Tolerance vs. Opiate Dependence
Although they do not necessarily mean you have an addiction, opioid tolerance and dependence are often present when someone is struggling with an opioid use disorder. Tolerance means that you need increasingly larger or more frequent amounts of the drug to achieve the same high. Dependence may develop over time as a person takes more and more opioid drugs to overcome tolerance. Physiological dependence means that your body requires opioids in order to function at an optimal level. If you abruptly quit using opioids once you're dependent, withdrawal symptoms will emerge. In order to alleviate these withdrawal symptoms, many people return to opioid use, thus creating a cycle of drug abuse and withdrawal symptoms that can ultimately lead to the development of an opioid use disorder—more commonly referred to as opioid addiction. Opioid addiction is a chronic and progressive condition that often requires treatment from a professional rehab.
Inpatient vs. Outpatient Treatment Facilities
Opiate addiction is treatable. Rehabilitation programs can be inpatient or outpatient. Inpatient facilities provide a place to live, meals, and on-site treatment options. Inpatient programs are more highly structured and relatively intensive when compared to many outpatient options. Many patients benefit from the 24-hour support and treatment and the separation from their previous drug-using environment and friends. Inpatient is often the appropriate setting for someone with:
- A severe opioid addiction.
- An addiction to more than one drug.
- Previous opioid withdrawal or detox experiences.
- A co-occurring mental health disorder, such as anxiety or depression.
- A co-occurring medical condition.
- A medical concern or special circumstance, such as pregnancy.
- A history of treatment noncompliance.
You may enter an inpatient rehab after completing detox or detox may be incorporated into the start of an inpatient or residential program. It's important that you do your research before picking a treatment facility so that you can ensure you receive the comprehensive care necessary to help you quit abusing opiates. You may receive opioid detox medications, such as methadone or buprenorphine (alone, or in combination with naloxone as Suboxone).3 These medications help to curb opiate cravings and mitigate unpleasant withdrawal symptoms, such as:3
- Rapid pulse.
- High blood pressure.
- Excessive sweating.
- Runny nose and tearing eyes.
- Muscle spasms.
- Nausea, vomiting, and diarrhea.
- Bone and muscle pain.
- Excessive yawning.
You'll receive a combination of medication, supportive medical care, and psychologist support during detox. Once you're stabilized and have completed the withdrawal process, you'll begin your opiate abuse treatment program. Every program has a different treatment philosophy, so they may vary in the amenities and services they offer and treatment modalities they use. In general, an inpatient rehab specializing in treating opiate addiction may include:3
- Group counseling, to build sober social skills and to practice utilizing coping skills.
- Individual therapy, to learn to recognize opiate-using triggers and to cope with them using positive, healthy behaviors.
- Family therapy, to improve communication between family members and heal any damaged relationships or boundaries.
- Support group meetings, to build relationships with other individuals in recovery and provide mutual support and encouragement.
- Medication-assisted treatment (MAT), which combines behavioral therapy with opioid dependence medications, such as methadone or Suboxone. These medications help to reduce cravings and decrease the risk of relapse. They can be taken for months or even years after treatment has been completed.
An outpatient opiate rehab facility provides treatment while patients continue to live in their own homes and keep their work or school routines. This option is less of an interference in someone's daily schedule than inpatient. There are several different levels of outpatient treatment, ranging from a couple hours per week to several hours per day. For instance, standard outpatient treatment often occurs in a clinic or doctor's office setting and the patient and provider may meet 1-2 times per week, for 1-2 hours each session. Alternatively, partial hospitalization programs (PHP), or day treatment programs, involve meetings 5-7 days per week, for many hours per session.3 It all depends on your specific treatment needs. People who may benefit from outpatient treatment include:3
- Those with a sober and strong support system.
- Those with reliable transportation to the facility.
- Those with relatively mild addictions.
- Those with little to no risk of experiencing severe withdrawal.
- Those who have already completed inpatient rehab and want step-down treatment.
What matters most is that you find professional treatment to help you recover from your opiate addiction and live a happier and healthier life.
Residential Rehab Facilities
A residential private rehab facility or treatment program can be extremely beneficial for someone struggling with an opiate addiction. Using opiates doesn't necessarily indicate addiction; many use opiate medications that are prescribed to help manage moderate to severe pain, but abusing or misusing opiates may indicate a need for treatment. This means using opiates in a manner that isn't prescribed, such as taking larger or more frequent doses, or snorting or injecting crushed opiate tablets. Once you're addicted to opiates, it can be very difficult to quit on your own, in part, due to withdrawal symptoms and intense cravings. A residential rehab can provide you with the evidence-based therapeutic interventions necessary to teach you stress-management, emotional-regulation, and drug-refusal skills. These skills can help you to obtain and maintain sobriety, even when faced with opiate triggers.
Some common therapies that are used during opiate treatment may include:4,5
- Cognitive-behavioral therapy (CBT), which analyzes the connection between thoughts, feelings, and behaviors, and teaches the patient how to recognize and avoid opiate abuse.
- Contingency management (CM), which provides patients with tangible rewards, such as vouchers, to encourage abstinent behaviors.
