Opioids are drugs that relieve pain and induce sleep. They can be synthetic, semi-synthetic, naturally present in the opium poppy like morphine and codeine or derived from an entirely different source, such as kratom. All opioids share one characteristic and this defines them as opioids: They bind to and activate the opioid receptors in the brain, which are the mu, the delta and the kappa, sometimes referred to as the MOR, the DOR and the KOR respectively. Not all opioids activate these receptors in the same way.
Some are partial agonists like buprenorphine, a opium derivative, and mitragynine, the alkaloid found in kratom. Most are full agonists and include oxycodone, morphine, heroin, hydrocodone, methadone, and fentanyl. Of those last six, only fentanyl and methadone are completely synthetic. Other opioid-related drugs, although not opioids themselves, are the antagonists. These include naloxone and naltrexone, both used to reverse opioid overdose. All opioids are addictive to one degree or another and all can produce a powerful opioid withdrawal syndrome if suddenly stopped. This article will discuss the question: “what is the treatment for opioid addiction?”
How does Addiction Occur?
Continued use of an opioid of any type will result in alterations in brain function and chemistry. Over time, these changes derange normal brain function to the point of it being unable to function without the presence of an opioid. Even kratom has been reported to produce an opioid-like withdrawal syndrome in some people who use it in high doses over a long period of time. However, kratom by itself has not been associated with the typical cause of opioid overdose: Respiratory depression. Many countries have banned the substance, and even a small number of states in this country have done the same.
When someone continues to ingest an opioid, the brain responds by growing extra opioid receptors and down-regulating its response to the drug. This means that more drug must be taken to get the same effect. The brain also slows or stops production of its own opioids called endorphins. These changes play key roles in the opioid withdrawal syndrome. Meanwhile, the liver is busy creating enzymes to inactivate the opioid before it can even reach the brain in the first place.
Once addicted, the brain creates powerful cravings for the drug. These cravings, along with withdrawal syndrome synptoms like vomiting, pain, insomnia, restless leg syndrome, diarrhea, depression, extreme weakness and cold sweats can make overcoming an addiction nearly impossible without help. Most addicted people will need this help to stop.
Medication-Assisted Treatment
This is also called MAT. It is not reasonable to expect someone addicted to opioids to stop using them without chemical help. The brain’s chemistry is altered and it needs this help. The most common medication for this is called Suboxone. It contains a partial agonist opioid called buprenorphine. This drug activates the mu receptor similarly to other full-agonist opioids, for example, heroin, but it cannot produce much euphoria, if any at all. It relieves withdrawal symptoms and curbs drug cravings very well for most people. When buprenorphine fails, the full-agonist, synthetic drug methadone will almost always work for just about any level of addiction, even high-dose heroin or fentanyl. If the person also has chronic pain, methadone is a good choice because it’s a superior analgesic highly effective by mouth.
Beware of Rapid Detox
There is a sham “rapid-detox” treatment for opioids. Touted as a painless way to eliminate the brain’s opioid addiction in just 72 hours, it involves deep sedation and the antagonist drugs naloxone or naltrexone. These are supposed to “cleanse” the receptors of opioids and allow the person to wake up feeling normal again. Don’t believe it. The method is ineffective and potentially dangerous. The person will emerge from sedation in the same stage of withdrawal as they would have been in, anyway.
Support for Opioid Addiction
After detox, rehab recovery treatment is essential for opioid dependence to treat the underlying causes. These can include:
- Equine, animal, nature, dance, art and water therapy
- Cogniitive behavioral therapy
- Dialectic behavioral therapy
- Eye movement and desensitization reprocessing (EMDR)
- Individual, group and family therapy
- Acupuncture
- Nutritional and herbal support
- Spiritual therapy
- Reiki and other types of massage
Acupuncture may be especially helpful for opioid addiction because it’s thought to help the brain release more of its own natural opioids called endorphins.
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