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Opioid Addiction Treatment And What Are The New Opioid Prescribing Guidelines?

Last Updated: January 14, 2022

Authored by Dr. Ahmed Zayed

Reviewed by Michael Espelin APRN

Opioids are a class of drugs used to manage pain. Even though they have a vital role to play in pain reduction management, especially in cases where a patient has undergone surgery or suffers from a condition like cancer, addiction to these drugs is becoming a global concern. Several opioid lawsuits against manufacturers, who tried to hide the risks from these drugs, have risen recently. In 2018, it was reported that around 10.1 million people in the United States misused opioids, and this could lead to overdose. In another report by the CDC, 2 out of 3 of these opiate overdose cases lead to death.

Reasons To Seek Professional Treatment For Opioid Addiction

Opioid addiction has become a significant problem. While scientific evidence supports the fact that these medicines can alleviate pain symptoms, the risk of addiction associated with these chemicals is a real concern that needs to be addressed. While some people are looking for resources to initiate an alternative to opiate rehab at home, it is critical to realize the risks when professional opioid treatment is not utilized. Below is an overview of important reasons why people should seek health professional services when they have become addicted to these drugs.

Unique Challenges Faced With Opioid Addiction Treatment

Each case of addiction is unique, and while there are several risks and concerns associated with this type of dependence, a one-size-fits-all approach to treating substance abuse disorders often does not yield the most effective results. These unique challenges faced by a person cannot be effectively addressed by remaining at home and not gaining help from a health professional who has been dealing with these issues for some time. A rehabilitation facility that offers professional opioid treatment programs can give the person access to services that would otherwise not be able to utilize. This includes opioid drug testing services, as well as counseling and potentially medication that may help to reduce withdrawal symptoms.

Risk Of Relapse

There is a danger of the patient relapsing when they undergo opioid addiction treatment without enrolling in opioid treatment programs or getting medical intervention from a professional and trained provider. Relapse puts the individual at a higher risk of several complex problems, such as combining substances. In one study published in the Journal of Addiction, it was reported that relapse after detoxification from opioids is high despite multidisciplinary endeavors, with a prevalence rate of 72-88%. In the same study, it was also reported that younger patients are more at risk of relapse.

Moreover, according to a study published in the Journal of Substance Abuse, there are many factors for relapse including verbal and physical abuse from family members and involvement in legal issues. In this study, it was reported that 100% of the subjects who had relapses were verbally abused by either their parents or spouses.

A doctor holds different pills in his hand.

Long-Term Effects of Opioids

The use of opioids causes many side effects. Although they are effective treatments for pain, misuse or abuse of these drugs may cause unwanted health effects. According to a study of medical doctors from India, the effects of opioids depend on the mu-opioid receptors they bind. These receptors are responsible for triggering the brain reward systems, causing mental changes. As of today, there are 3 mu-opioid receptors: mu-1, mu-2, and mu-3. Take a look at the information below about how these mu-opioid receptors work.

  • Mu-1: Responsible for algesia and dependence
  • Mu-2: Responsible for euphoria, dependence, respiratory depression, miosis, decreased digestive tract motility/constipation
  • Mu-3: Responsible for vasodilation

According to a study of medical doctors of the USA, long-term use of these opioids can cause downregulation of the mu-opioid receptors. Eventually, when there is downregulation, mental health dangers such as tolerance, dependence, and addiction may occur. When this happens, patients should consider looking for resources to help them get successful recovery from these drugs.

Risk Of Accidental Death

In a clinical review by medical doctors from Connecticut, drug overdose is the leading cause of accidental death in the United States, and the most common drugs are opioids. According to recent news, the risk of accidental death due to overdose has increased by up to 29% in the year 2020. Opioid overdoses contribute to millions of deaths each year – and this is an important factor to consider for someone who is showing signs of addiction to these drugs. Current opiate misuse measures and studies show that overdose is a common problem that contributes to these drug-related deaths. Without understanding appropriate opiate dose conversion factors, the risk of overdosing becomes possible and this may even lead to accidental death in some cases.

