Nitazenes Rehab - Abbeycare

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KEY TAKEAWAYS

Educate clients on how NTZ’s unpredictable potency (50–500x heroin) contributes to “severe” sweating and restlessness during withdrawal [1][2]
Develop skills for coping with “episodes of depression” and “anger at yourself” during weekly 1-hour therapy sessions [3][4]

Below, we discuss possible approaches that meet the specific rehab needs around nitazenes. Not all treatment centres will provide these specific interventions.

For an overview of the Abbeycare programme contents for nitazenes rehab, click here.

When Is Nitazenes Rehab Necessary?

Nitazenes Potency

Nitazene analogues (e.g. Metonitazene, Protonitazene, Isotonitazene, Etonitazene), being 50 – 500x stronger than heroin, mean nitazenes rehab is necessary because [1]:

A medically supervised detox is required to safely manage sweating and restless legs developing around 7 hours after last taking NTZs, described as “so severe” by some users who claim to be “unable to work” due to the intensity [2]
Psychoeducational groups provide a straightforward transmission of facts about the risks (e.g. overdose) of heavy use (e.g. smoking NTZs every 60 mins) to foster emotional and behavioural change [3][4]
Trained medical staff are available to frequently monitor and assist patients who display signs of prolonged toxicity (e.g. respiratory rate < 8 breaths/min or pupil size ≤ 2 mm) after vaping NTZs through refillable e-cigarette devices. Hospital detox will be referred where appropriate [5]
“Coping with Cravings” exercises may be implemented into 60-minute skills training sessions to identify and manage situational cues (e.g. boredom) that trigger “strong desires” after previously taking up to 10 doses daily [2][6]

Although stable recovery (5+ years) is the desired outcome of rehab, counsellors are required to discuss harm reduction strategies regularly throughout NTZ's addiction treatment, including overdose education and naloxone (NLX) distribution, because [6]:

Multiple naloxone doses (e.g. 2 nasal + 1 IV) are often required to prevent fatal overdoses due to NTZs having 31 – 42x greater agonism to µ-opioid receptors than fentanyl and morphine [2][4]
SAMHSA states that treatment services should promote a philosophy of hope and healing by linking patients to programmes (e.g. SSPs) that provide infectious disease care after claiming to “Take and inject whatever is available” [4][6]

Using Nitazenes Alongside Depressants

Using nitazenes alongside alcohol means rehab is necessary to safely detox from two central nervous system (CNS) depressants whilst addressing the underlying causes and risks of concurrent use (e.g. responsible for 10% of acute poisonings) by [5]:

Receiving ongoing monitoring in a controlled environment after a comprehensive treatment plan (e.g. 300mg/d thiamine to prevent Wernicke’s encephalopathy + 75μg clonidine for NTZ-induced restless legs) is developed [7]
Engaging in psychoeducational activities to raise awareness about the health consequences of NTZ + alcohol abuse, including the 27% increase in seizures experienced by AUD + OUD patients compared to OUD patients alone [8]
Practising drug and alcohol refusal skills using role-play after identifying emotional triggers (e.g. untreated depression) for alcohol + NTZ abuse during 90-minute group counselling sessions with around 8 – 15 members [3]

Nitazenes rehab is necessary to control the high rates (75%) of sedative co-exposure in substance abusers who are hospitalised after mixing NTZ analogues (e.g. protonitazene, isotonitazene) with benzodiazepines or sedating antihistamines [5].

