OPIODS Treatment Options Summary

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OPIODS TREATMENT OPTIONS 1

OPIODS Treatment Options

Summary

There are many treatment options (inpatient, outpatient, andaftercare) available for opioid addiction. These options markedlydecrease cravings and withdrawal symptoms and prevent relapse. Themost effective treatments for this dependence involve detoxificationby administering detox medications such as methadone andbuprenorphine. Both can be used during inpatient and outpatienttreatment under the supervision of a physician. It is imperative tomaintain the right dosage of these medications since an overdose canbe lethal and under-dose may not be effective. These drugs areadministered to eliminate the toxic substances present in opioid. Theonly difference between inpatient and outpatient treatment options isthat the former involves an admission of a patient to a rehab centerto be placed under the supervision and treatment of a physician andin a safe and restricted environment. This environment hinders accessto drugs during treatment. The latter option involves visitingtreatment facilities, receiving medication, and going back home. Itdoes not require admission to a rehab center. Inpatient option costsare higher than outpatient costs due to the availability of moreservices. Patients who have undergone either of these treatmentoptions can undergo aftercare treatment, which involves enrollment totwelve-step programs to smoothen the transition to normal life andget additional support. Aftercare treatment also includespsychotherapies and staying in residences, which forbid drugs oralcohol and offer a safe place to stay during early recovery. One ofthe organizations that help drug addicts to recover is BrandywineCounseling &amp Community Service. This is a non-profitorganization, which offers holistic care to individuals living withmental health, drug addiction, and challenges related to HIV. Itempowers its clients to prevent and minimize their risks for drugaddiction, mental health issue, HCV, and HIV by providing resourcesand information needed to recognize and treat their symptoms [ CITATION BCC17 l 1033 ].

Treatment

Medical Detoxification is the major treatment given for opioid. It isa medically supervised and controlled withdrawal from drugs thatcause addiction under a physician’s care. Since abusing drugs oralcohol can result in physical dependence with time, stopping drug oralcohol use leads to withdrawal symptoms in persons with thisdependence. The process of detoxification is intended to treat thebodily impact of withdrawal and to eliminate toxins in the bodyresulting from the chemicals found in alcohol or drugs. The mostcommon detoxification drugs include methadone and buprenorphine andcan be used for both inpatient and outpatient treatment [ CITATION Kle12 l 1033 ].

Methadone is long-acting and orally efficient and safe therefore,results in smoother withdrawal. The initial dose is usually less than35 mg, e.g. 10 or 20 mg. More should be given only if the symptomsare not cured within an hour. The overall 24-hour dose should neversurpass 40 mg within the first few days. In case a patient isnontolerant, an initial dose may be dangerous if continued for morethan two days due to increasing levels of methadone in the blood. Itis imperative for clinicians to be alert for signs of motorimpairment or drowsiness. It is possible to ascertain physicaldependence by precipitating withdrawal through naloxone, waiting tillthe patient develops signs of withdrawal. Once the patient’scondition has become stable, the dose is slowly decreased by eitherreducing the drug by 5 mg every day till zero dosage or reducingdosage by 10 mg daily till it reaches 10 mg then by 2 mg daily(Kleber, 2012).

Buprenorphine is effective, long-acting, and safe by the sublingualpath however, it is likely to precipitate withdrawal signs ifadministered rapidly after an opioid agonist. Assuming the patienthas withdrawal signs and has waited for a minimum of twelve hoursafter short-acting opioid and thirty-six hours after takingmethadone, buprenorphine is usually useful to ease these symptoms andhas low chances of precipitating withdrawal. This medication is alsohelpful in emergency section settings. Detoxification of heroine isusually managed through administering buprenorphine two to fourmilligrams sublingually after a mild-to-moderate withdrawal hasemerged. Another dosage of buprenorphine two to four milligrams canbe administered about one to two hours later according to the comfortlevel of the patient. The recommended overall dosage of buprenorphineor the first day is eight to twelve milligrams. For many patients, agradual taper over one week is considered safe as well as welltolerated approach [ CITATION CRC15 l 1033 ].

Inpatient treatment

Inpatient treatment for opioid involves admission to a rehab centerand is mainly designed for individuals with severe opioid addictions.Most of the rehab programs take thirty days, sixty days, or ninetydays however, they can be customized according to the needs of apatient or life situation. At the centers, a patient is examined forany co-occurring psychological health disorders. The patient alsogoes through a systematically supervised detoxification period, whichinvolves administering detoxification drugs such as methadone andbuprenorphine. After detoxification, treatment continues inrestricted, safe environment, which serves to hinder access toopioids during treatment. This environment also lowers the number ofstressors that the patients in recovery are likely to face. Mentalhealth experts normally devise individualized treatments for thepatients and give the individuals in the process of recovery anopportunity to withdraw from opioid addiction away from an unstableor stressful home environment, which can trigger relapse easily(Kleber, 2012).

The cost of inpatient opioid treatment is usually between $2,000 and$25,000 for a thirty-day rehab program. Inpatient treatments are moreexpensive than outpatient treatments because the availability oftreatment facilities like rehab centers is usually limited (there arefew beds in a given treatment facility). Besides, the vast extent ofinvolvement, which the staff of the treatment facility has with apatient, different amenities available to patients, and the fact thatsupervision and treatment are given on a twenty-four-hour basis makethe inpatient program relatively more expensive (Recovery.Org, 2013).

Outpatient treatment

Outpatient treatment is designed for patients who don’t needtwenty-four-hour care. Outpatient facilities offer ‘step-down’care level, which gives the patients a flexible alternative to day orresidential treatment. The caregivers carry out an individualizedexamination and multidisciplinary treatment according to thetwelve-step philosophy. The patients can also get recommendations forcommunity services as well as ongoing support. Depending on theirneeds, they can receive treatment up to three hours every day, threedays every week while continuing with their normal day-to-day life athome. The cost of outpatient treatment can vary from free to about$10,000 (Recovery.Org, 2013).

Aftercare treatment

After a patient has exited the rehab program, they may receivespecial group counseling, enroll in a twelve-step program likeNarcotics Anonymous, or receive individual therapy. A system ofsupport regularly offers aftercare treatment to help avert relapseand encourage recovery. Even though it is normal to feel some senseof shockwave after leaving a rehab program, patients are usuallyencouraged to continue being confident in their ability to recover.Continual psychotherapy and enrolling for a twelve-step program isuseful to smoothen the transition to normal life and get additionalsupport. It is also imperative for these patients to considersober-living homes, more so if their living conditions are dangerousor unstable. A sober-living home refers to a residence, whichprohibits drugs or alcohol and limits the number of visitors allowedwhile offering a safe place to stay during early recovery (CRCHealth, 2015).

References

BCCS. (2017, March 26). About BCCS. Retrieved from Brandywine Counseling &amp Community Services: http://www.brandywinecounseling.org/

CRC Health. (2015, March 25). Opiate Detox Treatment Centers. Retrieved from CRC Health: http://www.crchealth.com/find-a-treatment-center/opiate-detox/

Kleber, H. D. (2012). Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience, 455–470.

Recovery.Org. (2013, June 14). How to Find the Best Residential Opioid Recovery Center . Retrieved from Recovery.Org: http://www.recovery.org/topics/find-the-best-residential-opioid-recovery-center/