Access To Medicated Opioid Addiction Treatment

Opiate replacement therapy is considered one of the effective opioid treatment programs to help a person’s addiction to these drugs overcome the dependence that developed without experiencing serious withdrawal symptoms. Patients will not gain access to the medications without consulting with a health professional, which is another reason why opioid treatment at a rehabilitation or opioid addiction treatment center is important.

Opioid Treatment Programs

Different opioid treatment programs may be included in a person’s program to assist with the cessation of drugs. In the majority of cases, a step-by-step process will be initiated, with some unique factors that are tailored to the specific scenario. The individual will first undergo an initial interview with an intake counselor at a rehabilitation facility. This helps the health professionals understand the physical and mental needs of the patient and develop a program that would yield more effective results.

Generally, there is a Medication-Assisted Treatment or MAT opioid program where medications and counseling will be combined in one session. In the majority of opiate use disorder cases, the types of opioid treatment protocols that tend to form part of such a program will be listed in the information below.

Opioid Detoxification

Opiate detox usually forms part of the initial treatment for opioid use disorder, as this is one of the most critical phases of the program. During detoxification, a patient will be provided access to a specialized opioid addiction treatment center in most cases, where they will stop using opioids and will be provided the care needed. Specialized care is needed during this time, as the withdrawal symptoms that occur shortly after the cessation of drug use can be quite intense for some people. This is especially the case with heroin users, as well as those who have been abusing and suffering from substance dependence disorder for a significant period.

Professional Psychological Therapies

Even though opioids have several physiological effects on the body, it is important not to overlook the mental complications that come with any type of addiction. As part of an opioid addiction treatment program, a person is likely to be offered access to psychological treatment services.

This Will Usually Include Access to Group Therapy, as Well as One-On-One Sessions With a Trained Counselor. Some Psychological Therapies May Be as Follows:

Here, the idea is to determine the root causes behind the person’s addiction, since in some cases there are mental issues that may be the underlying cause to address during treatment.

Medicated Treatment

Based on MAT opioid protocol, Buprenorphine has been the most widely known medication for opioid treatment, and, in 2017, a new innovative Buprenorphine brand called Sublocade has been introduced in the global market. Sublocade is a once-a-month MAT opioid injection for those addicted to opioids. Moreover, aside from Buprenorphine, the National Institute on Drug Abuse reports that some of the most effective medicines that may be used for opioid addiction treatment also include:

The report also states that Buprenorphine and the drugs listed above can help to address the current epidemic that the world is facing with addiction. It is critical for individuals with this type of dependency to consider opting for a Medication-Assisted treatment or MAT opioid protocol, where one of these drugs may be provided to them to help with the process. For example, a methadone clinic is a place for people suffering from addiction. Such clinics use Methadone to reduce cravings and withdrawal symptoms.

However, various medicines have been proven to offer an effective way of tapering a patient off opioids. These medicines do not come with the adverse effects of opioids, but may still help to reduce the severity of withdrawal symptoms that a patient experiences, especially during the detoxification period of a treatment program at a rehabilitation facility. These types of medicine can be given to patients only after getting approval from the doctor.

New Opioid Prescribing Guidelines: Their Benefits For Patients

Infographics - new prescribing guidelines.

Opiate pain management risks present tumultuous challenges for both patients and healthcare providers alike. The epidemic has led to the enforcement of rules and regulations to better guide the prescription and use of these painkillers and other controlled substances. Today, there are laws guiding physicians for responsible opiate prescribing schedules to ensure that these highly potent medications are only prescribed as a last resort for treatment. As such, CDC developed helpful resources on the best provisional care for chronic pain. The opiate prescribing guidelines seek to provide meaningful information on how healthcare providers should prescribe opioids for pain and necessary measures.

Infographics - guidelines explained.