Atypical Withdrawal Syndrome

Nitazenes' atypical withdrawal syndrome means rehab is necessary to safely manage symptoms (e.g. cold sweats, psycho-motor agitation) often lasting 2x longer than withdrawals from other pharmaceutical opioids (e.g. morphine, fentanyl) because [7]:

The loss of NTZs high binding affinity for µ-receptors (Ki = 1.09) precipitates a “flu-like” feeling with twitching, shaking, anger, and depressive episodes requiring symptomatic treatment (e.g. 5mg olanzapine) for up to 28 days [2][7]
Supportive care strategies (e.g. relaxation techniques, sleep hygiene) are implemented into the programme to assist patients who claim “The symptoms remain for days, feeling cold, sweating, tremors" after ceasing daily NTZ use [4]
Despite having a similar onset to heroin withdrawal (e.g. 6 – 24 hours), NTZs' symptoms are typically more severe (e.g. “intense psychic stress” for 7 days vs agitation for 5 days) due to NTZs being up to 500x stronger [1][7][9]

Nitazenes rehab helps to prevent periods of “intense use” (e.g. injecting NTZs every 2 – 3 hours for 1 week) after short-term abstinence (e.g. 1 month) by offering symptomatic treatment and psychosocial support throughout the typical 28-day programme to [4]:

Manage insomnia with education about “healthy sleep habits” (e.g. no electronics 30 minutes before bed) as an alternative to taking 1.5mg etazene every 30 minutes until falling asleep [2][6][7]
Minimise cravings, nausea, and jaw tension using 60-minute coping skills training, 4 – 8mg ondansetron, or 400mg ibuprofen as required to manage persisting symptoms rather than taking 1g isotonitazene to “relax” [6][7][9]

Addiction Developed Through Contaminated Drugs

Becoming addicted to nitazenes due to contaminated heroin means rehab is necessary because specialised treatment with a trauma-informed approach (e.g. 8 phases of EMDR + 90-minute sessions using imagery and in vivo exposure) is needed to [10]:

Address fear, panic, and confusion triggered by a near-death experience (e.g. losing consciousness + acute kidney injury: CK = 364 IU/l) after intending to smoke the “usual amount of heroin” that was unknowingly contaminated with isotonitazene [11]
Process traumatic memories associated with needing multiple naloxone doses (e.g. 400 μg + overnight infusion) to reverse hypoventilation after taking heroin mixed with an NTZ analogue up to 500x stronger than the intended substance [1][5]
Manage delayed cognitive reactions (e.g. flashbacks, intrusive memories) using 10-minute mindfulness exercises and grounding techniques (e.g. emotional dial) after “feeling dizzy following a few inhalations” and overdosing on a psychoactive substance believed to be heroin [10][11]

Nitazenes are often detected in the global illicit drug market, particularly in tablets mimicking authentic oxycodone “M30” formulations, and rehab is needed to support patients who become addicted to the “strong effect” after daily use because [12]:

Regular educational sessions (e.g. 45 minutes 1 x p/wk) inform users that some counterfeit tablets contain an average of 3.9 mg of metonitazene, equivalent to approximately 23mg of fentanyl, which is over 10x the estimated lethal dose [3][12]
Supervised detox management is required for sweating, shaking, and breathing difficulties that develop around 7 – 9 hours after taking the last “M30 pill” contaminated with etonitazepyne [2]

Detox For Nitazenes In Rehab

The detox process in nitazenes rehab is comprehensively managed using opioid substitution therapy (e.g. up to 32mg/d buprenorphine) and symptomatic medication (e.g. 5mg olanzapine, 75μg clonidine, 400mg ibuprofen) for 7 – 14 days to [7]:

Manage agitation, jaw tension, insomnia, and nausea during the first week of abstinence by stabilising sympathetic activity and excitatory signalling after previously consuming 1g Isotonitazene per month [9]
Minimise the severity of leg restlessness, diaphoresis, and tremors developing around 8 hours after taking the last NTZ dose using a partial opioid agonist to replace NTZ's high binding affinity (Ki = 1.09) for the µ-receptor [2]

Therapeutic Content In Nitazenes Rehab

While Abbeycare does not adapt therapeutic content for clients with NTZs addiction, the standard 4-week rehab programme aims to address a variety of physical and psychological needs (e.g. sleep hygiene for insomnia) and additional counselling may be facilitated through GP referral after treatment. Please contact us for more information.

