You may not realize this, but the human body produces its own natural opioids, called endorphins. Endorphins are released when a person experiences pain, excitement, love, sex, or exercise.
These endorphins attach themselves to the opioid receptors in the brain, called the mu receptor, and act as a natural painkiller and/or brings about a feeling of pleasure or well-being. If you were to break your arm, for instance, the opioids your body produces would act effectively with the opioid receptors in your brain to mitigate the pain temporarily.
When opioids, such as Oxycodone, Vicodin, Fentanyl and Heroin, are introduced into the body, they react with the opioid receptors in a more powerful way than the natural opioids. After a while, if a person continues to use the outside opioids, they replace the natural opioids because the brain doesn’t need to react supply the receptors if they are already being satisfied.
The receptors can also build a tolerance to the opioids, resulting in the need to take stronger doses as time goes on. When you stop using the opioids, the body does not immediately begin sending the natural opioids to the receptors. For a while, it expects the outside opioids to keep coming. It takes some time for the body to begin producing natural opioids in normal quantities. This is what causes withdrawal. The person will not begin feeling normal again until the usual quantities of natural opiates are being produced.
If you or a loved one is suffering from prescription drug dependency, addiction, Substance Use Disorder (SUD) or Opioid Use Disorder (OUD), reach out for help and find a recovery treatment program.
Table of Contents
Signs and Symptoms of Opioid Use Disorder (OUD)
- Being on the defensive
- Blaming others
- Lack of eye contact
- Isolation and being secretive
- Changing to a new group of friends
- Not showing up without notice
- Abandonment of daily routines or important activities
- Lack of care in personal hygiene and appearance
- Changes in physical appearance, like weight gain or loss
- Pinpoint (constricted) pupils
- Slowed breathing
- Decrease or increase in sexual desire
- Needle marks on arms, hands or feet
- Decreased appetite
- Sudden mood swings from irritability to euphoria
- Decreased motivation
- Doctor shopping
- obtaining prescriptions from different doctors without previous doctors’ knowledge
- claiming they have lost their prescription
- complaining they need a stronger prescription
- Paraphernalia in rooms or waste cans
- medication bottles with labels removed
- burned tinfoil
- bloodied cotton swabs
- hose clamps
- bent spoons
- rolled up dollar bills
- Heavy tobacco use
- Personal or family history of OUD
- Childhood trauma, PTSD
- Previous struggles with depression or anxiety
- Risk-taking or thrill-seeking tendencies
- History of problems with work, family, friends
- History of legal problems
According to the Mayo Clinic website, up to one-third of the people who take opioids for chronic pain, misuse them and 10 percent eventually suffer from OUD.
Important treatment steps should include comprehensive and uniquely tailored methods assessed by a treatment team to provide a possible combination of Medically Assisted Treatment (MAT) to taper comfortably while also providing mental and behavioral therapies in order to identify the root cause, stop the use and fully recover.
What is Opioid Withdrawal Like?
- The length of time using the substance
- The substance itself
- The method of abuse (e.g., snorting, smoking, injecting, or swallowing)
- The amount taken each time
- Family history and genetic makeup
- Medical and mental health history
What happens during withdrawal?
The body produces natural opiates that control pain, anxiety and depression. If a person gets a broken leg, for example, the body doesn’t produce enough opiates to treat the pain. External opiates treat the pain, but over time and prolonged use, the body’s receptors in the brain, the spinal cord and gastrointestinal tracts become desensitized to them and higher dosages are needed to achieve the same effect. The increased consumption creates the dependency on the receptors and when the person stops taking the opiate the body reacts to the lack of the opiate it had been taking.
What are the symptoms?
Generally, physical opiate withdrawal symptoms can be anywhere from mild to severe and can last anywhere from a few days to a month. It comes in two phases. The initial phase can include these symptoms:
- Muscle aches
- Excessive sweating
- Runny nose
- Extreme cravings
- Excessive yawning
- Insomnia and restless leg syndrome
- Dilated pupils
- Rapid heartbeat
- Nausea and vomiting
- Abdominal cramps
- High blood pressure
While these symptoms are very unpleasant and painful, they usually begin to improve within 72 hours, and within a week there should be a significant decrease in the acute symptoms. Longer term symptoms are usually more behavioral and emotional.
In study after study, physician-supervised use of Medication Assisted Treatment (MAT) is proven to be the most effective method for handling opioid dependency comfortably, when used in conjunction with behavioral therapies and counseling, significantly outperforming traditional forms of treatment that rely on counseling alone or MAT alone.
Loved One With Opioid Addiction?
