All posts in Opiate Addiction

Opioid Addiction Treatment Requires a Team Approach

No opioid addiction treatment plan succeeds alone. It is always a team effort.

The opioid addict cannot be trusted to do it on their own. It will fail. A team approach must be developed and coordinated.

Once a client with opioid addiction has been assessed, a treatment plan is developed. The clinician will then discuss with the client the recommended opioid addiction treatment plan. Every treatment plan is customized for that client.

Research has shown that opioid treatment plans succeed when there is a “team approach.” *** Treatment goals and schedules are discussed, medications are explained and a counseling plan is coordinated.

The client has several basic responsibilities:

  1. Keep all appointments.
  2. Take the prescribed medications.
  3. Use only the drugs prescribed.
  4. Agree to drug testing on a regular basis.
  5. Allow trusted family, friends, and colleagues to be involved as part of an accountability team.
  6. Stay away from all persons who may cause the patient to return to drug addiction.

Once the client has agreed to their opioid treatment responsibilities, the case manager then recruits a team around them. An opioid addiction treatment team may include the following:

  1. Narcotics Anonymous sponsor: Their treatment plan may compel them to join NA. A sponsor may take them to the homegroup meeting. The client who attends on a regular basis establishes a recovery network and a reliable routine. They participate in the group’s business and decide how the group’s meetings should be conducted.
  2. Drug counseling: This is crucial for the client to understand the nature of their addiction, recognize the stimulus that is part of their addictive behavior, and create coping mechanisms to resist addiction. The treatment plan may have both group therapy and individual therapy.
  3. Family, friends, and colleagues support system: The client’s motivation to succeed in opioid drug addiction therapy often comes from outside of themselves. Family members and trusted friends may function as “partners” in their therapy. They can motivate the client to attend meetings, channel their addiction into positive activity, and confirm that the client is adhering to the treatment plan. They may also provide a “wall” against outside negative forces (i.e. drug dealers, drug-addicted friends, bad influencers, etc.).

Opioid addiction treatment will succeed when there is coordination among the physicians, counselors, 12-step program leaders, family, friends, and colleagues working together as a team. The client has a dependable and trustworthy group that cares about them and is willing to be with them at every step of the recovery journey.

If you or someone you know needs methadone treatment, consult one of our experienced counselors. The Concerted Care Group of Central Baltimore, MD, and Brooklyn, MD, has a compassionate methadone maintenance treatment team that 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.

*** Team approaches to drug addiction can be found at the National Center for Biotechnology website.

Substance Abuse Treatment: Opioid Addiction and COVID-19

The COVID-19 pandemic has wreaked havoc on opioid users as overdoses in the United States have increased by 18% since quarantine orders were issued in March. *** Depression, lockdowns, anxiety, unemployment, deaths, and erratic news stories have all been factors in the spike of these numbers.

So, now that we have experienced this pandemic, once it’s over will the COVID vaccinations work? Most opioid addiction treatments (OUD-Opioid Use Disorder) include methadone and Suboxone for long term management of what is known to be a chronic disease. 

More than forty states have reported a steep increase in opioid-related deaths. Mental health issues have been heaped on drug users as they turn to illegal drugs to cope with the pandemic. The federal government is providing assistance for treatment options but states are responsible for providing and monitoring treatments to people to avoid leaving their homes, to avoid congregating in clinics, because of fears of COVID, and due to mandates to reduce exposure risk. Maryland, where Concerted Care Group is based, had a slight increase in deaths from drug and alcohol intoxication during the first quarter of 2020 as the lockdown was getting underway.

Opioids, however, caused almost 90% of the fatalities in Maryland during the first half of 2020. The synthetic opioid fentanyl killed 1,100, or 83% of “overall cases”, a 12% uptick from 2019.

What are we to make of these statistics? How can we possibly reduce opioid-related fatalities during a pandemic? 

There are ways we can help friends and loved ones who are struggling during this time. Here are five ways you help:

  1. If you notice someone you work with or employ is continually renewing an opioid prescription for lower back pain – please work together with employers, friends, and health insurance consultants to ensure we plan and design programs to meet employees’ underlying health conditions. They should also be assigned a treatment counselor to follow the course of their care.
  2. Employees should not flush their unused prescriptions or throw them away as this is a hazard, both environmentally, and to those who may come in contact with controlled substances inadvertently. Instead, distribute drug deactivation and disposal pouches for scientifically proven, safe, at-home drug disposal.
  3. Employee education programs that explain opioid addiction, treatment, and safe drug storage and disposal should be implemented. 
  4. Make individuals who are prescribed controlled substances accountable by visiting them at least weekly to make sure they are not relapsing into addiction. If they are not a member of Narcotics Anonymous, they need to get a sponsor and join as soon as possible. Ask a physician for a referral to a medical professional in addiction medicine. Then, take the patient in for treatment yourself. Asking them to go on their own may be too great a step to do.
  5. Be encouraging.  Let your friend or loved one know that opioid addiction can be managed successfully, even during a pandemic. Don’t be confrontational. Be compassionate and strong. Insist that they get help and that you and others will be with them from the consultation with the physician to the treatment. Studies have shown that support goes a long way.

The COVID-19 pandemic has a complicated life and opioid addicts have paid the price. Many of them have hit new lows and have suffered. But, even in these times, there is help and recovery. Substance abuse is a treatable disease and recovery is possible.

