< On this Page
On This Page ×

Opiate Addiction

Opiate Addiction

The last decade or so has shown an alarming increase in the use and abuse of opiates, both illicit and legally prescribed. Their devastating effects are hard to comprehend. According to recent statistics from the Centers for Disease Control and Prevention (CDC), opioids were involved in over 42,000 deaths in the U.S. in 2016, and opioid overdose deaths 2016 were five times higher than in 1999. Further, a study conducted by Blue Cross of its members from 2010 through 2016 found that the number of people diagnosed with an opioid addiction – including illicit forms like heroin, and prescription forms such as hydrocodone and oxycodone – climbed nearly 500 percent. Possibly the most shocking fact of all is that recent government statistics show drops in life expectancy in both 2015 and 2016. The biggest factor influencing these drops? Drug deaths fueled by the opioid crisis.

For those who have been directly impacted – either through their own struggles with opiate abuse or with those of family or friends, the existence of the opioid epidemic is all too real. Fortunately, opiate addiction is a treatable medical condition, and long-term freedom from opiate abuse is possible. This guide is designed to serve as a primer on opiate addiction: its signs and symptoms, treatment options, and what you can do to help yourself or a loved one suffering from opiate dependence to get better.

Expert

William Dawson
View Bio
Opiate vs. Opioid

In the past, the word opiate referred to natural substances derived from opium (an extract of the opium poppy), and opioid referred to synthetic or semi-synthetic substances that bind to the same brain receptors as opiates. Today, in most cases, opiate commonly refers to both natural and synthetic substances, while opioid continues to refer to synthetic substances, although opioid is also at times used to refer to both natural and synthetic substances.

The last decade or so has shown an alarming increase in the use and abuse of opiates, both illicit and legally prescribed. Their devastating effects are hard to comprehend. According to recent statistics from the Centers for Disease Control and Prevention (CDC), opioids were involved in over 42,000 deaths in the U.S. in 2016, and opioid overdose deaths 2016 were five times higher than in 1999. Further, a study conducted by Blue Cross of its members from 2010 through 2016 found that the number of people diagnosed with an opioid addiction – including illicit forms like heroin, and prescription forms such as hydrocodone and oxycodone – climbed nearly 500 percent. Possibly the most shocking fact of all is that recent government statistics show drops in life expectancy in both 2015 and 2016. The biggest factor influencing these drops? Drug deaths fueled by the opioid crisis.

For those who have been directly impacted – either through their own struggles with opiate abuse or with those of family or friends, the existence of the opioid epidemic is all too real. Fortunately, opiate addiction is a treatable medical condition, and long-term freedom from opiate abuse is possible. This guide is designed to serve as a primer on opiate addiction: its signs and symptoms, treatment options, and what you can do to help yourself or a loved one suffering from opiate dependence to get better.

Opiate vs. Opioid

In the past, the word opiate referred to natural substances derived from opium (an extract of the opium poppy), and opioid referred to synthetic or semi-synthetic substances that bind to the same brain receptors as opiates. Today, in most cases, opiate commonly refers to both natural and synthetic substances, while opioid continues to refer to synthetic substances, although opioid is also at times used to refer to both natural and synthetic substances.

Signs of Opioid Dependence

There are a large number of physical, psychological and behavioral signs and symptoms that indicate opiate abuse or addiction. Below is a list of the most common of those signs and symptoms. It’s important, however, to bear in mind that no single person suffering from opiate dependence will likely display all of the signs listed here.

Physical

  • Changes in energy levels; drowsiness; sleepiness; nodding off; exhaustion
  • Nausea; vomiting
  • Constipation
  • Itching
  • Sweating
  • Sleeping difficulties
  • Lack of Appetite
  • Slowed breathing
  • Constricted pupils
Psychological/Emotional

  • Heightened anxiety; anxiety attacks
  • Euphoria (usually short-lived)
  • Depression
  • Irritability
  • Confusion; memory lapses
  • Hallucinations; paranoia
  • Mood swings
Behavioral

  • Forging opioid prescriptions
  • Doctor shopping for prescriptions
  • Lying about drug use and related matters
  • Anti-social behavior; avoiding social events, family activities, etc.
  • Decreased performance at work or in school
  • Legal problems, like stealing money or drugs
  • Using prescription opioids beyond the prescribed time period; taking bigger dosages than prescribed
Opiate Overdose Signs and Symptoms