Recovery from Opioid Use Disorder (OUD) is a difficult dance. The steps are strenuous, complicated and require practice, determination and often, a supportive partner. Many people with a loved one suffering from OUD are often looking for effective ways to be that partner and help their loved one master the steps.
So, what can you do?
It’s the opening step. Recovery is stressful for everyone, so a stress-free, trusting environment is key.
- Communicate in an honest, non-threatening manner. Avoid language that stigmatizes your loved-one’s condition. See this link for examples. Remember that communication includes listening.
- Avoid nagging, criticizing, lecturing, name-calling and hyperbole
- Don’t engage in addictive behaviors yourself
It takes two to dance, so trust goes both ways.
- Keep from stepping on each other’s toes and establish clear expectations so that both partners know what behaviors are acceptable.
- Don’t put up with bad behavior from your loved one.
It’s difficult to have all the answers yourself. Accept that fact and look for support from peer groups and professionals.
Embrace the Treatment Process
If you are involved in your loved one’s treatment, be honest about your feelings and expectations, be non-judgmental and listen with an open mind. If your loved one is in treatment alone, respect their privacy. If they don’t want to talk about it, don’t push and do not inform friends, family, or others about it.
Overall, understand that this dance is a marathon, change does not happen in one night of dancing. If you are looking to find treatment for your loved one or yourself, there's no shortage of support available.
Getting to Recovery from Opioid Use
Endless headlines regarding the increasing numbers of overdoses, suicides and drug use abound. Covid-19 has compounded feelings of isolation, helplessness and despair though what is rarely reported is the amount of those who’ve successfully committed themselves to recovery in this time, as well. Help is all around. And, help has evolved to meet needs such as through teletherapy.
Countless articles such as "The Epidemic Raging Within the Pandemic" circulate news cycles all over the country even though inpatient and outpatient opioid recovery treatment options are available via private and public options. The article focuses on West Virginia, though applies nearly everywhere:
"Long before the pandemic came along, the nation, especially Appalachia, was in the throes of a deadly epidemic: opioid and meth addiction. It was a crisis that tore apart families, devastated communities, and destroyed lives. As the pandemic continues, so does the opioid epidemic, with the pandemic's widespread effects causing opioid addiction to escalate at alarming numbers.
The Overdose Data Mapping Application Program report published in May showed fatal overdoses rose by almost 11.4% over the last year. In July, the American Medical Association warned about an increase of reports from across the country showing a dramatic increase in opioid-related mortality during the pandemic."
Covid-19, job loss, insurance concerns, housing loss, transportation issues can contribute to the perception that help is unattainable when resources are more available than ever. An important piece of this is in recognizing the connectivity craved by all. If substance use or addiction is a disease, diagnosis is vital so that ongoing care - and connection - can begin. Recovery treatment begins a relationship between not just patient and healthcare provider but person to person. In the case of comprehensive outpatient care that allows one to continue work or look for work, patients can immerse themselves in new healthy relationships with a team of recovery care professionals including doctors, PAs, nurses, counselors, care ambassadors and so on. Every visit, whether in person or via telehealth, is a check-in mentally, emotionally and physically. The need for real human connection is vital in an era of unprecedented isolation, an epidemic and technology working against us.
The importance of treatment for addiction can begin with Medically Assisted Treatment (MAT) to get one feeling better and Intensive Outpatient Treatment to get one into group, family and individual counseling suited to needs and schedules. Peer to peer recovery also provides another level of connection opportunity. Being able to do all this in one location, under roof with one team, a patient learns to trust which is proven vital to successful outcomes. Trust that there's attainable help out there. Trust the connectivity of a team approach to your recovery.
Can Peer Recovery Make a Difference to Opioid Recovery?
Peer support is rapidly emerging as an effective element of recovery from Substance Use Disorder (SUD). Peer Recovery Support Specialists are individuals who have achieved significant recovery of their own and are trained to use their experiences of recovery to assist others in their journeys to recovery.
Peer support can fill a gap that often exists in treatment by focusing on recovery first and by helping to rebuild and redefine the person’s community and life. Many people find it easier to open up and be honest in this kind of relationship and this kind of honest relationship makes those in recovery more inclined to take the proper steps toward recovery.
I’m not a counselor. I’m a mentor,” said Amy Burrows, a Peer Recovery Specialist working with Symetria Recovery.
