Treatment for Narcotic and Opioid Painkiller Addiction

Detoxification and withdrawal

Narcotic and opioid painkiller addiction leads to real changes in certain areas of the brain. Prescription drug addiction alters the circuits responsible for mood and “reward” behaviors. In addition, long-term prescription drug abuse affects virtually all the systems in the body. Cutting off the supply abruptly leads to opioid withdrawal symptoms.

Symptoms of opioid withdrawal include:

  • Craving for drugs
  • Diarrhea
  • Large pupils
  • Abdominal pain
  • Chills
  • Nausea/vomiting
  • Body aches
  • Agitation/mood swings

Someone with an established narcotic addiction will usually do almost anything to try to avoid the intensely unpleasant process of withdrawal, which is a major reason for relapse and continued abuse.

Opioid withdrawal can last hours, days or weeks, depending on how long and how much a person has used the drug of choice. After the intense initial symptoms subside, some physical and mental discomfort may persist for weeks.

Medications for Opioid Withdrawal

There are medications that are used to prevent symptoms of opioid withdrawal during detox, easing the person out of physical dependence. The most commonly-used are listed below:

Methadone is a long-acting opioid drug. It activates the same opioid receptors as narcotics, effectively eliminating withdrawal symptoms. Providing the correct dose of methadone prevents opioid withdrawal symptoms and eases drug craving but it does not provide the euphoria. The dose can be slowly tapered off, lessening a person’s physical dependence without withdrawal symptoms. Methadone is one of the most effective treatments for narcotic addiction.

Buprenorphine and Naloxone (Suboxone) is a newer combination drug that helps for detox from prescription opioid addiction. Buprenorphine activates opioid receptors, reducing drug craving and preventing withdrawal. Naloxone helps prevent misuse of the medication. Buprenorphine without naloxone is potentially addictive.

Maintenance Therapy After Detox

Experts say psychological and social factors are the main drivers that push addicts back to using. Stress and situations that remind the brain of the drug’s pleasure are common triggers. Most people who go through detox and short-term counseling will relapse to prescription drug abuse.

Studies show that the chances of beating narcotic addiction are better with long-term maintenance therapy with either methadone or buprenorphine paired with naloxone (Zubsolv, Bunavail, Suboxone). These drugs are used during the maintenance phase of treatment.

Methadone and Suboxone have gained wide acceptance as maintenance therapy.

Some people have a high rate of relapse when maintenance therapy is stopped, and so they remain on the medicines for decades. In others, maintenance therapy is tapered off over months to years.

Naltrexone (ReVia, Vivitrol) is an opiate receptor-blocking medication used in maintenance therapy for narcotic addiction. Unlike methadone and Suboxone, naltrexone does not activate receptors at all, so it does not reduce opioid withdrawal or craving. However, because naltrexone blocks opiate receptors, a person won’t get high if he or she uses drugs while taking the medicine. The drug is usually ineffective by itself, because people can simply stop taking it and get high shortly after.

Recovery is possible. No matter what you are experiencing right now, you can achieve recovery.

Hear the stories of Tennesseans who have walked the same path on the Department of Health’s Faces of Opioids page.