Recognizing and responding to the signs of an opiate overdose can often mean the difference between life and death. Common overdose signs include:

  • Pinpoint pupils
  • Unconsciousness; inability to wake up
  • Respiratory depression or arrest
  • Cold or clammy skin; bluish or purplish-black lips or skin underneath fingernails
  • Vomiting

If someone is displaying one or more of these signs, take immediate action and call 911. While waiting for emergency medical help to arrive, roll the person on his/her side to help avoid choking on vomit while unconscious. If conscious, talk to the person and try to keep them awake.

How to Help Someone with Opioid Dependence

Coping with a love one suffering from an addiction to any form of opiate is difficult. It’s particularly hard for friends and family members who have never before dealt with opiate addiction. It’s difficult at times to even know if someone has an opiate abuse problem. Complicating matters is the fact that addicts often deny their problems and resist any attempts by others to help. That doesn’t mean you shouldn’t try, however. Here is some useful information and advice on how to help someone abusing opiates – whether they want help or not.

Deciding to help someone with an opiate addiction begins with recognizing that he or she has a problem. That can be harder than you might think. Usually there is some activity or behavior that first raises a concern. Once that happens, it’s time to consider whether the person is showing any of the signs or symptoms of abuse discussed above. Additional signs to look for include changes in physical appearance (dirty clothes, lack of grooming, etc.), sudden or drastic changes in personal relationships (new, questionable friends and acquaintances), and indications of financial problems (like frequently asking to borrow money).

Another great way to know if someone is using opiates is to ask. In many cases, the response will be defensive or belligerent, which may itself be an indication of a problem. But there’s also the possibility that the addict is ready to admit his or her problem, and to seek treatment. All it takes is someone asking the question.

Asking about opiate abuse brings up the broader topic of how to talk to someone with an addiction problem. If you think you’re ready to speak to a loved one about your concerns for their health and wellbeing, there are a number of factors to keep in mind:

  • Do some planning: Prepare ahead of time for what you want to say, and where and how you want to say it. Educate yourself a bit on opiate addiction and its treatment. Objective facts are a great tool in persuading a person with a drug abuse problem.
  • Don’t speak to the person when he or she is high: You probably won’t be able to get your message through to someone when they’re under the influence. Best to wait until he or she is sober, if possible.
  • Do expect resistance: Denial is often the first line of defense used by an addict when confronted about his or her addiction, so don’t be surprised if that’s the initial response you receive.
  • Don’t be judgmental: Speaking of resistance, nothing is as likely to ignite it as criticism and accusations. Better to just express your concerns and stick to the facts.
  • Do listen: Keep an open mind and willing ear. Nothing is more likely to sabotage your talk than being closed to what the addict has to say.
  • Be ready with some suggestions for treatment: The goal is to persuade the addict to seek help. Make it easier for him/her by having one or more treatment options available to share.

A drug intervention is a process designed to confront an addict with the goal of getting him or her to recognize the critical nature of their addiction and to seek help to get clean. Interventions can take two forms: formal and informal. An informal intervention typically involves one or two persons meeting with the subject of the intervention to express their concerns about the subject’s opiate abuse, and to offer encouragement to get help.

A formal intervention normally involves the participation of several family members and friends of the subject overseen by a professional interventionist. The formal intervention is carefully planned in advance, and follows a given structure that allows participants to express their concerns about the subject’s drug use and, if the subject refuses the help offered, the consequences for that refusal. Formal interventions commonly occur when all other efforts to get the addict to seek help have failed.

One very important way to help a loved one fight opiate addiction is by identifying relevant support resources, like local treatment centers and 12-step meetings. Providing the addict with a list of available support services makes it much more likely that he or she will accept the aid being offered. To find treatment centers, community groups, and other support programs in the addict’s area, start with the Substance Abuse and Mental Health Services Administration (SAMSHA) National Helpline at 1-800-662-HELP (4357). The helpline is free, confidential, and accessible 24 hours a day. Two other excellent resources for locating treatment services are SAMSHA’s Behavioral Health Treatment Services Locator and the American Academy of Addiction Psychiatry’s Practitioner Database. For help finding a professional interventionist, contact the Association of Intervention Specialists.

