Opioid Pain Medications

Prescription opioids work in two ways:

1. By lowering the number of pain signals your body sends to your brain
2. By changing how your brain responds to pain. Some may also produce feelings of pleasure or a “high”.

Opioid use disorder means several things:

• Either you are not taking the medications the way your doctor prescribed
• You are using them to get high
• Or you are taking someone else's opioids

When you become addicted to opioids you keep taking these drugs even when they cause you harm.

Opioid pain medicines include Vicodin, codeine, Percocet, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, paregoric, sufentanil, and tramadol. Codeine is often found in prescription cough syrup as well.

If you are living with chronic long-lasting pain, many other treatments are available. These include safer medications and non-drug therapies such as acupuncture, chiropractic, mindfulness meditation, massage, guided imagery, physical therapy, gentle exercise such as swimming and tai chi, and walks in nature. Even eating a healthy diet and taking certain supplements can improve your brain chemistry and reduce the experience of pain.

WHY ARE OPIOIDS ADDICTIVE?

Opioid drugs change your brain by creating artificial endorphins (the natural “feel good” brain chemicals that can decrease pain and increase pleasure). Too much opioid use can cause your brain to rely on these artificial endorphins and over time the brain can even stop making natural endorphins on its own.

Drug tolerance: When your body gets used to the effects of opioids you need a higher dose to get the same pain relief. So as you develop drug tolerance, you will need to take more opioids.

Drug dependence: When you have taken a drug for a long time it changes the way your body works. These changes cause withdrawal symptoms when you stop using the drug.

Addiction: Drug tolerance and dependence are a normal part of taking any opioid drug for a long time. You can be tolerant to, or dependent on, a drug and not be addicted to it. Addiction, however, is a disorder. When you are addicted to a drug your body and your mind need the drug to function in the world. Addiction causes you to compulsively seek out and use the drug, even when it harms your health and causes problems in your life.

Thinking about the major signs of addiction to opioid medications may help you look at your own use of pain medicines. Signs include:

• Craving the drug
• Not being able to control the urge to take it
• Continuing to use it without your doctor’s consent
• Using it in a different way than prescribed
• Taking it for the way it makes you feel, not just for pain relief

These screening tools can help you look at your drug use to see if it is harming your health and your life. You can take them in your own home or wherever you feel comfortable. The results are private and you get immediate online feedback on your drug use.

There are many stages in the recovery process. The first steps are accepting that you have an addiction that you can’t manage and it is harming your health and your life. When you are ready and willing to change it is time to plan your recovery.

Learning about different recovery choices can help you see a path ahead and get the support you need. There are many tools to help you each step of the way.

Treatment for opioid use disorder generally includes:

• Counseling and behavioral therapies such as cognitive-behavioral therapy (CBT). These can help you change patterns of thinking that are linked to addiction. You will learn coping skills to manage stress and cravings. CBT is often used in individual, family, or group counseling.
• Medication-Assisted Therapy (MAT) combines FDA-approved medications to treat opioid use disorders with counseling and behavioral therapies to help relieve withdrawal symptoms and cravings. This approach increases your chance of success, as it works on the physical, mental and emotional aspects of recovery.
• Residential or hospital-based treatment (both in-patient and out-patient). These structured programs may help you remain in treatment longer which increases your chances for success.

Our TREATMENT section has a broad range of recovery options to help you find the treatments that best meet your needs.

Also see our PROGRAMS & SUPPORT section for ongoing ways to support your recovery.

Medication-Assisted Treatment (MAT) includes more than medicines. Counseling, behavioral therapies and social support are very important parts of the treatment too.

The medications used work in different ways to help treat opioid addiction.

• Naltrexone prevents other opioids from affecting the brain
• Buprenorphine and methadone relieve withdrawal symptoms and craving
• Lofexidine reduces the physical symptoms of withdrawal and shortens withdrawal time

Some people worry that medications used in medication-assisted treatment (MAT) substitute one drug for another. But this is not true. When you are treated for an opioid addiction, the dosage of medication used does not get you high. It only helps reduce opioid cravings and withdrawal. This gives time for the brain circuits affected by addiction to rebalance, allowing them to heal during the recovery process.

MAT can increase your chance of success by working on many aspects of addiction - the physical, mental, emotional and spiritual. For example,

• Counseling is important because it helps you change old patterns of thinking and learn new ways to manage cravings and stress.

• Social support, such as a 12-step or other peer-support recovery group, helps you feel connected with others and share experiences of recovery

• Spiritual connection - through nature, meditation, religious studies, poetry or whatever you find helpful - nourishes your soul and gives you a larger view of life

To learn specific information on medications for opioid addiction see our Medications to Treat Addiction section on Heroin and Opioids.

To learn more about Lofexidine, click here.

