Addictions to anything-drugs, alcohol, sex, gambling-are quite serious. Every addiction has its own craving.
When it comes to opioid users, their cravings are massive and control their lives. In order to understand what opioid users go through, we must first define a “craving.”
According to Frontiers in Psychiatry, a craving:
“ is an overwhelmingly strong desire or need to use a drug, is a central component of OUD and other substance use disorders.”
Opioid Use Disorder (OUD) is sweeping the country. Whether the opioid is used for treatment or as an illicit drug, the craving for it is overpowering. The opioid user has a focused compulsion to use the drug as the euphoria and emotional response that it gives is motivational to continue the addiction. This craving is long-lasting and cannot be filled unless the opioid is used. (Craving is included in the definition of opioid dependence in the International Classification of Diseases, Eleventh Revision.)
Addiction is, however, a chronic relapse based on the brain. There are many theories as to why someone would risk their health, reputation, occupation, and family to use opioids. One theory, known as “Opponent Theory,” proposes that the opioid user’s euphoria masks the pleasant or unpleasant sensations. Thus, they have the moment of enjoyment then come down, only to feel bad later. A short time later, the craving hits again, and the opioid addict returns to the drug.
Does this really explain the intense cravings experienced by opioid users? Do cravings ever go away?
Even in recovery, cravings may not disappear completely. But to say they “never go away” is both inaccurate and discouraging. An opioid user need not believe cravings will dominate their life forever.
Coping techniques, medications, and other forms of ongoing treatment can be of great help to the person in recovery. Recovery may follow them through life, but they also should know that cravings may fade with time.
What is needed to help break the addiction is the commitment of the opioid user in recovery to remain in treatment and learn coping mechanisms. As recovery moves into six months and beyond, cravings are less powerful. Opioid users even begin to master the craving control techniques they have learned in recovery.
Sobriety is the goal, and that comes with complete abstinence to the drug. Typically, this comes after six weeks in rehabilitation. There is no clear “rehabilitated” moment for every user. It is different for everyone.
It’s realistic, even after years of being sober, that former opioid users will have cravings from time to time. They may even be tempted to visit the places where they purchased the drug and used it. This is very normal and is reported by many former opioid users long after recovery and rehab.
However, these cravings are less of a desire to do the drug again and more of an annoyance. The psychological triggers to use opioids have passed, and now they can use the coping mechanisms they learned in treatment.
The bottom line is this: Opioid cravings are not something that “enslave” a person all their lives. Treatment, medications, behavioral therapy, and a healthy support system of family and friends can help a person overcome and even end opioid use for a lifetime.
If you have cravings for opioids, consult an expert. The Concerted Care Group of Central Baltimore, MD, and Brooklyn, MD, has a compassionate Behavioral Health team which includes therapists, a psychiatric nurse practitioner, a nurse practitioner, and a psychiatrist. Services include individual and family therapy for adults and adolescents. Group therapy and psychiatric services are available for adults.
Contact us at (833) CCG-LIVE to make an appointment.
For more information on opioid cravings, see this link.