What Are Opiates?
Opiates refers to a class of drugs that are found naturally in the opium poppy plant. They work on the brain to produce a wide range of effects including relief from pain. (1)
Prescription opioids are used to block pain signals between the brain and the body and they are typically prescribed as a treatment plan for moderate to severe pain.
Once you take opioids, they are converted into morphine and they bind themselves to the opioid receptors such as those involved with pain perception, reward, and other areas that are critical for life. (1)
Opiates drugs include both legal and illegal painkiller medications, which are also called ‘opioid painkillers.’
Opiate drugs have serious effects on the body. They will make you feel happy, ‘high,’ and relaxed. These are some of the reasons why opiates are so addictive. (2)
Opiate detox rehab treatment is pretty common and most drug addiction treatment centers offer it as part of their addiction treatment plans.
Legal opioid drugs are prescribed and administered in a safe way, with corresponding correct dosages.
The legal forms of opioid drugs are:
Meanwhile, heroin is an illegal opioid drug.
Another not commonly known opioid drug is Suboxone, which works by tightly binding to the same receptors in the brain as other opiates, such as heroin, morphine, and oxycodone.
According tot he National institute of drug abuse, legally prescribed opioid painkillers are used to treat the following conditions: (3)
- Moderate to severe pain
- Pain experienced by cancer patients
- Pain during the end-of-life stage
- Chronic non-malignant pain (CNMP), which are caused by injuries or diseases that last longer than 3 to 6 months.
- Osteoarthritis
- Fibromyalgia
- Tissue or nerve damage
- Chronic abdominal pain such as pancreatitis and Crohn’s disease
- Acute pain – short-term and caused by specific events such as accidents, surgery, or childbirth
- However, because opioid drugs are highly addictive, they are prone to misuse and abuse.
Most people turn to heroin after prescription drugs become unavailable as heroin is presented as a cheaper and available option.
The addiction treatment for opioid drug abuse involves intense symptoms of withdrawal and should be done at an in patient detox and treatment center.
The medical personnel at the treatment centers are trained to help ease withdrawal symptoms, and drug cravings. It is also important to get involved with support groups during the drug detox, as they best understand heroin dependency and are always willing to help.
The Drugs Wheel
The Drugs Wheel is a way of classifying drugs based on the effects they have on the body.(4)
According to the Drugs Wheel, people addicted to heroine and other opioids experience the following:
- Euphoria – the feeling of getting high
- Relaxation or a sense of peace/well-being
- Relief from pain
- Slowed-down concentration
- Sleepiness and inattentiveness
- Feeling “floaty”
- Reduced sex drive
Why Are Opiates Addictive?
Opiates take effect on the nervous system (brain + spinal cord + nerves branching off to different parts of the body). (5)
They have powerful, painkilling effects in too-high levels. These high levels are not naturally achieved by the human body.
Opiates change the chemistry of the brain, making the brain used to the too-high level of pain relief.
When opiate use is stopped, relief from pain is reduced significantly.
Since the body got used to a high level of pain relief, any measure of pain can come across as intolerable.
It is in this light that the symptoms surface. Any drug abuse symptoms from withdrawal can be pretty severe and it is advisable to have a medically assisted detox as the first phase of the addiction treatment. (5)
For individuals who have become dependent on opiates to block all effects of pain, nothing but the relief from pain that opiates offers will do.
Withdrawal symptoms associated with stopping opiate use opiate drug addiction treatment are: (6)
- Sensitivity to stress
- Anxiety/ Irritability
- Body coordination can be jerky (can have tremors)
- Abnormal sleep pattern (either insomnia or sleeping too much)
- Emotional numbness/ blanking out/ daydreaming
- Easily distracted
- Loss of focus/ memory problems
- physical and mental health problems
The potent, fast-acting nature of opioids is hard to match. This is why they are the most preferred prescription painkillers to treat pain.
Some describe getting rid of opiates as moments spent in panic, when the reality of not using is scarier than the actual experience.
Heroin Detox and Heroin Withdrawal Symptoms
Heroin is one of the most common opioids addiction, and the first step towards a heroin addiction treatment is heroin detox.
In a rehab clinic, professional help assists in overcoming heroin withdrawal symptoms for quitting heroin cold turkey.
Stopping the use of heroin addiction can be described with the following timeline
6 to 30 hours after heroin addiction stops:
When going through heroin addiction treatment, one is likely to experience heroin withdrawal symptoms a few hours after their last heroin abuse. The psychological withdrawal symptoms include; (7)
- Being emotional, in tears, or feeling down
- Anxiety, excessive anger
- Resistance, denial, attempts to escape the detox process
- Excessive yawning, sleepiness
- Conversely, insomnia
- Muscle pains and aches
- Runny nose, feeling as if having a flu
- High blood pressure
- Sweating excessively
Anyone suffering from heroin use disorder may also experience some mental health conditions, and the withdrawal may cause a rapid onset of the above heroin withdrawal symptoms.
72 Hours after the last intake
In about three days after stopping the drug use, one will experience the following heroin addiction withdrawal symptoms;
- Diarrhoea
- Nausea
- Vomiting or gastric pain
- Goosebumps/ Cold flashes
- Craving for opiates
Lingering Withdrawal Symptoms
Other than the above listed symptoms, some additional heroin withdrawal symptoms include the following;
- Memory and mental health problems; one’s memory is not like what it was before the physical dependence of opiates.
