Opioids are substances derived from the opium poppy. Once opioids are consumed, they bind to receptors in the brain, spine, and elsewhere in the body. The receptors then send signals to the brain telling it to reduce pain sensations, thus creating an analgesic effect in the body.
Prescription opioids, such as morphine, oxycodone, and fentanyl, are prescribed for short-term and chronic pain management; examples of name-brand opioid painkillers include Vicodin®️, Percocet®️, and OxyContin®️. Non-prescription opioids, or street drugs, include heroin and opium, which are illegal. The Drug Enforcement Administration’s controlled substances schedule places the majority of opioids in the top two schedules, indicating the drugs have a high potential for both abuse and dependence.
Buprenorphine, the active ingredient in SUBOXONE, is also an opioid — but it is different from other opioids. As a partial agonist, buprenorphine does not create the euphoric high produced by full-agonist opioids (such as fentanyl and heroin). Buprenorphine does, however, activate the brain’s opioid receptors just enough to stop cravings and withdrawals. The Kentucky Board of Pharmacy, as well as certain federal authorities, regulates buprenorphine doctors and patients in Kentucky.
After stopping opiates, the brain’s reaction is immediate. Opioid withdrawal symptoms begin 48–72 hours after a patient stops using the drug and can last 1–2 weeks. The severity of withdrawal symptoms depends on how frequently the patient abused opioids. There are both physical and psychological withdrawal symptoms that include the following:
A person who has taken opioids for only a couple of days or weeks may be able to quit using his or her own willpower. The safe way to stop is by tapering off the drug by using gradually smaller amounts over an extended period.
However, people addicted to opioids, and even patients who have taken opioid medications responsibly for years may struggle to quit by themselves. Tapering will suppress, though not eliminate, withdrawal symptoms. And a person with a high tolerance and strong cravings will find tapering off opioids difficult or impossible.
Patients with substance use disorders often have had their decision-making abilities held hostage by the disease of addiction. These patients need assistance from doctors or addiction specialists, who often recommend a two-pronged treatment consisting of buprenorphine medication and some form of counseling.
Addiction is a chronic disease affecting brain function — that is the consensus of today’s medical professionals. And at Lake Behavioral Health, we treat substance use disorder just like any other medical condition.
A person with opioid dependence, or an addiction to other drugs or alcohol, is not mentally weak or morally bankrupt; he or she is affected by a chronic condition, a disease of the brain.
In many cases, substance use disorder is genetic and passed down from parents to children. Meanwhile, friends or spouses can also exacerbate each other’s addictions through behavioral triggers.
How does opioid dependence affect the brain? It begins with the fact that the brain produces natural opioids, called endorphins, along with dopamine, a chemical that causes euphoria and is released as a reward for a specific behavior, such as exercising or eating. Compared to these chemicals, taking opiates creates similar but far more intense feelings of euphoria. And as more opioids are consumed, the brain begins to rewire itself: it stops producing the chemicals and instead relies on the drugs. With no drugs, the brain is depleted of certain chemicals it can no longer produce, and the results are feelings of lethargy, anxiety, and depression. By this point, taking opioids is the only way to generate the chemicals in the brain that makes the person feel normal. Therefore, opioid dependence is not a habit or a character defect; it is a chronic disease of the brain.
Chronic disease often has no cure, but its symptoms can be controlled by treatment. This is the case with opioid dependence. Through treatments, such as buprenorphine medication and counseling, a person with substance use disorder can recover from opioid dependence.
A proclivity toward addiction is often genetic and will last a lifetime. However, a person can use addiction treatments to stop any current, ongoing abuse of opioids or any other substance, and take steps to keep at bay future impulses for substance use.
The length of treatment for drug or alcohol addiction varies for each person. However, research shows that extended treatment periods lead to better rates of recovery.
For recovery from opioid dependence, one year of medicated assisted treatment and counseling is considered the minimum. Some patients take SUBOXONE (or another buprenorphine medication) for several years, and others for a lifetime. However, patients can taper down their doses, with a doctor’s approval and supervision, during treatment.
Substance use disorder is a chronic disease that, for many patients, never goes away. That said, with the right treatment plan, a person can stop using drugs or alcohol altogether, as well as prevent cravings and withdrawals and learn to live a healthy, normal, and productive life.
Just as no two people are the same, no two patients will experience the same treatment outcomes. Substance use disorder is a complex condition that can affect patients differently based on their history of drug use and even genetics. That said, patients all have the ability to stop using drugs or alcohol and lead a normal life; it is only a matter of finding the best treatment for the individual.
For the treatment of opioid addiction, the most effective approaches are intensive outpatient therapy and medicated assisted treatment. These multi-pronged approaches encompass buprenorphine treatment (either with SUBOXONE or a pharmacological equivalent, such as Subutex®️), along with services such as mental health assessments, physician visits, targeted case management, individual and family therapy, peer counseling, educational support services, and more.
Positive outcomes are also contingent on the length of treatment and the patient’s commitment. Motivated patients who take the buprenorphine as prescribed and attend counseling regularly for at least one year tend to see the best results.
Although there is no easy test to determine that a person is addicted to opioids, there are indicators of when the disease has taken hold of someone. When the person obsesses about getting opioids and then spends much of his or her time either using the drug or recovering from its effects, he or she is likely showing signs of addiction. If a person appears to have unexplained changes in social values, engage in risky behavior, or experience deteriorating relationships with family, friends, or a spouse, these are also potential indicators of substance use disorder.
Admitting to a substance-abuse problem is one of the hardest things a person can do in life. Even when the addiction is evident to everyone else, the person who has the problem still might struggle when asking for help. Family and peer support can go a long way toward encouraging someone with opioid dependence to seek treatment. For tips on finding help or assisting someone else with a substance abuse disorder, please contact Lake Behavioral Health.
SUBOXONE is a medication used in the treatment of opioid addiction. The primary ingredient is buprenorphine, a partial agonist that creates side effects that are milder versions of those of an agonist opioid, including sedation, dizziness, and nausea. A secondary ingredient in SUBOXONE is naloxone, an antagonist. This ingredient blocks opioid receptors in the brain and can cause side effects that mimic slight withdrawal, such as headaches, lightheadedness, and trouble sleeping. If SUBOXONE is used with another opioid, the naloxone in the medication can create full-blown feelings of withdrawal. Usually, any side effects of SUBOXONE abate after a few days as the patient adjusts to taking the medication.
Compared to other opiates, SUBOXONE has much lower rates of abuse and addiction. As a partial agonist opioid, the medication has limited psychoactive effects — taken as prescribed, SUBOXONE only delivers enough pain relief and euphoria to mask any feelings of opioid cravings or withdrawals. However, if the medication is abused, it can create a slight high, though nothing compared to the effect of a full-agonist opioid. Because of its low risks of abuse, SUBOXONE is highly effective in the medicated assisted treatment of opioid addiction.
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