Spotting an opioid problem
Any use of an opioid drug, other than medically prescribed, is a sign of abuse, whether that’s regularly taking the drug recreationally, or just occasionally taking a slightly higher dose. One of the problems of opioid abuse is that it can be hard to spot if it developed from a prescription. Opioids are given to relieve pain, which is a subjective symptom, and it can be hard, even for the person taking the drug, to fully understand why they feel they need it; are they taking it to feel better because of the pain relief, or because of the endorphins?
At the lower end of the scale, any use that is not prescribed should be a warning. It might be that the prescription is not right, but it could also mean it’s being taken for different reasons than intended. As abuse become addiction, the signs become clearer. The user will find they think a lot about taking the drug, perhaps experiencing changes in mood, or even being unable to function normally, if they are unable to take it. They might find other parts of their life suffering as a result, and might see their behaviors change as they try to source additional supplies of the drug.
Addiction to opioids works like any other addiction, but because of the way opiates work they are particularly adept at creating addictions.
Opioids are prescribed for pain relief. They work by blocking opioid receptors and generating the endorphins that naturally provide pain relief in the human body. However, they stimulate the production of much more endorphins than normal, making them ideal for treating moderate to severe pain.
Endorphins also create feelings of pleasure in the brain, so they are good at changing the brain’s neural pathways to develop an addiction. Over time the tolerance that can develop to any drug, the psychological dependence — based on the desire to feel good — will be joined by a physical dependence in which the brain and body adapt to only function normally when opiates are in the system.
Rehab for opiate addiction
Like any other addiction, it is possible to beat opiate addiction. While the treatment will depend on the length and severity of the drug abuse, the drug in question and the individual involved, the basic model of recovery from addiction involves detox, rehab, and recovery.
How these are managed will depend on the situation. However, for most opioid addicts it might be best to consider inpatient rehab. The ready availability of opioid medications means that the potential for temptation and relapse is high. Inpatient, or residential, rehab means the addict can be treated in an environment free from stress and temptation, so they can focus on recovery.
Residential facilities also bring other benefits, from round-the-clock support, to the network of fellow residents that creates a ready-made peer group. And many are equipped to properly manage any co-occurring disorders, such as depression or anxiety, increasing the chances of a successful recovery.
The purpose and aim of rehab is not to ‘cure’ an addiction — addictions cannot be cured in the traditional sense — but to empower and prepare the patient for a life where they can manage and overcome the temptations of their previously addictive behaviors.
The stages of rehab
For most people the stages of rehab merge into one another, overlapping and moving at a pace that works for them. Each will bring its challenges, but with the support of a good facility and loved ones, can be faced successfully.
Detox is the first stage, and involves the body removing traces of the drug from the system. This can be particularly difficult with opioid abuse, especially when the more powerful opioids are involved, and the withdrawal symptoms can be severe. For this reason, substitution will often be used, using less potent opioids and smaller doses to effectively taper detox rather than going cold turkey. This approach is generally recognized as the most successful way to manage opioid addiction.
Rehab is the main stage, where the patient will be prepared for their opioid-free life. This can involve different therapies, helping them understand the effect of their addiction on themselves and others. It will also help the patient identify the causes and triggers behind their drug use, and develop mechanisms and strategies to avoid repeating that behavior. Many will also include group therapy, for example a twelve-step program, to help develop a supportive peer network that will last beyond the rehab.
Recovery is the life-long final stage. During recovery patients will start their drug-free life. They may continue to receive support from their rehab facility and continue to participate in twelve-step groups or receive therapy.
Opioids are powerful drugs and, used properly, effective in helping people recover from injuries and operations. But that power also makes them potentially dangerous. However, with the right support it’s possible to overcome abuse and addiction and live a life that’s free from opioid dependency.