There are several different options to be considered for an individual who needs opioid addiction treatment. When choosing a facility and whether or not to attend detoxification treatment, patients are given many choices so that their opioid addiction treatment can best meet their needs during this difficult time.

Essentially, medication and behavioral therapy are the two main treatment types which can be used independently or together. According to the NIDA, “Although behavioral and pharmacologic treatments can be extremely useful when utilized alone, research shows that for some people, integrating both types of treatments is the most effective approach.”

Facility Options

Patients who are choosing to attend opioid addiction treatment have their first option in a facility type. This is a delicate step because, while some may think they need inpatient treatment, they may actually benefit more from outpatient treatment and vice-versa. Knowing the difference of the two facilities will help make your options more clear and allow you to make an informed decision about your opioid addiction treatment type.

• Inpatient treatment
  • 24-hour facility
  • Patient stays overnight
  • Controlled environment
  • Treatment is suggested to last at least 90 days or more for best effects
  • Usually more expensive
  • Medication and therapy offered as treatments
  • Patient is often given access to other treatment types which fluctuate from acupuncture and yoga classes to arts and crafts and financial assistance
  • Luxury and private facilities exist
  • Free and low-cost facilities exist
  • Better for patients with
    • High psychiatric severity
    • Severe addictions
    • Co-occurring mental disorders
    • No support system at home
• Outpatient treatment
  • Patient visits the facility (usually daily, at least at first)
  • Patient goes home at night
  • Treatment is suggested to last at least 90 days or more for best effects
  • Usually less expensive
  • Medication and therapy offered as treatments
  • Range in other treatments fluctuates from vocational counseling and legal help to drug education
  • Free and low-cost facilities exist
  • Better for patients with
    • No co-occurring mental disorders
    • Less severe addictions
    • The ability to juggle treatment and other responsibilities
    • A strong support system

Consider your needs (whether or not you need to be home at night, if you are able to receive treatment and balance your life, if you need treatment for a co-occurring mental disorder as well, etc.) and decide which treatment facility is right for you. This is an important choice to make when it comes to your opioid addiction treatment.

Medication Options

Most facilities provide pharmacological options to their patients for addiction recovery. When patients are dealing with the intense withdrawal symptoms, cravings, and other issues that come from opioid addiction, these can be very beneficial and help patients focus on the other side of their treatment: therapy. There are facilities which provide natural addiction treatment (without medication), but in most cases, some kind of medication option is recommended.

There are several medications which are used in the treatment of opioid addiction in either the long term or the short term. You and you doctor will likely choose the one that is best for you, and this may change over the course of your treatment.

These medications are:

• Methadone
  • According to the CDC, “Methadone is a synthetic agent that works by “occupying” the brain receptor sites affected by heroin and other opiates.”
  • It can be used for both short term addiction and detox treatment and long term maintenance, which many opioid addicts need. Methadone maintenance helps people stop abusing opioids while keeping them maintained on methadone for as long as necessary.
  • Methadone can be taken once a day, and the treatment regimen can be continued for a few weeks, years, or even indefinitely.
  • The use of methadone has shown significant decreases in illegal opioid abuse, crime, illness, overdose, and death as compared to those who do not use it.
  • Its drawbacks are that it can cause addiction itself if abused and that it is widely available through illegal channels.

• Buprenorphine
  • Buprenorphine is a partial opioid agonist and is sold as both Subutex and Suboxone, the latter of which contains naloxone as well.
  • This treatment is often used for those who are looking to detox and attend addiction treatment in order to stop abusing opioids. However, patients can be maintained on buprenorphine as well.
  • Suboxone’s inclusion of naloxone makes it easier to avoid abuse of the drug, as patients who crush it up and snort or inject it will experience withdrawal symptoms as a result.
  • Buprenorphine is relatively new, safe, and beneficial to many patients and, unlike methadone which a person needs to obtain from a treatment facility, it can be prescribed in a doctor’s office.
• Naltrexone
  • Naltrexone is a “long-acting opioid antagonist” and is better for the treatment of professional healthcare workers or other individuals who are very serious about ending their opioid addictions (Harvard Medical School).
  • Other patients find naltrexone difficult to use as it precipitates withdrawal symptoms in anyone who is currently dependent on opioids. For this reason, it is not very well tolerated by most individuals.
  • However, it also “blocks opiate receptors [and] neutralizes or reverses the effects of opiates.”

Therapy Options

Therapy is essential to most individuals’ treatment regimens for opioid addiction. While this is so, there are some options for different therapy treatments. Some patients may use more than one during their time in treatment, either at the same time or changing as they progress toward their recoveries.

These therapies are:

• Cognitive-behavioral therapy or CBT
  • Probably the most commonly used behavioral treatment for opioid abuse and addiction, CBT helps patients “learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse and to address a range of other problems that often co-occur with it” (NIDA).
• Contingency management or CM
  • In CM, patients are able to receive vouchers that reward them for staying abstinent from opioids.
• Group therapy
  • Group therapy is often used to allow patients a chance to meet as speak with other individuals who have experienced the same issues as a result of opioid addiction.

There are many options when it comes to opioid addiction treatment. Always remember that the course of your treatment may see changes in which treatment option is best for you, and your treatment program should reflect those changes over time.