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Treatment For Opioid Addiction

By Randy Moraitis, MA, CIP, BCPC

In my last blog post entitled “10 Facts About Opioids” I shared that according to the Centers for Disease Control (CDC) the United States is in the midst of a prescription painkiller overdose epidemic and discussed important facts about opioids such as heroin, vicodin, etc.

This post will follow up on our look at opioids with a discussion of treatment options for opioid abuse and addiction.

Treating Opioid Overdose
Currently there are some very effective drugs for opioid overdose. If someone overdoses on opioids and is barely breathing and close to death, an opioid antagonist such as naloxone, can be administered. This can provide immediate relief because it blocks the opioids from binding to the receptors in the brain.

Thankfully, more and more first responders, as well as citizens, have been trained in the use of naloxone and this has led to saving many lives.

Treating Opioid Addiction 
The first step to treating opioid addiction is detoxification (detox). Detox is extremely challenging because opioid users experience such intense withdrawal symptoms when they quit taking the drug.

I have seen this first hand numerous times while helping addicts get clean. I even once had an individual do their entire detox in my home without medication as they had no other treatment options. It can get messy and ugly!

Users encounter severe withdrawal symptoms that mirror the opposite effects of the drug. Instead of feeling euphoric, the user is extremely depressed. Instead of pain relief, users experience many aches and pains. Instead of constipation, users have diarrhea and other flu-like symptoms.

It is common to treat opioid addiction by administering a slower, longer acting opioid, such as methadone instead. Methadone maintenance is the most common treatment for heroin addiction and it has had significant success. One study showed that 80 percent of people who stick with a methadone maintenance program for one year end up abstinent from heroin for one to three years afterwards. By contrast, only 12 percent of people who drop out of methadone maintenance stay abstinent that long.

Other opioids are also regularly used in the treatment of heroin addiction. In fact, heroin itself is used in the treatment of heroin addiction in a number of countries. The idea is to give users a lower, but stable, prescription dose of heroin without all the risks associated with obtaining and using heroin on the street. Not surprisingly, heroin addicts are more likely to stick with a heroin maintenance program compared with a methadone maintenance program, and perhaps as a result, they’re less likely to use illegal drugs.

Other opioid drugs are frequently used in treating opioid addiction. Of course, this is very controversial as this is simply substituting one addiction for another.

Another common approach to treatment is to remove any reward associated with relapse. This is done by having the patient take an opioid antagonist such as naltrexone which blocks the rewarding effects of the opioids. This treatment works well with individuals highly motivated to quit who continue taking the naltrexone, but a problem arises when an individual gets very strong cravings and stops using the naltrexone.

In addition to pharmacological treatments, it can be most helpful if opioid addicts also receive cognitive behavioral therapy where they are trained to recognize and avoid their triggers for drug use.

It is also very helpful for the addict to receive counseling and coaching to move forward with a healthier life, and to be in a healthy supportive community which may include 12 step groups like Narcotics Anonymous or Lifelines.

Finding freedom from opioid addiction is very difficult, but it can be done with effective treatment, as well as healthy community and support in the life of the addict. If you have a loved one struggling with an opioid addiction, do not give up on them. Do all you can to get them into treatment, perhaps even an intervention, as it just may save their life!

For more information or to take the first step in getting a loved one help call 949-303-8264 or email randy@carepossible.org.

Websites: www.carepossible.org and www.randymoraitis.com

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10 Facts About Opioids

By Randy Moraitis, MA, CIP, BCPC
According to the Centers for Disease Control (CDC) the United States is in the midst of a prescription painkiller overdose epidemic. The most commonly abused opioids are:

  • Hydrocodone (e.g., Vicodin)
  • Oxycodone (e.g., OxyContin)
  • Oxymorphone (e.g., Opana)
  • Methadone (especially when prescribed for pain)

Frequently, when an individual no longer has access to prescription opioids, they turn to heroin which is both affordable and easy to acquire.

Presented here, with the goal of increasing awareness, are some basic facts about opioids.

