What is opioid abuse and addiction?
Drugs like fentanyl are intended only for clinical use, and when used as directed the risk of addiction is small. However, as soon as a drug is used in a way that wasn’t intended by the clinician, it is being abused. This might mean using more than the prescription states, or more frequently, or preparing the drug to use differently. When used outside a clinical setting fentanyl is usually prescribed as a patch that releases small amounts of the drug over a period, but these patches are often scraped to get the drug.
Opioids work by binding to the opioid receptors in the body, which then triggers the production of neurotransmitters like endorphins which help relieve pain. These endorphins will also create the feelings of pleasure and euphoria that are associated with recreational drug use, and in some people these feelings can lead to addiction.
Fentanyl is fast acting as well as powerful, and this means the brain can quickly develop the association, and addictive neural pathways, that result in the compulsive need to take the drug. And because it is so powerful, the physical dependency, where the body needs the presence of the opiate to function can be hard to manage.
Can fentanyl abuse and addiction be treated?
Like any abuse or addiction, it is possible to treat an addiction to fentanyl. However, because the drug is so powerful it is sensible to address the abuse with the right support. The withdrawal from fentanyl can be difficult, and substitution therapy, where the drug is replaced with a less potent alternative to taper the intake is usually recommended.
Although abuse and addiction can be treated at either a residential center or as an outpatient, treatment for fentanyl abuse is usually best managed with a stay in a residential rehab to begin. Residential, or inpatient, treatment offers many advantages, including round-the-clock support through the difficult withdrawal phase, but also provides a supportive and substance-free environment, during the first steps towards a drug-free life.
What happens in fentanyl rehab?
Starting a drug-free life has three steps, detox, rehab, and recovery. Usually, the boundaries between these are not clear, and sometimes it might not be possible to tell exactly what stage someone is in.
Detox is the first stage. Short for detoxification, it is a natural process in which the body cleans itself of the drug. Detoxification is happening all the time, and is just a natural process that most people do not pay it any attention as their body manages and metabolizes the toxins in their body.
Depending on the length and severity the drug abuse, the body will adapt to the presence of the drug. This can have physical effects, the opioid receptors can affect things like motor function and digestion, and psychological effects because without opioids to stimulate production there will be fewer endorphins and dopamine. While the physical processes of a detox can be relatively quick, the psychological effects can take a lot longer to resolve.
One of the benefits of residential treatment is that professionals are present to help manage the withdrawal process, not just managing any substitution, but also offering the right treatment for any other co-occurring disorders that might arise, such as a new or recurring depression.
Rehab is the step during which the patient begins to prepare for their drug-free life. The focus of this stage will be developing an understanding of how the abuse or addiction started, and how to prevent a relapse.
This will often involve different types of therapy. Counselling, where a patient can explore issues and feelings without judgement, can be helpful in identifying factors that might have prompted the addiction. Cognitive behavior therapy, or CBT, is also often used to help the patient practically by identifying negative thought processes that might prompt addictive behavior, and develop strategies to interrupt those processes. Twelve-step programs are also a popular option. These have the benefit of providing a peer group that can provide ongoing support to each other throughout the rehab and recovery process.
Recovery is the final process. Most people will transition to recovery slowly from rehab, continuing to receive support from their residential rehab facility after they have moved out. Recovery is a life-long process, since there is always the risk of addiction, so many will continue with things like therapy or participation in twelve-step programs.
Dealing with opioid abuse and addiction can be a long and difficult process, especially with a drug as powerful as fentanyl. However, with the right help and support, and, most importantly, the desire to be drug-free, recovery is possible.