Resisting the Urge to Self Medicate with Opiates

Resisting the Urge to Self Medicate with Opiates


How can a person resist the urge to use opiates such as Vicodin or heroin when they are trying to get clean and sober and turn their life around?

I have a few suggestions for anyone who is struggling with opiate cravings.

First and foremost is the suggestion to attend inpatient rehab. I am talking about the kind of facility that has a 28 day program which also includes a medical detox as well as residential treatment. This is really a total solution because, not only do they help you to safely detoxify your body physically, but they also attempt to give you tools and resources so that you can maintain recovery after you have left the facility. They often will have group therapy, 12 step meetings, individual counselors, and a dedicated aftercare plan that is all laid out for you when you transition out.

This is really the number one suggestion for anyone who is struggling with addiction of any kind, because it gives you so many resources and advantages that other solutions just cannot compare with. For example, you could always just go see a therapist or a counselor, but then you would not have any help with the physical withdrawal symptoms (which in the case of opiate detox, can be fairly significant). Or you could simply start attending NA, or Narcotics Anonymous meetings, but then you would still have the problem of physical withdrawal.

In addition to missing out on the medical detox portion of rehab, you might also miss out on a lot of other things that are not necessarily obvious or easy to replace, such as peer interaction, holistic groups at the treatment center, meeting just the right therapist or counselor at just the right time, having a safe place to be for 28 days, and so on. There are multiple factors that make inpatient treatment the slam dunk choice for anyone who is struggling with addiction. Trying to conquer your disease with a solution less than inpatient rehab is going to be an additional challenge for you.

So maybe you can arrange for inpatient treatment and maybe you cannot. If you can, that’s great, and I would urge you to take it very seriously and get every resource that you can out of the experience. If you cannot attend inpatient rehab, then I would first urge you to look at what excuses you might be making that are obviously just that–excuses. Anyone can go to rehab, whether they believe they can or not. We all have excuses and justifications for why we are so integral to the world that we cannot possibly be whisked away for 28 days, but those are all lies and excuses that we make up. To wit, what if you suddenly overdosed or died? Would the world continue to turn then? Of course it would. And it will keep turning while you are in a 28 day program as well. No one is so important that they cannot go for a month of their life in a facility so that they can save their life and continue to live.

Of course, the real battle with triggers and urges begins once you are done with inpatient treatment. While you are in rehab they will likely medicate you in order to help you get through withdrawal, and that is fine. Go with it and do what they suggest and you will come out of treatment clean and sober. But then the challenge is to start rebuilding your life in such a way that you are able to resist temptation in the future.

It is actually very easy to remain clean and sober while you are in a rehab facility. The temptation is removed; you are in a safe place, and you are likely going to be medicated to a small degree. This sets you up for success while you are in the 28 day rehab stay. After that, you must follow through with your aftercare if you want to continue to thrive in recovery.

There are several tools that are available to you post-treatment. I will give you a few examples and talk about what has worked best for me.

The first tool is something that they almost certain educated you about in rehab, which is AA and NA meetings. One of the most universal and basic suggestions in recovery is to simply go to a meeting if and when you have a craving to use. Better yet, most people suggest that you simply go to an AA or NA meeting every single day for the first 90 days of your recovery. This may sound like a huge commitment, but once you get into the habit of daily meetings they are not a big deal as far as scheduling or logistics. Going to a meeting every day can become natural and normal for you, and you will wonder why you never did this in the past. Doing 90 in 90 can be a huge foundation block for your early recovery. I recommend it.

The second tool would probably be part of your aftercare recommendations after leaving rehab, which would be either individual counseling sessions or IOP therapy. This can be critical for people in early recovery because you might have to deal with some issues that are really not appropriate to discuss at an AA meeting, nor would you want to in the first place. In addition, I got several suggestions from my therapist in recovery that were not things that people at AA and NA were telling me. These were things like quitting cigarettes, exercising every day, and going back to college. I did this these things because my therapist suggested them to me, not because someone at an AA meeting suggested it. And it just so happened that those suggestions made a huge impact on the quality of my recovery.

Another tool that you can consider in terms of fighting off urges and cravings for opiates would be to investigate the idea of MAT. This stands for “medication assisted treatment” and it generally comes in the form of a medicine known as Suboxone or Subutex. These medicines are partial opiates that do not fully get a person “high,” but they can be used in a maintenance capacity to help them to overcome their cravings. Some people take this medicine for several months following treatment and it has been shown to be effective when combined with therapy and social support (such as NA meetings).

It is critical to understand, however, that using MAT such as Suboxone without also working a real program of recovery is not going to produce the results you want. Everyone secretly believes that they can short cut the system, use MAT, and somehow just live their life in recovery without doing any of the actual work. It would be nice if we had a miracle cure like that, but no such cure exists. Therefore, MAT is not a magic pill just yet, and continues to be a supplemental therapy instead. Make sure you use it like one, rather than relying on it fully to keep you clean. Good luck!