Opioids are a class of drugs that are derived or synthesized from the poppy plant. All prescription versions of this drug share the class with heroin, opium and morphine. Though highly addictive, opioids are some of the most prescribed medications for pain in the United States with over 190 million prescriptions written each year. As such, opioid abuse has quadrupled.
Becoming addicted to opioids can happen to anyone. Some experts believe that abuse is rampant today because addiction can happen quicker than once previously believed. While the average prescription written is normally for anywhere between 4-16 days, the average time it takes to become dependent on the medication is five days, while the odds of chronic abuse seems to skyrocket when a second prescription is filled.
Research shows that opioid addicts have lost gray matter in their brains, resulting in less critical thinking while at the same time increasing the likelihood of impulsive behavior; a dangerous combination that advances opioid abuse and dependence. While the brain loses volume, it also loses the ability to repair itself as the addiction cycle continues.
Even though opioids provide pain relief and, for some, feelings of well-being and euphoria, abuse can be dangerous. As a patient gets used to taking more to subdue pain, the higher tolerance creates a higher risk for side effects like fatigue, chronic constipation, bronchospasm, nausea, confusion, chest pain, and even death.
List of Prescription Opioid Drugs
Often a prescription may be written with names of medication we do not recognize. This could be dangerous as someone may be taking prescription opioids in more than one medication and not realize it. And since these medications can make us more sensitive to pain, a patient might take more in the belief and hope that it will help dull the pain faster and longer. The cycle of abuse often begins here.
Learning the names of opioid drugs may help you or a loved one avoid accidental addiction and overdose. The following is a list of common prescription opioids with their brand names:
- Buprenorphine (Butrans)
- Fentanyl (Fentora, Sublimaze, Onsolis, Duragesic, Actiq and Abstral)
- Hydrocodone (Hysingla, Zohydro ER)
- Hydrocodone with acetaminophen (Vicodin, Norco, Lorcet and Lortab)
- Hydromorphine (Exalgo and Dilaudid)
- Meperidine (Demerol)
- Methadone (Dolophine and Methadose)
- Morphine (Avinza, Morphabond, Oramorph, MS Contin, Roxinal-T and Kadian)
- Oxycodone (OxyContin, Oxyado and Xtampza ER)
- Oxycodone with acetaminophen (Percocet and Roxicet)
- Oxycodone with Naloxone (Targiniq ER)
- Tapentadol (Nucynta ER)
Prescription Opioid Withdrawal
Withdrawal from prescription opioids is known to be uncomfortable. Side effects of opioid abuse are dangerous, but the withdrawal symptoms can be just as dangerous. The initial withdrawal phase may be intense depending on how much of the medication was taken, the physiology of the user and how long the opioid abuse lasted.
Initial withdrawal may begin anywhere within 6 to 30 hours from the time the last dose was taken. Physical symptoms are prevalent and may be harsh.
Early withdrawal symptoms may include:
- Muscle aches
- Increased tearing
- Runny nose
Late withdrawal symptoms may include:
- Abdominal cramping
- Dilated Pupils
Withdrawal often peaks around day four of the last dose. During this time cravings for the opioid used may intensify as well as a continuation of physical withdrawal symptoms. As a person often experiences multiple symptoms at a time, they may appear to have a very bad flu.
After the initial detoxification phase, most patients will experience emotional or psychological withdrawal symptoms. While some physical symptoms in milder form may last, more often the side effects noticed will be insomnia, depression, anxiety and restlessness. These happen as the brain is attempting to reset and adjust to life without the medication.
It is crucial to receive the right treatment at this time in order to help avoid relapsing. Some unresolved emotional or psychological issues may surface that may not have been previously addressed. While they may have been numbed from using opioids, the issues usually do not resolve because of the drug. Because abstinence from the drug can allow these feelings to come back, oversight may be necessary to help someone avoid relapse. Intense cravings for the drug, along with depression, anxiety and other hidden issues may trigger a relapse. All stages of opioid withdrawal require professional help and oversight. It is important to help the patient avoid relapse or acquire their own replacement drug like heroin, opium or morphine.
Treatment for Prescription Opioid Drugs
For most addictions to prescription opioids, medical intervention is highly recommended. This may include the use of a weaker medication that can take the place of the opioid to help slowly wean off the drug. Other medications may be prescribed to help ease heavy side effects of withdrawal as well.
Buprenorphine and naltroxone are two replacement medications that replace an opioid that was abused. These are approved by the FDA to help ease psychological cravings that often interfere with recovery. The severity of a person's abuse or addiction of an opioid determines the length of the medical detoxification program, but the average program lasts three weeks. At this point, psychotherapeutic counseling should be incorporated to help with psychological and emotional issues associated with addiction.
Inpatient residential treatment programs are most effective for long term recovery success. Medical detoxification protocols are overseen while group therapy, individual therapy or sometimes 12-step programs are available on site. Staying in a facility helps ensure the recovering patient has access to lower dose painkillers if necessary, or transition drugs to help leave their opioid dependency behind.
Addiction therapists can help create individualized programs and supervise during the entire recovery process. The patient will be taught skills to continue living a sober life. These inpatient programs often last around three months.
Outpatient treatment for opioid abuse and dependency is an option that may be necessary for some who cannot leave their responsibilities behind. Outpatient methods do work and have a substantially increased success rate when opioid maintenance is used compared to when detoxification is followed only using psychotherapy treatments.
An outpatient facility often begins with a detoxification program organized by a medical professional to help determine which, if any, pain medications, or replacement drugs may be necessary to help the person be more comfortable during treatment and avoid relapse. The patient may visit a clinic or hospital a few times a week or daily to follow through with this part of the treatment.
Other Useful Therapies
Group therapy, individual counseling, 12-Step and Cognitive Behavioral Therapy (CBT) are all valid methods that may be offered to complete addiction treatment. Group therapy and 12-Step programs both help patients recover as they share stories that instill hope and even learn stress and life coping skills from peers who have been through recovery.
Individual therapy is helpful to learn why addiction took over in the first place. Buried or unknown psychological, emotional and even behavioral issues can be addressed, and proper treatment can be discussed to help the patient move forward and live a productive life while avoiding relapse.
Cognitive Behavioral Therapy is the most touted for prescription opioid abuse, due to the amount of research done proving it has a high success rate. Instead of focusing on a person's personality profile, a CBT therapist will instead focus on the current lifestyle situation to see how to best learn from it and change it in a positive way.
Treatment for prescription opioid drug abuse and addiction is unique to each individual. Getting help to recover from opioid addiction can be the meaning between life and death. If you or a loved one is addicted to prescription opioid drugs, seek help from a quality rehabilitation center immediately. You do not have to suffer, help is readily available if you are ready to recover.