Opioid Addiction and Treatment in the United States: An In-Depth Overview


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Opioid Addiction and Treatment in the United States: An In-Depth Overview

 This article provides an in-depth overview of opioid addiction and treatment in the United States. It discusses the causes, symptoms, and risk factors associated with opioid addiction.

Opioid addiction is a major public health problem in the United States. In 2014, there were more than 2 million Americans who abused prescription pain relievers or heroin. The number of deaths from drug overdoses in the United States has more than tripled since 2000, and these deaths are largely due to opioid addiction.


A General Overview of Opioid Addiction

The problem of opioid addiction is a complex one, with many factors contributing to the issue. The most common opioids include heroin and prescription painkillers like oxycodone, hydrocodone, and codeine. 

These drugs act on the central nervous system to reduce pain perception, which is a natural function of opioids in the body. When taken in excess or used for an extended period of time, however, the body begins to build up a tolerance. As this occurs, users must take greater amounts of opioids in order to achieve the same pain-relieving effects. This increased dosage can lead to severe dependence, which is defined as the need for a substance in order to function normally.

Tolerance to and Dependence on Opioids

Opioid tolerance and dependence are two of the most common characteristics of addiction. Tolerance refers to the body’s decreased response to a substance over time, while dependence is an intense physical need for that same substance. When tolerance develops and the user needs greater amounts of opioids to achieve the same pain-relieving effects, dependence can occur.

 This means that if the user suddenly stops taking the drug, he or she will likely experience withdrawal symptoms such as nausea, vomiting, sweating, and intense cravings. In severe cases of opioid dependence, the user will experience life-threatening withdrawal symptoms without medical treatment.

Tolerance and Dependence in Chronic Pain Patients

In a study of chronic pain patients, researchers found that more than half of the participants developed tolerance to opioids. In addition, almost 75 percent of those who developed tolerance showed signs of dependence on their medication.

Tolerance and Dependence in Cancer Patients

A study of cancer patients receiving opioids for pain relief found that about 40 percent developed tolerance to the drugs. As with chronic pain patients, most of the cancer patients who developed tolerance also showed signs of dependence.

Tolerance and Dependence in Non-Cancer Patients

A study of noncancer patients receiving opioids for pain relief found that about 20 percent developed tolerance to the drugs. As with cancer patients, most of the noncancer patients who developed tolerance also showed signs of dependence on their medication.

Toxicity and Overdose in Cancer Patients

A study of cancer patients receiving opioids for pain relief found that 15 percent experienced toxicity from the drugs. Toxicity is a condition in which adverse reactions to medications produce harmful effects on organs or other body systems.

Some Opioid Use and Addiction Statistics

Patterns of opioid use and related harms have changed in the United States over time. In particular, opioid-related overdose deaths have increased sharply since 2000. The increase has been driven largely by a rise in overdoses involving prescription opioids, especially opioid pain relievers (OPRs) such as oxycodone, hydrocodone, and methadone. 

From 1999 to 2008, deaths involving these drugs nearly quadrupled (2). OPRs are usually prescribed for pain relief, but they also have psychoactive properties and can be misused. Since 1999, the number of overdose deaths involving OPRs has exceeded those from heroin and cocaine combined.

This increase in overdose deaths has occurred among all age groups, but the highest rates are among adults aged 25 to 54 years. Since 1999, fatal overdoses involving OPRs have more than tripled among women.

The increase in deaths involving OPRs has been accompanied by a sharp rise in treatment admissions for primary abuse of these drugs. In 2009, nearly 1.3 million Americans aged 12 or older needed treatment for OPR abuse, a 68%  increase from the 894,000 who received such treatment in 2000.

In 2010, nearly 2.2 million people aged 12 or older needed treatment for an illicit drug or alcohol use problem (other than dependence on OPRs), a rate of 8.9 per 100 persons. The number of treatment admissions for primary abuse of OPRs increased from 1,000 in 2000 to more than 21,000 in 2009. In the span of nine years, there was an increase of more than 20,000% and it has kept rising.

The Psychological Approach to Opioid Treatment

The psychological approach to addiction is based on the idea that a person’s thoughts, feelings, and behavior are all interconnected. When you feel anxious or stressed, your brain will release stress hormones such as adrenaline and cortisol.

 These hormones can have a powerful effect on your thoughts and feelings, causing you to feel fearful or anxious. In the same way, if you feel unhappy or depressed, these negative emotions can cause you to crave drugs or alcohol as a way of escaping from your feelings.

