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Treating Opioid Addiction
Types of Opioid Treatment
Many people with addictive disorders go to hospital emergency rooms because they’re in crisis. Most hospitals provide an evaluation and assess the patient’s primary need and then connect him or her to the right treatment that best addresses their unique needs. Many general hospitals don’t admit patients solely for withdrawal or substance abuse treatment, unless there is some other factor such as a significant other medical problem present.
Substance use disorders can be best treated on an outpatient therapy basis, or in an inpatient program dedicated to the treatment of people with addiction. Many of these programs use medications to help patients transition from physical dependence on opioids.
Medicines Used to Treat Opioid Addiction
Methadone, when administered properly, is included in treatment with counseling and is always provided in a clinic setting when used to treat opioid use disorder. It helps to relieve withdrawal and address cravings.
The medicine buprenorphine also relieves opioid cravings without giving the same high as other opioid drugs. Prescribed by many physicians from office settings, this is typically a daily dose placed under the tongue and also can be delivered as a once-a-month injection or through thin tubes that are inserted under the skin and that last six months.
These medicines both activate opioid receptors in the body that suppress cravings and are effective and similar in safety and side effects, and typically used for maintenance treatment. They also can be used to taper a person off of opioids. However, it is common for patients to relapse, and physicians must try something different with those patients who relapse several times. Patients who are highly motivated and have good social support have a tendency to do better with these therapies.
Naltrexone is a very different medicine and doesn’t turn the opioid receptor on, but instead blocks the euphoric/sedative effects of opioids. A patient’s system must be completely free of all opioids before beginning naltrexone. It can be taken orally or as a once-a-month injection.
Naloxone can be used in an emergency situation when respiratory arrest, due to an opioid overdose, has occurred or is eminent. Naloxone flushes out receptors and can reverse the overdose but is not a form of addiction treatment.
How to Encourage Someone to Seek Help
With substance abuse, when patients are ready to deal with their issues they need an open door and help immediately. The person with an addictive disorder should want to participate in treatment. Navigating that change can be challenging for friends and family members.
How successful is opioid treatment?
The success of therapy for substance use disorder varies by patient and by severity of the disorder, and also can be influenced by complications of comorbidities, such as alcohol use or mental illness. Research has shown that there is a higher rate of substance use in patients with diagnoses such as depression and those who use other substances such as alcohol.
Integrated treatment for both mental health and substance use disorders are needed in cases where these occur together. The environment and family or friend relationships can also play an important role. Some patients will repeat therapy and relapse many times before having success.
Where can people get help?
Addiction services as well as a methadone clinic are offered at Johns Hopkins Bayview Medical Center and The Johns Hopkins Hospital. For information on substance abuse programs at either location, please call 410-550-6911.
Do treatment facilities take insurance and how costly is treatment?
Treatment costs and insurance coverage vary. Consult with your insurance provider for specifics.
- If you are having a medical emergency, call 911.
- If you need crisis assistance, many local health departments have crisis hotlines that can connect residents to treatment resources.
- Training in the administration of naloxone for a loved one with substance use disorder is offered in most communities.