly ween you down off of them in order to minimize the withdrawal symptoms altogether. This might not be a completely pain free detox but it is a lot better than kicking the drugs cold turkey.
The other benefit of detoxing from opiates in a treatment center is the added support that you receive there. In most cases you will be exposed to their residential program as well, in which they attempt to teach people how to live a life without drugs.
What about drug therapy or drug maintenance?
One option for people who are trying to recover from opiate addiction is to take a synthetic opiate every day so that they do not return to their drug of choice. This is a highly controversial approach because essentially the addict is submitting themselves to dependence on the drug in order to try to limit and control their use. For example, some people take a drug called Methadone on a daily basis in order to stay off of heroin or other opiate drugs. This is generally distributed from a clinic. There is also the option of using a pill called Suboxone for long term opiate drug maintenance. This medication is probably a better option for most people because it does not produce the same “doping effect” that methadone does, but it still helps people who have a strong addiction to opiates. Of course, there are some negatives with Suboxone as well….all things that you should discuss with your doctor, of course.
For someone who has struggled with opiate addiction for a long time, and has never succeeded in really accumulating any clean time, drug therapy can seem like a good strategy that might be highly beneficial to them. I think at some point, people get desperate enough and think of this as a magic bullet. They see opiate maintenance as a possible cure for their problem. I think it is important to stress that drug therapy is pretty much useless without an accompanying change in lifestyle and a dedicated effort at personal recovery. In other words, if the only thing a person does is get on drug therapy, they are not going to enjoy lasting, long term recovery.
I believe this to be the case because I work in a treatment setting and I have been able to get a feel for the success rates with drug therapy over the last few years. Those who go on some sort of drug therapy have a tendency to keep coming back to treatment (for detox and residential treatment). What does this tell us about drug therapy? It tells me that it doesn’t really work that well in most cases.
This is not to say that it does not work for anyone, or that a person should never consider it. I still think there are certain addicts who are good candidates for drug therapy, simply because they have abused their body for so long with opiates that they have little chance of ever feeling normal again without some sort of “help.” In extreme cases like that I think drug therapy might be a necessary component so that a person can even have a chance at recovery.
Just understand that drug therapy is not a magic bullet.
If you or someone you know is struggling with opiate addiction
The best step for most people who are struggling with opiates is to seek professional help. This will generally mean attending treatment at a local treatment center or drug rehab. There, you can get detoxed from the drugs and start learning a new way to live without medicating yourself. If you have chronic pain issues, then you would do well to start exploring new ways to deal with your chronic pain as well. The most important thing at this point, though, is that the person surrenders to the idea that they have a disease and that they need to ask for help. Doing so is probably the best indicator of real change for the addict.