CDC Opioid Prescribing Guidelines Explained

The CDC opiate prescribing guidelines is a prescription directive for healthcare providers, to be referred to when recommending opioids for chronic pains except for active cancer treatment, end-of-life care, and palliative care. The new guidelines for prescribing opioids largely expatiates on the information below:

  • Opioid treatment should be initiated as a treatment for chronic pain- Clinicians should consider therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient
  • Establish and measure goals for pain and function and consider how therapy will be discontinued if benefits do not outweigh risks
  • Discuss with patients known risks and realistic benefits of therapy and patient and clinician responsibilities for managing therapy
  • Use immediate-release opioids when starting
  • When opioids are started, clinicians should prescribe the lowest effective dosage
  • When opioids are needed for acute pain, prescribe no more than needed
  • Follow-up and re-evaluate risk of harm; reduce dose or taper and discontinue if needed (risk assessment and addressing the dangers associated with the use of opioids)
  • Use urine drug testing to identify prescribed substances and undisclosed use
  • Avoid concurrent benzodiazepine and opiate prescribing
  • Arrange a treatment for opioid use disorder if needed

In response to the intensifying epidemic of opiate abuse, the 2019 prescribing guidelines have provided strict laws. The rationale behind the new guidelines prescribing opioids is to further improve communications between the patient and the physician on the benefits and risks of opiate use, also to mitigate the risks involved with long-term opiate use.

Infographics - how can new opioid guideline help.

How Long Does Opioid Rehabilitation Last?

Limited effectiveness has been observed in rehabilitation that lasts for a period that is shorter than 90 days. This means patients who are undergoing opioid treatment at a rehab or opioid addiction treatment center should consider a longer-lasting program to assure the success of the therapy. When opiate replacement therapy is utilized, then the patient needs to undergo residential treatment and obtain access to a supportive aftercare system as well.

In these cases, qualified rehab may be required for a period of up to 12 months. The specific period during which the person will be treated for their addiction does depend on the severity of the dependency that has developed.

Seeking Rehab For Opioid Addicts: What To Look For?

With professional treatment for an addiction to opiate-related drugs being critical, individuals are advised to seek resources such as rehabilitation programs that can provide them with appropriate rehabilitation services. There are a few facts that people should take into account when looking for a treatment for opioid use disorder:

  • Budget and location are two of the most important factors that should be kept in mind when looking to undergo treatment for opioid use disorder. A person should consider whether they would like to be treated at a local facility that is close to them or rather undergo rehabilitation at a resort.
  • Individuals that do not have access to health insurance might have to utilize the services of a facility that offers more affordable detox services or perhaps consider a payment plan.
  • The person should also take note that facilities offer different approaches to opioids dependence treatment. Some offer faith-based treatments, while others might rather take a more generalized approach. The person should consider which method they prefer.

Take note that resources such as rehab centers are effective techniques to get a successful recovery from opioids. Aside from this, understand that addiction recovery entails stages and processes to avoid the possibility of relapse. Thus, a relapse prevention plan is necessary for patients who want to have a safe and successful recovery from opiate abuse and addiction.

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Page Sources

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  5. Drug Approval Package: SUBLOCADE (buprenorphine). (2017, November 30). FDA. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/209819Orig1s000TOC.cfm
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  7. Friedman, A. S., Terras, A., & Kreisher, C. (1995). Family and client characteristics as predictors of outpatient treatment outcome for adolescent drug abusers. Journal of Substance Abuse, 7(3), 345-356.
  8. National Institute on Drug Abuse. (2021, August 3). Medications to Treat Opioid Use Disorder. https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/overview
  9. Schiller, E. Y., Goyal, A., & Mechanic, O. J. (2017). Opioid overdose.

Published on: September 17th, 2019

Updated on: January 14th, 2022

About Author

Dr. Ahmed Zayed

Dr. Ahmed Zayed is a Bachelor of Medicine and Surgery. He is graduated from the University of Alexandria, Egypt. Dr. Ahmed Zayed has a passion for writing medical and health care articles and focuses on providing engaging and trustworthy information to readers.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.