- Community reinforcement approach (CRA), which is a 24-week outpatient program in which patients receive counseling, classes to learn vocational skills, classes to improve social functioning, and material incentives. Patients learn several different coping mechanisms to promote abstinence.
- Multidimensional family therapy, which improves family functioning.
These therapies may be combined with methadone or Suboxone as medication-assisted treatment (MAT) to help people quit abusing heroin or prescription painkillers, such as OxyContin.
Best Inpatient Drug Rehab Center
Inpatient opiate rehabilitation programs are required by federal law to protect the privacy of their patients. The overall privacy of your private rehab center, though, depends on which opiate rehab facility you choose. Private rehabilitation facilities may offer options such as a private room and high security.
How Long Do I Stay?
The length of your stay at a private rehab facility depends on several factors. There is no predetermined length of opiate addiction treatment; different people require different treatment durations. That being said, research supports the fact that positive treatment outcomes are associated with more extended periods of treatment, such as 90-day treatment programs. Outpatient and inpatient programs shorter than 90 days may have more limited effectiveness in creating lasting changes in opiate abuse.6
Some research suggests that 12 months is the minimum an opiate-addicted individual should receive methadone maintenance. Many people take methadone for several years following the completion of rehab.6
I Want to Find an Executive or Luxury Rehab Center
If corporate responsibilities have kept you or your loved one from getting help for a substance abuse problem or behavioral addiction, executive rehab programs are the answer. By combining great substance addiction and behavior treatments with the flexibility of computer and cell phone access, an executive or CEO can get healthy in a private and comfortable environment.
Many modern addiction treatment centers offer the luxury amenities you'd expect to find in the nation's finest hotels, with your success and comfort being the top priorities. From private rooms and 5-star chef-prepared meals to fine linens and gym facilities, you can get the best substance and behavior addiction treatment for yourself or your loved one while relaxing in style.
What Happens During Treatment?
Private rehab facilities take several steps to help you achieve your goal of ending your addiction to opiates.
Intake: Before you begin your opiate treatment program, you meet with the staff to assess what type of care you need.
Detoxification from opiates: Detoxification is the process of eliminating opiates from your system.
Addiction therapy: Once the opiates have left your system, you start therapy to help you end your addiction. This will likely include group and individual therapy.
Specialized care: If your addiction to opiates stems from another medical condition, your treatment staff will assist you in getting the medical help you need, along with any other specialized care you may need.
Extended care and aftercare: Once your opiate treatment program is completed, your recovery journey is not over. You will need the support and structure provided by various aftercare outlets as you reintegrate into your life. Aftercare may include attending group meetings, such as Narcotics Anonymous, or individual counseling.
How Much Will It Cost?
One of the biggest concerns when you're considering a private rehab facility is paying for treatment. Some private rehab facilities take health insurance, while others require private payment. Don't let treatment costs keep you from investigating your options. Many facilities will work with you and your family to finance your care costs.
For instance, some rehabs offer sliding scale options, in which the treatment cost is reduced to what you can reasonably afford to pay based on your income and financial situation. Others offer the opportunity to create a payment plan in which you pay off your treatment bill in affordable installments. Some opiate addiction treatment centers provide scholarships or grants for people who need formal substance abuse treatment but can't finance a program themselves.
Other people may resort to crowdfunding on sites, such as GoFundMe and IndieGoGo, in order to raise the funds they need from family members, friends, and caring anonymous individuals. These sites provide you with the opportunity to share your story of opiate abuse and addiction and express your earnest desire to get clean and sober.
Other options include purchasing health insurance from the healthcare marketplace, opening a healthcare credit card, or taking out a loan.
Where to Get Help
There may be treatment programs near you, but it may be better to relocate for treatment. Relocating or traveling may assist you in achieving a fresh start, without the distractions of friends or family. Staying near home may allow you to see your loved ones more frequently, which may be helpful if they support your treatment.
Once you've completed your treatment at a rehab facility, you'll need community support. It's critical to find group support, such as local NA meetings, and to continue any other treatment recommended by your care providers, which may include individual counseling, group therapy, sober living homes, alumni programs, or vocational training. If you're interested in attending a support group but would prefer an alternative to the 12-step approach, there are non-12-step programs, such as SMART Recovery and Secular Organizations for Sobriety, which utilize evidence-based approaches for addiction and mental health treatment. They focus on empowerment and self-reliance.
Learning About Options
Opiate rehabilitation can be complex, and there are many aspects of treatment to investigate further. Interventions, for example, are a means of getting an addicted loved one to accept treatment. Assessment, intake, detox and opiate withdrawal are all steps along the path to wellness. Understanding the differences between residential treatment and outpatient treatment is critical to making an informed decision.
Never Too Late
Opiate addiction is treatable. No matter how discouraged you or your loved one may be, you can turn your addiction around with help.
1. National Institute on Drug Abuse. (2018). Opioid Overdose Crisis.
2. National Institute on Drug Abuse. (n.d.). Heroin.
3. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment, Treatment Improvement Protocol (TIP), 45.
4. National Institute on Drug Abuse. (2018). Treatment Approaches for Drug Addiction.
5. National Institute on Drug Abuse. (2018). Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids.)
6. National Institute on Drug Abuse. (2018). How long does drug addiction treatment usually last?