Other support resources include Narcotics Anonymous, Nar-Anon, SMART Recovery, Women for Sobriety, Jewish Alcoholics, Chemically Dependent Persons and Significant Others (JACS), and Celebrate Recovery (a Christian-based support group).

What to Expect from an Opiate Treatment Program

Treatment for opiate addiction takes two basic forms: outpatient and inpatient. In outpatient programs, the patient resides at home or some other location outside the treatment center, and typically spends a specified number of hours each day, or several days a week, at the center. Inpatient treatment involves moving into the treatment center for a given length of time, typically a minimum of approximately 30 days, although stays may be much longer. Inpatient rehab programs normally require the patient to remain on-premises throughout the treatment period, and to strictly adhere to a number of rules of behavior.

Opiate addicts in an inpatient treatment program will spend their time attending individual and group therapy sessions, education lectures on addiction and the development of sober living skills, homework assignments, and participating in a variety of physical and mental wellbeing activities. Patients are provided three full, nutritious meals each day. In most cases, patients will share sleeping quarters with one or more individuals in treatment. Following their inpatient stay, patients will normally step-down to an outpatient treatment program, or return to their regular lives, although with continued participation in local 12-step group meetings and activities.

  • Detox: Withdrawing from Opiate Addiction
  • Visiting Someone in Rehab
  • Addiction Therapy: Participating in Treatment
  • The first step in the opiate addiction rehab process (following the decision to go into treatment) is substance withdrawal and detoxification. Withdrawal from opiate addiction, particularly when done “cold turkey” – that is, without medical supervision – can be extremely unpleasant. Withdrawal symptoms include nausea, vomiting, diarrhea, body aches, stomach pain, shaking and chills, anxiety and depression, among others. Even with the use of medications to decrease cravings and allay symptoms, withdrawal from opiate dependence can be physically, mentally and emotionally exhausting. Opiate withdrawal can last from a few hours to several days, depending on the length and severity of the patient’s drug use. Some discomforts may linger for weeks following the initial acute stages of withdrawal.

    Professionally supervised detoxification employing medications to lessen cravings and symptoms is highly recommended for most individuals seeking to withdraw from opiate dependence. In most cases, detox will require staying in the hospital or treatment center during the initial stages of withdrawal. Outpatient detox may be possible for those whose opiate use is shorter-termed and less severe.

  • Visiting loved ones while in treatment is generally encouraged by rehab facilities, at least following the first week or so of treatment. Visits can have a positive effect on the patient by reinforcing the visitor’s commitment to the patient’s recovery. Family visits may have a negative impact, however, if the visitor brings any lingering toxic family issues along with them to their visit. It’s important, therefore, to visit only if you can offer the patient encouragement and praise for their hard work at recovery.

    Rules regarding visitation vary by facility, but pre-approval of the visit is almost always a requirement. Expect to be searched upon arrival, so do not attempt to smuggle anything in to the patient, even if you believe what you’re sneaking in is harmless. And be prepared to follow all facility rules to the letter. Remember, you’re there to support your loved one’s recovery efforts, not to cause trouble.

  • Opiate addiction isn’t just damaging to the addict, it’s also devastating to the addict’s relationships with his or her spouse, children, parents, siblings, close friends, and others. Healing those relationships, therefore, becomes an important element in the recovery process. And that requires the active participation of family in the recovery process.

    Many treatment centers incorporate couples and/or family therapy sessions into the addict’s rehabilitation program. Family members are highly encouraged to attend and participate in therapy, if available. The benefits are substantial. Family members can learn about addiction and its impact on the individual addict. Family therapy also offers a setting in which issues regarding trauma, enabling, and the substance abuse of other family members can be confronted and resolved.