Peer recovery support specialists engage in a wide range of activities:
- Advocating for people in recovery
- Sharing resources and building skills
- Building community and relationships
- Leading recovery groups
- Mentoring and setting goals
Their roles may extend to:
- Providing training to and supervising other potential support workers
- Developing resources
- Administering programs
- Educating the public and policymakers
- Improving the relationship with treatment providers
- Increasing treatment retention
- Increasing satisfaction with the overall treatment experience
- Improving access to social supports
- Reducing re-hospitalization rates
- Reducing substance abuse
- Reducing relapse rates
- Decreasing emergency service use
- Decreasing involvement in the criminal justice system
What about Painfree Withdrawl? Where Does Medication Assisted Treatment (MAT) Fit into Opioid Withdrawl?
Medication Assisted Treatment (MAT) or Medication Assisted Recovery (MAR) is the physician-supervised use of medication to treat opioid (including heroin) use, dependency and abuse (addiction). In study after study, medication assisted opioid treatment is proven to be the most effective method, significantly outperforming traditional forms of treatment that rely on counseling alone. MAT can reduce pain and cravings associated with tapering or withdrawl from opioid use.
At intake, you undergo a 360-degree assessment to determine which medications are appropriate. From here, you work closely with your personal care team to develop a recovery plan that evolves over time.
Suboxone is often the "M" in Medication Assisted Treatment (MAT) for Opioid Use Disorder. It is a sublingual film with a combination of its active ingredients – Buprenorphine and naloxone – that creates unique properties that lower the potential for misuse or overdose and diminish the withdrawal symptoms and cravings caused by physical dependency on opioids.
Buprenorphine is the main ingredient. It is an opioid partial agonist. That means that it acts as an opioid, just like oxycodone, heroin, or methadone, but in low to moderate doses. Think of the opioid receptors in the brain as a door. Your brain throws the door wide open for most opioids, but only partly open for Buprenorphine.
Naloxone is an opioid antagonist that blocks opioid receptors from the effects of an agonist. So, it acts to counteract the high you might otherwise feel from the Buprenorphine.
These two ingredients work together effectively when administered in doses which are slowly decreased over time. This enables a person to work through recovery while leading a more normal life without the intense pain and suffering of opioid withdrawal.
Suboxone was developed to ease the severe symptoms of opioid withdrawal. If an individual has a strong desire to stop taking opioids, but is powerless to get through the withdrawal symptoms, then that person may be a candidate for a monitored and regimented Suboxone program.
Chief Medical Officer of Symetria Recovery Dr. Abid Nazeer adds,
How is Group Therapy Used in Opioid Addiction Treatment and Recovery?
Counseling is a pillar in treating people for Opioid Use Disorder (OUD). OUD is more than just a physical dependence on substances. There are various psychological and social factors that can be addressed through therapy that can advance recovery and reduce the risk of relapse. While many types of therapy can be useful during Medical Assisted Treatment (MAT) programs, Group Therapy creates a safe and non-judgmental environment that can be especially effective in creating positive long-term outcomes in several ways:
- Members of the group are able to interact with other people who are learning how to cope with their own illness, especially during the early stages of recovery.
- Sharing experiences with the group can boost confidence and self-esteem, plus reduce the stress and guilt group members might be feeling.
- Cognitive sessions can help group members recognize their own mindsets and the situations that dial up cravings. Patients learn how to avoid these triggers by enacting positive, healthy thoughts and feelings.
Similarly, Family Group Therapy is also available as a way to help family members learn how to cope with and advance the recovery of their loved one.
How effective is it?
People are fundamentally social creatures. People’s lives are shaped by group experiences. So, group therapy is really a natural process that has been proven to be highly effective. By joining a group, you are not only influenced by others, but you can learn about your own power and influence within the group. The effects of these sessions can extend to include outside relationships in every aspect of the patient’s life.
During the Covid-19 pandemic, limited face-to-face contact presented a challenge to keep providing group therapy services going. Fortunately, where face-to-face sessions might be unavailable or inconvenient, there are virtual intensive outpatient services available to help patients continue their recoveries.
Outpatient substance use and opioid addiction recovery treatment facilities such as Symetria Recovery offer Self-Management and Recovery Training (SMART) support groups where patients share their experiences and develop the skills and tools they need to manage their behaviors. All SMART support group meetings are led by trained counselors who are specifically certified in SMART facilitation, as well as in Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT) services. This is just one aspect available for treating the whole person with substance use disorder at Symetria Recovery. The difference at Symetria Recovery is in having one full team of doctors, PAs, nurses, counselors and ambassadors assigned to meet your needs under one roof. Your unique plan to recovery is customized to meet your needs.
Get Help Fighting Opioid Addiction Today
If you’ve been worried about a loved one, or if you’re concerned about the way you use your pain medication, we urge you to contact us as soon as possible for help. To take the first step, contact us online or call (888) 782-6966 right away.