CBT Adapted For Nitazenes Craving Cycles

CBT craving interventions may be adapted for nitazenes rehab to help patients cope with “strong desires” in recovery as an alternative to taking 1 - 1.5mg every 10 - 30 minutes to satisfy the craving by [2]:

Using a psychoeducational approach to describe the time-limited nature of cravings (e.g. 7 – 20 minutes) and comparing the sensation to a ‘hunger pang’ that varies in intensity before subsiding [6]
Engaging in experiential exercises for around 5 minutes to practice coping skills (e.g. reading, playing a game) after identifying situational cues (e.g. seeing someone use a refillable e-cigarette device) that trigger NTZ's cravings [6]
Incorporating reframing techniques into 60-minute sessions to encourage the use of alternative positive meanings/perspectives on the present situation (e.g. “I feel bad without NTZs” to “The craving is uncomfortable, but I can manage”) [4][6]
Rating the intensity of the craving and associated emotions (e.g. sadness) on a scale of 1 – 10 after counsellors discuss how the brain adapts over time to trick the user into feeling like NTZs are ‘needed’ to ‘quieten’ discomfort [6]

Thomas et al. (2021) found that nitazene cravings subsided within 7 days of inpatient drug addiction treatment after a male patient initially claimed to “need” the substance in greater quantities and more frequently during active use [9].

Trauma Informed Therapy Adapted For Unknowingly Becoming Nitazenes Dependent

Trauma-informed therapy may be adapted for those who unintentionally become addicted to nitazenes after repeatedly consuming 3.7 – 4mg Metonitazene from counterfeit oxycodone tablets by [12]:

Incorporating 1-hour clinical interviews (e.g. ELS) into treatment sessions to gauge the severity of PTSD symptoms (e.g. intrusive memories) triggered by a traumatic event (e.g. overdose) following accidental NTZ consumption [10][12]
Encouraging patients to practice grounding techniques (e.g. toe wiggling) to manage surges of panic reminiscent of an accident (e.g. collapsing in the street + 24-hour hospitalisation) caused by unintentional NTZ exposure [10][11]
Hosting psychoeducational groups focusing on 4 components of trauma recovery (creating safety, regulating emotions, addressing loss, redefining the future) to minimise “intense psychic stress” and psycho-motor agitation [9][10]
Developing a ‘resource box’ filled with printed educational materials (e.g. RP 29 Coping With Feelings) to help patients manage trauma-related symptoms (e.g. anxiety, shame) after unintentionally taking 4mg protonitazene daily [12]

60-minute trauma-informed therapy sessions may be provided in NTZ's rehab to reduce PTSD symptoms (e.g. intrusion, avoidance) and anxiety by up to 70% within 3 months using psychoeducation, relapse prevention, exposure, and processing techniques [13].

Aiming To Address The Unpredictability Of Nitazenes Sobriety

Resilience training may be incorporated into 1-hour CBT sessions in nitazenes rehab to help patients cope with the unpredictable physiological and psychological effects (e.g “episodes of depression, anger at yourself”) after discontinuing NTZs by [4][14]:

Encouraging the use of stress management techniques (e.g. repeating a chosen ‘focus word’) and self-regulatory practices (e.g. PMR) to manage discomfort from sweating, pain, and tremors lasting “for days" according to some patients [4][14]
Developing and practising anger control skills during early recovery (< 1 year), including deep breathing, visualisation, and cognitive restructuring to challenge negative thoughts and irritability after abstaining from using NTZs every 2 – 3 hours [4][6]t
Discussing “resilient responses to trauma” (e.g. bonding with family and community) to help patients cope with, respond to, and heal from the consequences of NTZs abuse (e.g. rhabdomyolysis = CK 18,500 U/L) [5][10]
Encouraging patients to engage in tasks (e.g. volunteerism) that help to foster resilience by redefining a sense of purpose and meaning after claiming “You perceive everything around you, but do not feel it correctly” during active use [4]

Sonbol et al. (2024) found that resilience scores increased by 44% after a 30-day OUD treatment programme provided therapy sessions to build resilience, self-esteem, and coping skills using the ABCD model, cognitive restructuring, and stress-management techniques [14].

