An estimated 3 million Americans are currently suffering from the effects of opioid use disorder, and most will need professional help and support to achieve and maintain their recovery. Fortunately, there are a wide variety of treatment options available for opioid use disorder that can help improve people's quality of life and prevent relapse. It's important to note that opioid use disorder, like any addiction, is highly treatable according to the National Institute on Drug Abuse.

With the right combination of medication-assisted treatment, therapy, and support, you or your loved one can find the help needed to achieve sobriety and start on your road to recovery.

What are Opioids and Opiates?

Although they are sometimes used interchangeably, there is a slight difference between opioids and opiates. Both substances are used as pain relievers and are derived from the poppy plant known as the Papaver somniferum. The poppy's sap has been used for hundreds of years to produce natural opiates. These naturally-derived opiates include:

• Opium
• Morphine
• Heroin
• Codeine

Opioids, on the other hand, include synthetic or man-made drugs that are far more potent than opiates. Opioids are commonly used as prescription drugs and include, among others:

• Fentanyl
• Hydrocodone 
• Oxycodone 
• Methadone

Regardless of whether someone is using an opioid or opiate, the brain does not distinguish between the two, and both can quickly lead to addiction.

What are Opioids and Opiates Used For?

Many medical providers prescribe opioids to treat chronic and acute pain, such as pain associated with:

• Cancer
• Cancer treatment
• Surgery
• Medical procedures
• Musculoskeletal ailments
• Traumatic injuries

Although they are considered addictive narcotics, opioids are powerful and effective at treating pain. As such, 191 million Americans were prescribed opioids in 2017 according to the CDC. Unfortunately, research has shown that there is a high incidence of prescription opioid misuse leading to the use of opiates such as heroin.

Heroin and other illicit substances, such as illegally-produced fentanyl, are also commonly used by those with opioid use disorder due to their pain-relieving properties in addition to other side effects such as:

• Euphoria
• Extreme joy
• Feelings of intense relaxation
• Slowed breathing
• Slowed heart rate

Why Are They So Addictive?

Opioids becomes very addictive because they are powerful drugs and highly effective at treating pain – this is what makes them so addictive once your pain subsides.

Brain Chemistry

Opioids work by binding to the opioid receptors in the brain, which send nerve signals (including pain signals) through the spinal cord to the rest of the body. Opioids block these pain signals, allowing people to feel relief almost immediately from pain.

However, over time, the increasing use of this drug leads to decreased ability of the brain to be sensitized to other forms of emotion, pleasure, and happiness. Chemical changes in the brain and body also lead to physical dependence, where people experience withdrawal symptoms if they stop taking opioids.

These withdrawal symptoms can be uncomfortable and include symptoms such as:

• Nausea
• Vomiting
• Diarrhea
• Seizures
• Tremors
• Hallucinations
• Sweating
• Increased cravings

Signs of Opioid Addiction

It's important to note that although physical dependence on a drug can be debilitating, it isn't the only sign to look for when identifying opioid use disorder. The DSM-5 states that people who suffer from opioid use disorder might also show signs of opioid addiction including:

• A desire, yet inability to stop using opioids
• Problems with work, school, or home obligations
• Strong cravings for opioids
• Continuing to use despite physical or psychological problems it may cause
• Using opioids in dangerous situations
• Giving up on certain activities due to opioid use

How MAT Can Help

One of the first steps in treating opioid use disorder is to stop using opioids altogether. Unfortunately, due to its withdrawal symptoms, quitting the use of opioids suddenly can be painful and result in unpleasant symptoms. This is where medication-assisted treatment or MAT comes in.

The FDA has approved medications to treat opioid use disorder, including:

• Buprenorphine
• Methadone
• Naltrexone

These medications help people stop using their opioid of choice, while also reducing cravings and minimizing withdrawal symptoms. Medication-assisted treatment has also been proven to be effective at preventing relapse and overdose, birth outcomes in pregnant women, and increasing retention rates in treatment.

Combining MAT and Psychotherapy

It's estimated that about 7.9 million Americans have a co-occurring disorder along with substance use disorder. Co-occurring disorders can include mental health disorders such as:

• PTSD
• Anxiety
• Depression
• Borderline Personality Disorder
• Bipolar Disorder
• Schizophrenia

Due to the high prevalence of co-occurring disorders and opioid use disorder, it's important to combine medication-assisted treatment with other behavioral health services. Treatment of opioid use disorder along with services such as:

• Psychotherapy
• Individual counseling
• Group counseling
• Cognitive-behavioral therapy
• Dialectical-behavioral therapy
• Trauma counseling

MAT has been shown to improve psychiatric symptoms, improve quality of life, and reduce or completely stop substance use altogether.

The Importance of Ongoing Care and Outpatient Treatment

Achieving sobriety is possible, and it can be done with the help of professional drug and alcohol counselors, medication-assisted treatment, and psychotherapy. Due to the nature of addiction and opioid use disorder, it's important for people to continue to seek help after finishing a medical detox or an inpatient program. 

Through ongoing care and outpatient treatment, people can ensure they continue to remain sober and continue their road to recovery.

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