- A slowed intellectual performance
- Sexual performance problems like impotence and irregular menstrual periods
- Teeth and gum problems
When the amount of alcohol/drugs in a patient’s system is gradually reduced, they will typically begin to experience withdrawal symptoms. (7)
Opioid/ Heroin Addiction Overdose
Aside from being highly addictive, opiates/heroin addiction can cause death from an overdose.
Overdose situations can be avoided by:
- Taking the exact dose as prescribed in order to avoid substance abuse
- Not mixing opioids with other pain medications
- Not using opioids and alcohol together
- Not mixing opioids with anti-anxiety drugs and anti-depressants
- Ensuring that opiate drugs are kept away from children and/or teenagers
Opioid overdose from substance abuse is life-threatening. In the event of overdose, immediate medical supervision is necessary. (8)
Buprenorphine is often the preferred option as an opioid replacement because it is a partial opioid agonist, meaning that it only partially stimulates the opioid receptors, causing a “ceiling effect” that makes it much more difficult to overdose on compared to other opioid drugs. (9)
What Opiate Detox Rehab Is Like
During the first few days, of heroin substance abuse treatment, the initial reaction to withdrawal and opiate detox may be strongly focused on the physical withdrawal symptoms. (10)
However, some may feel emotionally overwhelmed, and unable to continue.
It is at this point that a personalised opiate detox treatment program comes in handy.
With a dedicated case manager, there’s better chance for the treatment succeeding, but with emotional and moral support. They will also help deal with severe withdrawal symptoms that can be fatal at this stage.
Here’s What A Typical Day In Rehab For Heroin Addiction Could Look Like:
Morning:
- Meditation / Reflection
- Detox medication (if prescribed)
- Breakfast
- Therapeutic session
Midday – Afternoon
- Lunch
- Therapeutic session (for example Cognitive Behavioural Therapy/ Holistic Care)
Evening
- Dinner
- Therapy sessions with a care manager
- Or accompanied attendance to a mutual aid (support) meeting
Therapeutic Help
In terms of effectiveness, treatments available for opioids addiction that show most promise are:
- Cognitive Behavioural Therapy
- 12 Step Facilitation
Opioid rehab success rate is not readily determined, as clinics vary widely in the type of treatments and length of treatments used.
What is clear is the fact that these approaches are the most utilized, with universal appeal.
After rehab, the use of the techniques learned can be carried on to support group sessions. The patients should continue with maintenance therapy.
Insights can also be explored in-depth during the behavioural therapy by the mental health professionals.
Opiate Rehab Aftercare
In an abstinence-based rehab clinic such as Abbeycare, a long-term commitment to recovery from opiate addiction requires adherence to an aftercare regimen.
Aftercare boosts the chance of full recovery because:
- Emotional and psychological support helps to alleviate feelings of loneliness
- Being in contact with a sponsor or an accountability partner encourages compliance to recovery commitments
- There is motivation through hope in a common vision of recovery
- New decision-making skills are learnt because of suggestions for the practical side of recovery
- Sticking with an aftercare plan creates structure in a life previously described as chaotic
In addition, an aftercare plan is made with peers who are also in a medication assisted treatment center.
As a result, different points of view can help when someone is stuck with a problem that is hindering recovery from opioids addiction.
Treatment with Naltrexone
Naltrexone is an opiate antagonist. Its main action is to stimulate the opioid receptors and stop endorphins (the body’s natural painkillers)(11)
When endorphins are blocked, the body compensates by producing more endorphins. When this happens, painful feelings are lessened.
In the UK, the NHS permits the use of Naltrexone as a drug to manage opiate dependency (11)
Naltrexone can also be given as Low Dose Naltrexone for the management of pain in some cases.
To add, Naltrexone can be helpful in treating Alcohol Use Disorder.
The prescription can be available with local GPs. Sometimes, the drug is sold under the names Nalorex®, Adepend® or Opizone®.
Naltrexone is given as a 50mg dose in tablet form.
However, in some cases, it can also be administered with an injection.
During inpatient care in an inpatient detox and rehab clinic, Naltrexone treatment is begun after the detoxification process has been completed as they withdrawal symptoms may become severe.
This is because Naltrexone is most effective when opioids have been completely removed from the body.
As part of a comprehensive treatment plan, Naltrexone is only used when counselling and social support programs are in place.
Dealing With Pain In Recovery
Pain management treatment is necessary, even if the person seeking relief from pain is in opioid addiction recovery (Opioids are supposed to control pain)
Guidelines for health care worker dictate that adequate relief from pain should be given for mild, moderate, and severe pain, to eliminate the physical symptoms of withdrawal from substance use disorder during the treatment program.
The first step in adequate pain management is determining which level of pain is experienced.
The second step in adequate pain management is recognizing that acute pain is a medical emergency.
Acute pain is short-term, and should be treated aggressively.
If the person experiencing the acute pain is in addiction recovery, steps must be made to guarantee that:
- The addiction concerns do not overshadow the pain being felt
- “Less addictive” medicines are prescribed in a thoughtful manner
- Under-dosing does not happen, because this leads to self-medication and psychological harm
- Professionally, experts are reminded that pain comes from psychological origins, with little to no physical basis are exceptions more than the norm.
In a rehab clinic such as Abbeycare, Addictions counsellors can work with clients to distinguish the contributions of feelings and thoughts to how pain is experienced.
It is hoped that after in-depth discussion and probing, clients can see that:
- Pain is sometimes motivated by cultural factors
- The expression and experience of pain can be encouraged or discouraged depending on who the person is with
- Mental health factors play a huge part in the interpretation and handling of pain.
In the end, the management of pain during opioid withdrawal can help eliminate drug cravings and any psychological symptoms during the drug rehab and medical detox programme.
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