Aftercare Planning In Nitazenes Rehab

Highlighting Elevated Mortality Risk Post-Rehab

Aftercare planning in nitazenes rehab aims to reduce the 50% overdose death rate (vs 9% for fentanyl) by [15]:

Extending the treatment duration (e.g. 28 to 90 days) if necessary, to provide ongoing monitoring and support over the ‘high-risk' period to prevent patients from returning to heavy use (e.g. every 2 – 3 hours) after 4 weeks of abstinence [4]
Providing risk education to raise awareness about how multiple NLX doses (e.g. 4 boluses) are often required to reverse an overdose due to NTZ's high affinity (Ki = 1.09) for the µ-receptor [2][15]
Emphasising the dangers of relapse (e.g. severe respiratory depression) after tolerance diminishes during rehab, despite developing at a fast rate initially (e.g. within 2 weeks of taking 5 – 10 doses daily) [2]
Scheduling weekly continuing care groups to strengthen and practice coping skills (e.g. 20-min walk) to aid recovery rather than engaging in self-destructive behaviour (e.g. taking 1.5mg etazene every 30 mins until falling asleep) [2]

Liaising With GP's To Manage Atypical Withdrawal Syndrome

Aftercare planning in nitazenes rehab involves liaising with GPs to manage NTZs atypical withdrawal syndrome by maintaining regular contact (e.g. check-ins every 1 – 2 weeks during the first 6 months + every 3 months after 1 year) to [16]:

Gauge patient progress after abstaining from heavy use (e.g. 5 – 10 doses daily) by asking questions such as “How would you rate your overall health right now?" (1 = excellent vs 5+ = poor) to establish medical requirements [2][16]
Discuss long-term treatment options (e.g. 40mg/d citalopram + talking therapy) for any persisting psychological symptoms to prevent “episodes of depression” and anger from interfering with the recovery process [4]
Advise about sleep hygiene (e.g. no electronics within 30 mins of bed) to help patients overcome sleep disturbances after repeatedly “nodding out” during active use [4][6]
Refer patients for specialist care if needed (e.g. neurologist) to manage any remaining signs of restless leg syndrome (e.g. electric sensations, itching) after previously taking ½ an etonitazepyne pill every 7 hours before rehab [2]

Connecting With Communities With Lived Experience Of Nitazenes Addiction

Aftercare planning in nitazenes rehab includes finding communities with lived experience of NTZs use, as meeting with peer coaches 1x p/wk for 1 month improves quality of life outcomes (e.g. self-care, mobility, anxiety) by 36% because [17]:

Despite previously struggling with OUD, peer coaches have achieved ≥ 2 years of abstinence and can help to inspire or instil hope in others recovering from NTZs addiction whilst responding with empathy and sensitivity [17][18]
Peer support workers help patients work towards a goal (e.g. within 90 days, I will find a job and work ≥ 5 hrs p/wk) by providing non-clinical support (e.g. creating a CV) to those who feel “unable to work” after discontinuing NTZs [2][18]
Some peer recovery support specialists provide daily check-ins via in-person recovery groups, 1-1 phone calls, or videoconferences to enhance motivation and offer a realistic outlook on recovery if “strong desires” for NTZs arise [2][17]
Peer support services actively link those in recovery to community-based services (e.g. primary care clinic) to provide diagnoses, advice, or treatment to individuals struggling with depression or anger after hourly NTZs use [4]

Ogungweru & Elisha (2025) found that 42 recovering synthetic opioid users provided an average score of 4.42 on a 5-point scale (0 = strongly disagree vs 5 = strongly agree) in response to the following statements about the impact of peer support groups:

‘Peer support groups provide me with valuable coping strategies for managing cravings,' and ‘The support I receive from peers in the group motivates me to stay sober’
‘Participating in peer support groups has improved my overall quality of life,’ and ‘Peer support groups have helped me better manage stress and anxiety related to my recovery.’ [19]

Nitazenes Recovery Challenges

Nitazenes Recovery Challenge	How Rehab Aims To Address
Unpredictable Potency (10 - 100x Stronger Than Fentanyl)	Medical detox for "intense" symptoms [9] Risk education (e.g. NLX use + overdose statistics)
Atypical Withdrawal/Relatively Unknown Relapse Effects	90-day stay for support over “high-risk” period [4] GP liaison for check-ups & advice + linkage to PSS
Unknowingly NTZs Addicted = Ineffective Detox Medications	LC-MS/MS to detect metabolites + establish treatment plan Trauma-informed therapy after accidental exposure
Limited Access To Specialised Nitazenes Rehab Programmes	NTZ protocols integrated into existing programmes Staff education about potency (500x heroin) [1] Linkage to others in NTZs recovery

Nitazenes Rehab Results

Abstinence Rate

The abstinence rate of synthetic opioid addiction treatment is around 57% because pharmacological (e.g. 25 – 50mg naltrexone) and psychological (e.g. psychoeducation, motivational enhancement therapy) interventions are used to [20]:

Suppress cravings after abusing NTZs 5 – 10 times daily using an opioid antagonist to block µ-receptors and modulate the release of dopamine in the brain’s reward system [2]
Encourage behavioural change using evidence-based information to discuss the drug-related harms (e.g. needing 4 NLX doses for overdose reversal) of heavy misuse (e.g. smoking NTZs every hour) [4]
Reduce trauma-related symptoms (e.g. flashbacks) by around 47% within 3 months using TF-CBT with psychoeducation to develop strategies for creating safety, regulating emotions, and addressing loss after a near-fatal overdose [13]
Strengthen internal motivation after counsellors ask open-ended, reflective questions (e.g. “What concerns you about your recent NTZs use?”) to highlight reasons to change (e.g. taking ½ - 1 pill every 7h to avoid withdrawal) [2]

Abbeycare provides NTZs rehab patients with take-home naloxone kits to aid recovery after abstaining from a highly potent new synthetic opioid.

Nitazenes Rehab At Abbeycare

Nitazenes rehab at Abbeycare is typically a 28-day residential programme that may be extended to 90 days (please contact our admissions team for further information) to support patients over the 'high-risk' period (i.e. 4 weeks post-discharge) and promote long-term recovery by:

Developing individualised detox plans based on the type (e.g. Isotonitazene), potency (e.g. 130x greater than morphine), and amount (e.g. 1g p/m) of nitazene abused, providing each patient with a key-worker for personalised support throughout
Using pharmacological (e.g. 5mg olanzapine) and non-pharmacological (e.g. mindfulness) interventions to manage the unpredictability of NTZ withdrawal symptoms (e.g. anger outbursts) with frequent monitoring by trained medical staff
Liaising with primary healthcare providers to maintain regular contact, diagnose, and treat any persisting symptoms (e.g. depressive episodes) as part of the comprehensive aftercare planning that takes place in the 3rd stage of the programme