Life after an Opiate Rehab Program

Getting an opiate addict into treatment is crucial, but it’s only the first step in the long-term recovery process. Sobriety requires a life-time commitment by both the addicts and those who love them. There are plenty of things loved ones can do to help a recovering opiate addict maintain sobriety:

  • Encourage your loved one to continue active participation in 12-step groups, and sober programs and activities.
  • Practice patience through the long haul of recovery, including the inevitable setbacks.
  • Provide a drug-free environment in your home and during shared outings and activities.
  • The hard fact is that relapse is a common occurrence, particularly when it comes to opiate addiction. If relapse occurs, refrain from judgment, offer encouragement to stop using immediately, and – if called for – support the loved one’s return to treatment.
Find Personal Support

When a loved one is struggling with opiate addiction, it’s all too easy to fall into the trap of making that struggle the primary focus of your own life. That’s a huge mistake. You really can’t help an addict with his or her problem if you don’t watch out for yourself first. Consider speaking with your family physician or therapist. There are also several organizations and peer groups that specialize in support for the friends, spouses and families of addicts, including Co-Dependents Anonymous (CoDA), Families Anonymous, Learn to Cope, Nar-Anon Family Groups, and SMART Recovery Family & Friends.

Q&A With an Opioid Addiction Expert

About William Dawson
About William Dawson

William Dawson is the Chief Operating Officer and Co-Founder of Renew Recovery, an outpatient drug and alcohol treatment provider with locations in Louisville, London, and Georgetown, Kentucky. Mr. Dawson holds a B.A. in Biochemistry with a minor in Business Management from Eckerd College. Prior to founding Renew, Mr. Dawson was Director of the Innovation and Commercialization Center for Greater Louisville, Inc.

  • Can you tell us a little bit about Renew Recovery?

    Renew Recovery is an in-network provider specifically focused on the outpatient level of care. We have medication-assisted treatment for drug dependencies, and I use that word very specifically. Medication-assisted treatment is used for drug dependency, which is just a component of the addiction. It’s a great tool, but it’s not a solution on its own. Additionally, patients receive structured mandatory psychotherapy, meeting with their primary therapist on an individual and group basis to address the psychological components of addiction. We also provide psychiatric evaluation and management of co-occurring disorders. Those that suffer from substance use disorders quite often have secondary underlying conditions: depression, anxiety, PTSD, things of that nature. So, we really focus on that treatment model.

  • What types of therapy do you offer patients to help deal with the issues underlying their addictions?

    We use the Hazelden Betty Ford Living in Balance program as our core curriculum, which is on the registry of accepted evidence-based practices. Therapy is delivered on an individualized basis based on the patient’s needs. It’s weekly individual sessions with group involvement on the front end focused more on the educational component. We also provide case management, so when needs are identified – with the physicians, psychiatrists or therapists, financial assistance or vocational assistance – those things can be addressed through case management. 

  • What is the first thing you would want someone know about treatment?

    I think understanding the different types of treatment options that are out there. I think that there’s sometimes the perception that “going to rehab” means that you are going to go into a 30-day residential treatment center, and that you have to leave your current living situation and return back after. There are options like Renew where we work with a lot of people that are part of the workforce, and we work around their schedules. The impact on their life is less dramatic. For the right patients, getting treatment doesn’t necessarily mean that you have to put the rest of your life on hold. 

  • How important is family involvement in the recovery process?

    You know, it depends on the specific case, but having a support network is incredibly important. The isolation that people go through when they’re in active use, it’s like a feedback loop. It makes the problem worse. Another thing that we do is host peer support groups at our locations. Having people around someone working toward their recovery that understand and are there to support them is really vital. 

  • Do you actually have family therapy sessions?

    Correct. If it comes up in individual therapy that there needs to be more family involvement, and they’re willing to participate in that, then we are able to provide it.

    Do you think that the public-at-large is starting to have a better understanding that addiction is a disease as opposed to a moral failing? Are you seeing that at all?

    I hope so. I’m very biased on this, because it’s what we as a company have been preaching for a very long time. In my conversations with people, once you explain the disease model of addiction, you can see a light bulb come on. It’s something where you have to kind of change your initial perceptions. And I think things like the opiate crisis that we’re in right now, we’re forcing people to do it because not long ago if you just said “heroin addict” and you closed your eyes, a certain image would just pop into your mind that couldn’t be further from the truth. This affects all socioeconomic levels. This is something that is rampant, and it’s time for us to look at it as what it is. We believe it is a manageable disease.