The Concerted Care Group of Central Baltimore, MD, and Brooklyn, MD, has a compassionate Behavioral Health team that includes therapists, psychiatric care, and nurse practitioners. 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 how the COVID pandemic has affected Opioid users, click here. 

Opioid Addiction: Why Do Users Have Cravings?

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 opioid 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.  

Opioid Addiction Treatment: Methadone vs. Buprenorphine

Opioid addiction is increasing as millions of American citizens are using it to alleviate pain. According to US drug overdose statistics

The death rate from drug overdoses more than tripled between 1999 and 2017, and that death rate from opioid overdoses increased almost six-fold during the same period. More people in the United States died from overdoses involving opioids in 2017 than from HIV- or AIDS-related illnesses at the peak of the AIDS epidemic.

As a result, new treatments for treating opioid addiction have been developed to help opioid addicts. Two of the most common drugs used are Methadone and Buprenorphine. There are two separate camps that believe that one is better than the other. We will examine both.

Methadone Treatment 

One of the main goals in treating opioid addiction is reducing the craving for it. Methadone is a proven and effective synthetic opioid that reduces the craving. It has a long history of effectiveness as it was developed by German physicians during World War II and later used by US physicians to treat extreme pain. (Addiction was accurately portrayed by Frank Sinatra in the film, “The Man with the Golden Arm”. It is heralded as educating the public on the dangers of heroin.) 

Methadone can be distributed as a liquid, powder, or tablet. It requires a prescription and must be monitored closely by a doctor. Methadone changes the way the brain and nervous system respond to pain. For pain, physicians typically prescribe methadone following surgery or in treatment from an injury or a chronic illness. 

Additionally, methadone treatment is helpful in eliminating addiction to other opioids. Known as “replacement therapy”, this treatment replaces the opioids in your system with somewhat milder effects. Relief comes slowly as it blocks the high that comes from drugs like oxycodone, hydrocodone, morphine, heroin, and codeine.  

Methadone treatment is most effective when supplemented with individual or group counseling. Opioid addicts are referred to drug counselors, social services, or medical personnel trained in opioid addiction counseling. Many companies offer these services under their medical benefits packages.   

Buprenorphine Treatment

Buprenorphine is an opioid medication that is also used to treat opioid addiction. It is dispensed in a physician’s office. It can also be taken at home as a prescription. 

Buprenorphine is known as “partial opioid antagonist,” meaning it may decrease physical dependence on opioids. Buprenorphine’s potential for misuse is lower than that of full opioids, and it also can reduce the craving for them. 

Buprenorphine is still an opioid, however, so its side effects can be problematic. It is known to cause euphoria and respiratory depression in some patients. In low doses, buprenorphine can produce a basic agonist effect to reduce cravings and withdrawal symptoms. It can, however, reach a “ceiling effect” when increasing doses of the drug begin to reach a plateau. At this point, buprenorphine may no longer be effective for the individual. 

 Conclusion

Both methadone and buprenorphine have been proven to be effective treatment options for opioid addiction. Methadone, however, may be the most effective for long-term treatment. 

If you or a loved one are battling opioid addiction, consult a physician immediately. They can recommend licensed drug addiction treatment centers suited to your needs. Opioid addiction cannot be treated alone. A team of medical personnel and addiction specialists are needed to help the addicted individual overcome this painful situation.

Concerted Care of Central Baltimore and Brooklyn, MD, Methadone Maintenance Treatment (MMT) utilizes methadone as one element in a comprehensive treatment program in which methadone replaces opiate drugs, including heroin and oxycodone. Call (833) 224-5483 or email info@concertedcaregroup.com for an immediate consultation.

Methadone Treatment: 5 Things to Know

Opioids are in the news.

From the news conferences to talk shows to television dramas, opioids and the people affected by them are getting a lot of exposure. Methadone abuse is costing lives and money. It’s taking a toll on American society. It cannot be ignored anymore.

Read more

Substance Abuse: What is “Whole Person, Whole Life Treatment”?

There are many ways to treat substance abuse.

In fact, there are probably as many different treatments as there are substances. Some substance abuse treatments are successful and have stood the test of time. Many others are trendy and controversial and have not withstood research and testing.

And while the success of any substance abuse treatment truly depends on the patient receiving it, the elements of the treatment and the treatment center doing it are also crucial. It is, ultimately, a team effort.

Read more

Interview: Alfreda Patterson, Substance Abuse Counselor

Ms. Alfreda Patterson is a Substance Abuse Counselor at the Concerted Care Group in Baltimore, Maryland.

She began working at CCG in 2015. Her personal experiences and deep desires to assist people motivated her to become a counselor. Especially, people who have substance abuse disorders.

Read more

Inside Baltimore City

Today the US Department of Health and Human Services (HHS) will take a step in a positive direction to combat the nation’s opioid epidemic. The HHS will announce a regulation to permit doctors to treat more patients with buprenorphine. The medication, which has been approved by the FDA for nearly 15 years, is the only drug whose prescription by a physician is limited by congress. The Baltimore City Health Commissioner, Dr. Leana Wen, applauded the HHS stating: “I commend HHS for making a decision based on science, not stigma.” Dr Wen explains, “When prescribed properly, medication does not create a new addiction, but rather manages a patient’s disease so that they can successfully achieve recovery.”

Read more