References

[1] Holland, Adam, et al. “Nitazenes—Heralding a Second Wave for the UK Drug-Related Death Crisis?” The Lancet Public Health, vol. 9, no. 2, Elsevier BV, Jan. 2024. Accessed 24 Oct. 2025.“Table 1.”
[2] World Health Organization. WHO Expert Committee on Drug Dependence. Forty-Fifth Report. 8 Mar. 2023. Accessed 24 Oct. 2025. “The individual described withdrawal (including sweating and leg restlessness) that was so severe that he was unable to go to work.”
[3] Center for Substance Abuse Treatment. Substance Abuse. Clinical Issues in Intensive Outpatient Treatment. Treatment Improvement Protocol (TIP) Series 47. 2006. Accessed 24 Oct. 2025.“Psychoeducational group sessions often are only half that long (e.g., a 30-minute lecture followed by 15 minutes for questions) because they focus on instruction instead of interaction, … stimulate discussion that helps participants relate the topic to personal experience and foster emotional and behavioral change.”
[4] Katri Abel-Ollo, et al. “The Nitazene Epidemic in Estonia: A First Report.” European Journal of Public Health, Oxford University Press, Sept. 2025. Accessed 24 Oct. 2025.“ The frequency of daily use ranged from once per day to every 2–3hours, with the exception being those who smoked nitazenes who reported hourly use. Nine-out-of-ten interviewees reported injecting nitazenes intravenously, while one smoked the substance.”
[5] Roberts, Darren M., et al. “Clinical Experiences with the Nitazene Class of Synthetic Opioids: A Cohort Study.” Annals of Emergency Medicine, 14 Aug. 2025. Accessed 27 Oct. 2025.“A range of routes of exposure were noted, most commonly vaping (through refillable e-cigarette devices using refill liquid) in 11/27 cases, … Hypoventilation was defined as respiratory rate less than 8 breaths per min, or unquantitated bradypnea that resolved with naloxone. Miosis was defined as pupil diameter of less than or equal to 2 mm.”
[6] Substance Abuse and Mental Health Services Administration. Counseling Approaches to Promote Recovery from Problematic Substance Use and Related Issues. Treatment Improvement Protocol (TIP) Series 65. 2023. Accessed 27 Oct. 2025. “EXHIBIT 3.11.”
[7] NSW Ministry of Health. Management of Withdrawal from Alcohol and Other Drugs Handbook. Dec. 2022. Accessed 27 Oct. 2025.“Table 10.8 - Symptomatic treatments.”
[8] Furo, Hiroko, et al. “Association between Opioid Use Disorder and Seizure Incidents among Alcohol Use Disorder Patients.” Substance Abuse: Research and Treatment, vol. 17, SAGE Publishing, Jan. 2023, pp. 1–7. Accessed 27 Oct. 2025. “Table 4.”
[9] Mueller, F., et al. “Isotonitazene: Fatal Intoxication in Three Cases Involving This Unreported Novel Psychoactive Substance in Switzerland.” Forensic Science International, vol. 320, Mar. 2021. Accessed 27 Oct. 2025.“Increasing withdrawal symptoms, such as: transpiration, nausea, jaw tension and intense psychic stress. During the short hospitalization, interrupted after seven days by the patient, the main initial symptoms were psycho-motor agitation, insomnia and episodes of cold sweating.”
[10] Substance Abuse and Mental Health Services Administration. Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. 2014. Accessed 27 Oct. 2025.“Treatment involves three main concentrations (past memories, present disturbances, future actions) and eight phases. Counselors may work with several phases in one session, ... Clients must have ample time to process their memories and integrate cognition and affect, so some sessions can last for 1.5 hours or more.”