1. Opium is the latex secreted from the seedpod of an opium poppy. Raw opium contains about 10 percent morphine and about 2 percent codeine. These are the opiate drugs, which just means that they’re natural products of the opium poppy. A number of other drugs, including heroin, are not contained in opium itself but are made from natural opiates or have very similar effects. These are sometimes called opioids.

2. The opiate drug morphine is among the most effective painkillers available today. Codeine has similar effects but is weaker than morphine. It’s often used to treat minor pain and as a cough suppressant. Of course, opium and drugs derived from opium are also often used recreationally, because they can produce a dreamlike, euphoric state.

3. People have known about those effects for a very long time. In fact, there’s evidence that the Sumerians knew about the psychoactive properties of the opium poppy plant as early as 3400 B.C. The Ancient Egyptians used opium medicinally. In the 1700s and 1800s, a mixture of alcohol and opium called laudanum became very popular and was widely used as a pain reliever, as a sleep aid, and to treat a variety of ailments. In the mid-1800s opium trade became a big business and even led to two wars, known as the opium wars, between the British and the Chinese.

4. In 1804, a German pharmacist isolated a pure alkaloid from opium and gave it the name morphine, after Morpheus, the Greek god of dreams. Morphine was more potent than opium or laudanum, and it became an invaluable tool to doctors in the treatment of pain. Morphine was administered to injured soldiers during the American Civil War.

5. In 1898, Bayer pharmaceutical company began selling a synthesized opioid that was one-and-a-half to two times more powerful than morphine, and it was marketed as a nonaddictive morphine substitute and cough suppressant—heroin. Bayer sold heroin for more than 10 years before its harmful effects were recognized and it was removed from the market. Heroin is now recognized to be among the most addictive drugs in the world.

6. Opioids are narcotic analgesics, which reduce pain without eliminating sensation. They’re distinguished from anesthetics, which reduce all sensation and often produce unconsciousness. Opioids also produce a dreamlike, euphoric state, which is what makes them attractive to recreational drug users, at least initially.

7. At higher doses, opioids produce a rush of euphoria. But the nauseating effects can become more severe, and some people also experience anxiety and restlessness. The most dangerous effect is a significant suppression of breathing. In fact, in an opioid overdose breathing can be suppressed enough to lead to death.

8. About 45 people in the United States die every day from overdosing on a prescription painkiller—that’s more than the number of overdose deaths from heroin and cocaine combined.

9. Similar to other drugs, opioids overstimulate the brain’s reward circuit and trigger a large release of dopamine. The brain interprets that dopamine as a reward prediction error, or an indication that taking the drug was better than expected. That reward prediction error in turn backs up to environmental cues that are associated with drug taking, so when the user encounters those cues in the future, he or she experiences a very strong craving to use the drug.

10. There are some very effective treatments for opioid overdose. If a drug user overdoses on opioids, is barely breathing, and is close to death, if someone administers an opioid antagonist drug, such as naloxone, the drug user will recover almost immediately, because the opioid will be blocked from binding to the opioid receptors.
If you have any prescription opioids in your home, be sure to keep them stored securely so any guests or visitors to your home will not be able to access them as these meds are frequently stolen.
In my next blog post we will look at treatment for opioid addiction. Special thanks to Professor Thad Polk of the University of Michigan for contributions to this blog.

If you or a loved one are affected by an opioid addiction, please contact me at randy@randymoraitis.com or 949-303-8264 to discuss options for healing.

You can visit my websites at www.randymoraitis.com and www.carepossible.org.

About Randy Moraitis

Randy is married to Kim and they live in Laguna Niguel. Together they have a blended family of five adult children and three beautiful grandchildren. (If you don’t believe Randy he will gladly show you pictures!)Randy is a Certified Intervention Professional (CIP) and expert in helping families affected by addiction and/or mental health issues. He is a Board Certified Pastoral Counselor and is both licensed and ordained as a pastoral counselor. He has five professional coaching certifications and loves working with clients on executive coaching, life coaching, wellness coaching and recovery coaching. Randy has a master’s degree with emphasis in theology and counseling, a bachelors degree in management and leadership, and a certificate in health and fitness with emphasis in exercise physiology and sports psychology from UC Irvine. He has been helping groups, individuals and families get mentally, physically and spiritually healthy in Orange County for over 25 years.

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