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Opioid Dependence

Opioid Dependence Information

Opioids are a class of drugs that include prescription painkillers like oxycodone, hydrocodone, and morphine, as well as the illegal drug heroin. Opioid addiction can be a serious problem with potentially devastating consequences.

Opioid addiction, like many substance use disorders, is a complex condition influenced by various factors. Opioids bind to specific receptors in the brain, leading to a release of dopamine, which creates a sense of pleasure and euphoria. Regular use can lead to changes in brain chemistry over time, causing individuals to develop a tolerance, requiring higher doses to achieve the same effect, leading to dependence and addiction. There is evidence to suggest a genetic predisposition to addiction. In addition, individuals with a family history of substance use disorders may be at a higher risk of developing opioid addiction. People with mental health disorders, such as depression, anxiety, or trauma-related disorders, may be more susceptible to opioid addiction. Some individuals may use opioids as a form of self-medication to cope with emotional pain.

Factors such as genetics, mental health conditions, and environmental influences can contribute to the risk of opioid addiction.  Additionally, continuous and prolonged use of opioids, whether prescribed for pain management or used recreationally, can increase the risk of developing dependence. Taking opioids at higher doses than prescribed or using them in larger quantities than recommended can elevate the risk of dependence. Individuals prescribed opioids for pain management are at risk of developing dependence, especially if the medication is used for an extended period. Individuals with a history of substance use, including alcohol or other drugs, may be more susceptible to opioid dependence. Co-occurring mental health disorders, such as depression or anxiety, can increase the likelihood of opioid dependence. Some individuals may use opioids as a way to self-medicate their mental health symptoms. Genetic predisposition can also play a role in an individual's vulnerability to opioid dependence. For those with a family history of substance use disorders, this may contribute to a higher risk. Certain demographics such as young adults and males have been shown to be at higher risk. Peer influence and social factors, including exposure to substance use in the community, can contribute to opioid dependence. Individuals who have experienced trauma, such as physical or emotional abuse, may also be more likely to turn to opioids as a way of coping, which increases the risk of dependence.

Opioid addiction can have severe consequences, including physical and mental health issues, overdose, and an increased risk of infectious diseases. It can also lead to strained relationships, financial problems, and legal issues.

Opioid Dependence Treatment

Treatment for opioid addiction often involves a combination of medication-assisted treatment (MAT), counseling, and support groups. Medications like methadone, buprenorphine, and naltrexone may be used to help manage withdrawal symptoms and cravings.

Strategies to prevent opioid addiction include proper prescription practices, public awareness campaigns, and increasing access to addiction treatment services. Efforts to reduce the stigma associated with seeking help for addiction are also crucial.

Medications We Use

  •  Buprenorphine: Buprenorphine is a partial opioid agonist. It binds to the opioid receptors, producing a milder effect compared to full agonists like heroin or oxycodone. Buprenorphine helps reduce cravings and withdrawal symptoms without producing a strong euphoria.

  • Naltrexone: Naltrexone is an opioid receptor antagonist. It blocks the effects of opioids by binding to the opioid receptors, preventing other opioids from attaching and producing their usual effects. This medication is used to help prevent relapse in individuals who have already detoxified from opioids.

  • Suboxone (Buprenorphine/Naloxone): Suboxone is a combination medication containing both buprenorphine (partial opioid agonist) and naloxone (opioid receptor antagonist). Naloxone is added to discourage misuse (injection) of the medication. When taken as prescribed, the naloxone has minimal effect, but if the medication is crushed and injected, the naloxone can precipitate withdrawal.

  • Clonidine: Clonidine is not an opioid but is sometimes used in the management of withdrawal symptoms. It works by stimulating certain receptors in the brain, which helps reduce sympathetic nervous system activity and alleviate withdrawal symptoms.

  • Naloxone (Narcan): Naloxone is an opioid receptor antagonist used for emergency treatment of opioid overdose. It rapidly binds to opioid receptors, displacing other opioids and reversing the effects of opioid intoxication, particularly respiratory depression.

 

These medications are often used as part of medication-assisted treatment (MAT) programs, which combine medication with counseling and behavioral therapies to address the opioid addiction. The choice of medication may depend on factors such as the individual's medical history, the severity of addiction, and the treatment plan developed in consultation with licensed healthcare professionals. MAT has been shown to be effective in reducing opioid use, preventing relapse, and supporting long-term recovery. At our office, a typical first appointment consists of meeting with your provider, discussing potential options, obtaining appropriate labs, paperwork, and the development of  a treatment plan. Induction therapies are then planned for initiation at a follow up appointment with a driver able to take the patient home. 

Therapy

 

Counseling therapy can help improve depression symptoms by helping you develop skills to more effectively deal with the thoughts and feelings you are having. These therapies consist of:

  • Cognitive behavioral therapy. This type of therapy will help you cope better with depression by teaching skills specific to management of organization, patterns of thinking, and behavioral patterns. 

  • Family therapy. Because many people with depression encounter loved ones, family members, and spouses who are unfamiliar with depression, this therapy can help them overcome the stress associated with living with someone who struggles with depressive symptoms. 

  • Music therapy. This therapy utilizes music to help relax an individual to enhance their mood. Music therapy activates  cognitive, motor, and speech centers in the brain to help improve overall functioning.

  • Talk therapy. This type of therapy employs a variety of techniques to help a person better deal with thoughts and behaviors.

  • Interpersonal therapy. IPT is a type of therapy that focus on personal relationships and how you feel. It is a short-term, intensive therapy.

  • Integrative therapy. This therapy approach takes aspects from different therapy types to create a personal therapy to best treat the presenting problem.

Opioid Dependence Resources

  1. Substance Abuse and Mental Health Services Administration (SAMHSA):

    • SAMHSA provides a national helpline offering free, confidential assistance 24/7. They can help connect individuals to treatment and support services.

    • Helpline: 1-800-662-HELP (4357)

    • Website: SAMHSA

  2. National Helpline for Opioid and Substance Abuse:

    • A helpline offering information, support, and treatment options for individuals and families dealing with opioid and substance use disorders.

    • Helpline: 1-800-943-0566

  3. Narcotics Anonymous (NA):

    • NA is a 12-step program that provides support for individuals recovering from addiction, including opioid dependence.

    • Website: Narcotics Anonymous

  4. Medication-Assisted Treatment (MAT) Programs:

    • MAT combines medications with counseling and behavioral therapies to provide a comprehensive approach to opioid dependence treatment. Local healthcare providers and addiction treatment centers often offer MAT programs such as at Pine Ridge Mental Healthcare.

  5. Opioid Treatment Programs (OTPs):

    • OTPs are specialized programs that provide medication-assisted treatment (e.g., methadone, buprenorphine) for opioid dependence. They are regulated by the Substance Abuse and Mental Health Services Administration (SAMHSA).

    • SAMHSA's OTP Directory: OTP Directory

  6. Local Health Departments and Community Health Clinics:

    • Local health departments and community clinics may offer addiction treatment services, including counseling and support.

  7. Community Support Groups:

    • Joining support groups such as Narcotics Anonymous or SMART Recovery can provide a sense of community and shared experience.

  8. Family and Friends:

    • Seeking support from friends and family is crucial. They can provide emotional support, encouragement, and help in finding appropriate treatment options.

  9. Crisis Helplines:

    • In case of emergencies or crisis situations, contacting local crisis helplines or national hotlines can provide immediate assistance.

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