[11] De Baerdemaeker, K. S. C., et al. “Isotonitazene, a Novel Psychoactive Substance Opioid, Detected in Two Cases Following a Local Surge in Opioid Overdoses.” QJM: An International Journal of Medicine, vol. 116, no. 2, Mar. 2022. Accessed 27 Oct. 2025.“The patient reported smoking his usual amount of ‘heroin’ and immediately feeling dizzy following a few inhalations. He sat down on the street after which he lost consciousness, ... Analysis of the patient’s serum collected at the time of arrival to the ED (3 h 30 min after the ambulance was called), detected the presence, ... isotonitazene at a concentration of 0.18 ng/ml.”
[12] Dugues, Paméla, et al. “Emergence of Counterfeit Oxycodone Tablets Containing Nitazenes in France: First National Alert and Analytical Characterization.” Toxicologie Analytique et Clinique, Elsevier, July 2025. Accessed 27 Oct. 2025.“The estimated metonitazene content averaged 3.7 to 4.0 mg per tablet, whereas protonitazene content was below 0.1 mg per tablet, ... tablets contained an average of 3.9 mg of metonitazene, equivalent to approximately 23 mg of fentanyl, over ten times its estimated lethal dose.”
[13] Saraiya, Tanya C., et al. “Helping Opioid Use Disorder and PTSD with Exposure (HOPE): An Open-Label Pilot Study of a Trauma-Focused, Integrated Therapy for OUD/PTSD.” Behavioral Sciences, vol. 15, no. 7, MDPI AG, June 2025, p. 874. Accessed 6 Nov. 2025. “Figure 3 - 7.”
[14] Hassan Mohammed Sonbol, et al. “Effectiveness of a Spiritual Adaptation of Cognitive Behavioural Therapy in Improving Resilience, Self‐Esteem and Spirituality among Clients with Opioid Use Disorder: A Quasi‐Experimental Study.” Journal of Psychiatric and Mental Health Nursing, vol. 32, no. 1, Wiley, Aug. 2024. Accessed 6 Nov. 2025.“Table 4.”
[15] Amaducci, Alexandra, et al. “Naloxone Use in Novel Potent Opioid and Fentanyl Overdoses in Emergency Department Patients.” JAMA Network Open, vol. 6, no. 8, American Medical Association, Aug. 2023. Accessed 6 Nov. 2025. “Table 3.”
[16] Lennox, Richard d., et al. “A Simplified Method for Routine Outcome Monitoring after Drug Abuse Treatment.” Substance Abuse: Research and Treatment, vol. 7, Sept. 2013, pp. 155–69. Accessed 6 Nov. 2025. “follow-up telephone calls at these intervals: once a week from months 1 to 3; once every two weeks from months 4 to 6; once per month from months 6 to 12 and once every three months from months 13 to 34. During each follow-up call the specialist discusses progress or obstacles regarding each of the goals defined in the discharge plan. Changes are made in the plan if necessary. Key data and any recommendations are recorded in the client records.”
[17] Langabeer, James R., et al. “Feasibility and Outcomes from an Integrated Bridge Treatment Program for Opioid Use Disorder.” JACEP Open, vol. 2, no. 2, Mar. 2021. Accessed 7 Nov. 2025. “Table 2.”
[18] Substance Abuse and Mental Health Services Administration. Incorporating Peer Support into Substance Use Disorder Treatment Services. Treatment Improvement Protocol (TIP) Series 64. 2023. Accessed 7 Nov. 2025. “EXHIBIT 6.1.”
[19] OGUNGWERU, Patience Obeunezi, and Otekenari David ELISHA. “Assessing the Impact of Peer Support Groups on Rehabilitation Outcomes among Individuals with Opioid Use Disorder in Port Harcourt Metropolis.” ALVAN JOURNAL of SOCIAL SCIENCES, vol. 2, no. 2, July 2025. Accessed 7 Nov. 2025.. “Table 1 - 2.”
[20] Sidana, Ajeet. “Oral Naltrexone in Opioid Dependence Syndrome: Revisiting Acceptance and Effectiveness for Relapse Prevention.” Delhi Psychiatry Journal, vol. 23, no. 2, Oct. 2020. Accessed 10 Nov. 2025. “Table 2.”

About the author

Mischa Ezekpo

Mischa Ezekpo has a Bachelors degree in Psychology from Northumbria
University, and a Masters degree in Childhood Development and
Wellbeing, from Manchester Metropolitan University. Since 2018, Mischa
has written and published work on Addiction, Mental Health, Depression, and Eating Disorders. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: February 20, 2026