Research shows that, for some people, using both counseling and treatment with medication is the most effective approach. Below are treatment locators that help you find providers that use these approaches.

12-step programs

Twelve-step programs are an important part of the recovery process. With addiction you can become isolated. The help of others is vital for healing.

These programs provide simple tools for living and guidelines on how to overcome addiction. They are based on a set of spiritual principles and the support of people who share their experiences of stopping drug use and staying drug free. People recovering from many types of addiction can join a 12-step program.

NON 12-STEP GROUP PROGRAMS

These self-help support groups give you tools to change the negative and defeating thoughts that are a big part of addiction. The focus is on finding strength and self-control within yourself. There are in-person meetings with peers, daily online meetings, chat rooms and message boards.

Faith-Based Programs

These programs approach recovery through various religious traditions including Christian, Jewish, Islamic and Buddhist.

A faith-based recovery program understands that addiction and substance use is not just a physical problem – it reflects the spiritual and emotional suffering of an individual. These recovery programs seek to restore each person’s well-being through guidance and spiritual support, and encourages them to transform their lives totally.

To learn more about the different religious-based programs see our PROGRAMS & SUPPORT section

APPs

Mobile apps are another tool that supports recovery. . They offer practical recovery support that is affordable, private and always available.

Apps can track sober time, help you manage triggers and emotions, find and share meetings, contact your sponsor discretely, keep you motivated, connect you with a recovery community, and more.

Many good apps are available for both the iPhone/iPad and Google Android phones. Of note, it is estimated that 7 out of 10 free apps use ads. This can be distracting and because ads use data they can cost you money in the long run. Many apps offer a premium version as an in-app purchase which has extra useful features and usually no ads. You can try out the free version of the app and upgrade to premium if it is helping you.

BUILD A SOBER NETWORK

Connect with people socially who are also working on their sobriety - for support, sharing and encouragement. Staying connected is a vital part of recovery so you don’t become isolated. Support helps you heal.

ONLINE MEETING AND CHAT ROOMS

A chat room lets you communicate in real time on the Internet. Everyone who is logged in sees what you are typing, but two people can still have a private chat on the side. People from any location can join in, making them an ideal format for groups of people.

Chat meetings are chat rooms with a chairperson who introduces topics for people to address. Chat meetings are scheduled in advance for a specific period of time.

NA and PA Online meetings usually use Zoom. The group sets them up, gets a meeting code and password and sends the information to all members of the group. Or the group sends the information to Central Office, who post the info online.

HOLISTIC APPROACHES

When you stop using prescription opioids you may experience withdrawal symptoms and feel anxious, sad, confused, and irritable. Your sleep and eating may be disturbed for a while. Holistic therapies can help you cope with these symptoms. They can also help you throughout the recovery process.

Holistic practices support you on many levels to allow deeper healing. They can help reduce your pain and build better health, inner calm and strength – so you can think more clearly and focus on what is best for you. You may also find it easier to connect with others, your deeper self or to something greater than yourself, however you define that.

For those in recovery, holistic approaches work best when they are part of professional treatment and they are often part of addiction recovery programs. Studies show that success rates improve strongly when holistic approaches are included in treatment.

• Practices like meditation, guided imagery, hypnotherapy, and tai chi help you reduce stress, feel calmer, and lessen withdrawal symptoms and cravings. They also help you manage chronic pain in ways that are healthier long-term.
• There is strong scientific evidence that acupuncture helps treat chronic pain.
• Yoga can help many mental and physical conditions including anxiety, depression, sleep problems, and pain.
• Chiropractic Spinal Manipulation is one of several options—including exercise, massage, and physical therapy—that can help relieve back pain, neck pain, headaches and pain from osteoarthritis and fibromyalgia. These and other holistic therapies can be used to manage pain and reduce opioid use.
• The National Institute of Health is funding research on treatments such as mindfulness meditation and cognitive behavioral therapy (a form of short-term therapy) that can help you stick with your treatment, improve your results, and reduce the chance of relapse. Giving people the skills to cope with pain long term is an important part of this program.

Part of a holistic approach also includes being in nature. Finding a safe, quiet and natural place can refresh the soul and provide the space to explore whatever form of spirituality moves you.

To learn more about specific holistic therapies and their place in recovery visit our Holistic Support section.

SOBER LIVING HOMES

Sober homes provide are designed as safe and supportive group living for people recovering from addiction. They are based on peer support, structure and learning new life skills in a setting that is free of alcohol or drugs. They serve as a transition between treatment and return to normal life.

Thousands of sober homes exist in the United States and there are many different types. At a minimum, they offer peer-to-peer recovery support while others have professional clinical services to promote long-term recovery. There are residences for specific populations such as language spoken, male or female, women with children, by age, co-occurring problems, medication status, and prison re-entry.

See our SOBER HOUSING section for help in finding sober living homes near you and throughout the U.S.