The psychological approach is based on the idea that addiction is caused by patterns of negative thinking and behavior, which can be changed.

The 12-step approach is based on the idea that addiction is a spiritual problem caused by an inability to connect with God or a higher power. This means that addicts need to surrender their lives to God or a higher power as part of the recovery process.

The cognitive behavioral approach is based on the idea that addiction is caused by negative patterns of thinking and behavior, which can be changed.

Opioids are a type of drug that is found in the opium poppy plant, called “Morphine” or “Heroin”. Opioids are used to treat severe pain. They can be given through a needle or a patch. There are also opioids that can be taken by mouth (called “Oral Opioids”).

There is no cure for addiction to opioids. However, there are medications that can help people stop using opioids. There are also behavioral therapies, such as cognitive-behavioral therapy and contingency management that can help individuals to recover from opioid addiction.

How Does Opioid Addiction Occur?

The main way that opioids cause addiction is by causing dopamine to be released in the brain. This causes a person to feel good, and want to experience it again. When this happens, people can become addicted to opioids. 

The brain develops a tolerance and so more of the drug is needed to feel good. As people continue to use opioids, they need more and more of the drug to feel good. This is called tolerance.

How Can Opioid Addiction Be Stopped?

People who are addicted need help in order to stop using opioids and recover from the addiction. The most effective treatment is a combination of medication and behavioral therapy. The FDA has approved two medications that can be used to treat opioid addiction: methadone and buprenorphine.

 Both of them help reduce cravings for opioids and withdrawal symptoms. People who are addicted to opioids need behavioral therapy as well, in order to learn the skills needed for a drug-free life. Behavioral therapies include:

  • Cognitive behavioral therapy
  • Contingency management
  • Motivational interviewing

The Substance Abuse and Mental Health Services Administration (SAMHSA), National Institute on Drug Abuse (NIDA), The United States Department of Health and Human Services (HHS), and many other related agencies have a guide for treatment providers that describes how to use these behavioral therapies to treat opioid addiction. They all recommend that a combination of medication and behavioral therapy is the best treatment for opioid addiction.

The Effects of Opioids

When you take opioids repeatedly over time, endorphins with the use of opioids over time. The tolerance, which is when the same dose of opioids stops triggering the strong floods of good feelings is built up. People who develop tolerance may feel driven to increase their doses to keep feeling good.

Doctors today are acutely aware of opioid risks and are reluctant to increase the prescribed dosage or even renew prescriptions. Some opioid users who believe they need an increased supply turn, at this point, to illegally obtained opioids. Some illegally obtained drugs, such as fentanyl, in the form of Actiq, Duragesic, and Fentora, are laced with contaminants, or much more powerful forms of opioids. Because of the potency of fentanyl, this particular combination has been associated with a significant number of deaths in those using heroin.

If the user has developed tolerance, they should first seek out their doctor’s help. There are better, safer choices available to help you make a change with as few uncomfortable and often dangerous side effects as possible.  Stopping opioid medications without medical advice and supervision is a bad idea. Quitting opioids abruptly can cause severe side effects, including pain worse than it was before you started taking opioids. Your doctor can help you taper off these powerful drugs slowly and safely.

Opioid addiction can cause many problems in the brain, such as reduced gray matter volume and white matter integrity. It also affects the structure of the brain and can cause problems with the way it functions. In addition, opioid addiction can also damage the immune system. This means that someone who is addicted to opioids may be more likely to get diseases, such as HIV or hepatitis.

The studies mentioned above show that people who abuse opioids are more likely to be involved in accidents and get injured. Opioid use may also cause problems with the muscles, such as weakness and spasms.

In addition to all of these problems, opioid addiction can also cause problems with the way people feel. Someone who is addicted to opioids may not be able to feel happiness, sadness, or pain. In addition, they may not be able to have normal feelings of hunger and thirst. They also may not be able to have normal sexual feelings or feel good about themselves.

It is important for people who are taking opioids to know the risks of opioid use and abuse. People who abuse opioids may have a hard time stopping opioid use or may be unable to stop using opioids on their own. They may want to talk with their health care provider about treatment options for opioid use disorder.

Treatment helps people stop using opioids and stay drug-free. Treatment can also help them learn how to manage stress, deal with past trauma, and improve their relationships. The best treatment plan is one that a person chooses for themselves. People may want to talk with their health care provider about the best treatment plan for them.

Opioid Addiction Treatment Modules

Treatment for opioid addiction is available in a variety of settings, including private physicians’ offices and clinics; hospitals; residential treatment facilities (for example, halfway houses); outpatient programs (for example, drug rehabilitation programs); and mental health centers. 

Treatment settings can vary in their approach to the treatment of opioid addiction; for example, some may emphasize one particular aspect (for example, medication-assisted treatment) more than another. If you would like to know more about the treatment option at West Valley Detox, call us and we will be happy to inform you of all the services we provide.

There are many types of opioid addiction treatment modules, such as:

  • Behavioral treatments include counseling and therapy to help people learn new ways of thinking, behaving, and interacting with others.
  • Medications can help treat opioid addiction by reducing cravings for opioids and blocking the effects of opioids if a person uses them again. Medication is only part of recovery. It is important to talk with a health care provider about the benefits and risks of taking medications for opioid addiction.

The most effective treatment plans include both medication and behavioral treatments.

Medication-Assisted Treatment (MAS)

The three basic types of medication-assisted treatment (MAT) for opioid addiction in the United States are Buprenorphine, methadone, and naltrexone. These are safe to use for months, years, or even a lifetime but a medical consultation is necessary before discontinuing use.

In MAT, medications are used along with other forms of treatment, such as psychosocial therapy. Although the most effective method of treating opioid addiction is MAT, only a small percentage of people who could benefit from this approach are able to receive it.

The Use of Buprenorphine and Naloxone in Opioid Addiction Treatment

Treatment programs that combine pharmacotherapy with behavioral therapy are the most effective. A combination of buprenorphine and naloxone (Suboxone) has been approved by the FDA for opioid addiction treatment. This combination has been shown to be safe and effective in treating opioid addiction, and it is also used for maintenance therapy.

Buprenorphine binds with opioid receptors in the brain but does not activate them, so it does not produce the euphoric effects or respiratory suppression that can lead to death. Naloxone blocks opioid receptors and is only effective if opioids are present in sufficient amounts to activate them. Thus, buprenorphine is effective in treating opioid addiction without the risk of overdose and death that can occur with full agonists like methadone.

Buprenorphine and naloxone are available in the form of sublingual tablets (Subutex) or film strips (Suboxone). Both forms can be easily crushed and snorted or dissolved in water and injected to produce effects similar to heroin.

Buprenorphine is also available as a transdermal patch (Butrans) that provides continuous delivery of the medication for up to 7 days. The patch is applied once a week, and it can be cut into smaller pieces if necessary.

Buprenorphine can be used to treat opioid addiction in conjunction with counseling and psychosocial support but it is not a cure for addiction. However, it can help patients recover from opioid dependence by reducing withdrawal symptoms and cravings for opioids.

The prescribing information for buprenorphine states that the treatment should be used in 

The Promise of an Opioid Vaccine!

NIDA is also working on vaccines that could prevent an overdose from ever happening in the first place. Vaccines for other drugs of abuse, such as cocaine and nicotine, have been successful in preventing people from getting addicted to these substances. Scientists are also studying a therapy that uses the body’s own immune system to fight off the effects of opioids.

NIDA supports research to develop a vaccine against heroin that would prevent someone from getting high if they ever tried it. Scientists are studying how the immune system responds to vaccines and how to best use this information to create new vaccines. NIDA is also funding research on antibodies that would block the effects of opioids, such as heroin and morphine, by attaching themselves to opioid receptors in the brain.

Scientists hope that these antibodies can be given to people who are addicted to opioids in order to help them stop using heroin or other drugs. This approach is based on research showing that an experimental drug called naltrexone (Revia) can block the effects of opioids and help treat addiction. Naltrexone is currently approved by the Food and Drug Administration (FDA) to treat alcohol addiction.

In addition, NIDA is funding studies to develop vaccines that would prevent heroin and other opioids from reaching the brain. Researchers are developing these vaccines by studying how antibodies work in the immune system. They are trying to identify the parts of opioid molecules that attach to receptors in the brain and develop vaccines that would prevent these opioids from attaching, or binding them so they don’t have an effect.

A vaccine could prevent the high that comes from any opioid drug. Vaccines are still in development and have not yet been tested in humans. No one can know for certain when, and if, these advancements will take place, so don’t wait around for a miracle to occur while you’re risking your life on a daily basis. The help you need is just a phone call away!+

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