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Understanding Opioid Addiction
Did you know?
Opioids are naturally occurring substances derived from the opium poppy and have been used for medical purposes for over 6,000 years. They are known for their ability to relieve pain and suffering and have other medicinal uses. However, opioids also deliver pleasure and relief from anxiety, leading to a long history of recreational use.
Pharmacology: Chemical Characteristics
Raw opium contains about 10% morphine by weight and a smaller amount of codeine. Heroin, which is derived from morphine, can pass through the blood-brain barrier faster due to added acetyl groups, making it more potent than morphine. Researchers have developed various prescription painkillers while trying to separate the pain-relieving effects of opioids from their dependence-producing effects.
Types of Opioids and Their Strengths
- Opium: Derived from the opium poppy plant and typically smoked.
- Codeine: A secondary active ingredient in opium, taken orally, and stronger than opium.
- Morphine: The primary active ingredient in opium, taken orally or injected, and 10 times stronger than codeine.
- Heroin: A potent derivative of morphine, smoked, snorted, or injected, and 3 times stronger than morphine.
- Prescription Opioids: These can be 3 to 100 times stronger than morphine.
Current Patterns of Abuse
- Heroin: About 0.2% of Americans report using heroin in the past year.
- Prescription Pain Relievers: Around 5% of Americans report nonmedical use of prescription pain relievers in the past year, with most taken orally. The most popular types are hydrocodone and OxyContin.
Prescription Narcotic Analgesics
- Natural Products: Morphine, Codeine.
- Semisynthetics: Heroin, Diamorph (unavailable in the U.S.).
- Synthetics: Methadone, Meperidine, Oxycodone, Oxymorphone, Hydrocodone, Hydromorphone, Dihydrocodeine, Propoxyphene, Pentazocine, Fentanyl.
Medical Uses of Opioids
- Pain Relief: Opioids reduce the emotional response to pain and diminish awareness of the pain.
- Treatment of Intestinal Disorders: They reduce colic and counteract diarrhea.
- Cough Suppressant: Positive effects follow drug use, and withdrawal symptoms are removed by continued use.
Misconceptions and Preconceptions
- Not all users experience euphoria from the initial dose.
- Tolerance to negative effects may develop more rapidly than tolerance to positive effects.
- Withdrawal is often like a mild to severe case of the intestinal flu.
- People usually don’t become dependent after one dose.
- Non-medical use of opioids is on the rise, with many switching to heroin because it is cheaper and easier to obtain.
- Fentanyl is the most potent and dangerous opioid on the market today.
The Symptoms of Opioid Addiction

Dependence Potential
- Tolerance: Higher doses are needed over time to achieve the same effects.
- Physical Dependence: Withdrawal symptoms appear after the last dose, but opioid withdrawal is rarely life-threatening.
- Psychological Dependence: Positive effects follow drug use, and withdrawal symptoms are removed by continued use.
Withdrawal Syndrome Symptoms
- Heroin or Morphine: Symptoms start 6 hours after the last dose, including craving, anxiety, yawning, perspiration, and more severe symptoms like nausea and vomiting after 36-48 hours.
- Methadone: Symptoms start 24 hours after the last dose and are less severe than those from heroin.
Toxicity Potential
- Acute Toxicity: Opioids depress respiratory centers in the brain, leading to slower and shallower breathing. Overdose can cause coma, depressed respiration, and pinpoint pupils, which can be counteracted with naloxone.
- Chronic Toxicity: Associated with injection use, leading to infections and the spread of blood-borne diseases like HIV and Hepatitis C.
What are the Risk Factors?
Depending on the type of opiate, the amount used, frequency, strength and half-life of that drug, along with the route of ingestion, this all affect the drugs safety and subsequent withdrawal effects upon cessation of that drug use.
Prescription, opiates, Fentanyl and Heroin are the most abused. Fentanyl is exceptionally dangerous, where a single use may be fatal. Heroin is frequently associated with needle use along with Hepatitis C and HIV / Aids. This occurs mostly from needle sharing and or unsafe sex.
Tolerance and addiction to the drug can occur quickly, repeated use results in decreased effect, leading folks to use more with potentially dangerous results. Various physiological effects occur including changes in body temperature and intestinal motility (contractions, constipation). Decreases in heart and respiration rate may occur, which could lead to an overdose and death.
Withdrawal is difficult. Leading to a long lasting ’intestinal flu’ combining nausea, vomiting with diarrhea, aches, pains and a general sense of misery. Rarely life threatening, but most unpleasant. In-patient detox or opioid replacement therapy is strongly suggested to manage withdrawal.
What is the Treatment?

There are several effective treatments for opiate dependence, often tailored to the individual’s needs. These treatments can be used individually or in combination, depending on the person’s needs.
Here are some common types of treatment:
Psychotherapy (Talk Therapy)
- Cognitive Behavioral Therapy (CBT): You have an automatic thought. That thought produces an emotion. As humans, our emotions can affect how we act. Once you recognize the thought and emotion associated with that thought, you usually have several choices to make, which can lead to consequences of your behavior. CBT aims to change the thought(s) to more productive and more helpful consequences.
- Dialectical Behavior Therapy (DBT): Combines CBT with mindfulness techniques and emotional regulation, often used for borderline personality disorder.
- Psychodynamic Therapy: Explores unconscious thoughts and emotions to understand and resolve psychological conflicts. This is a long-term therapy, typically working with the same psychodynamically trained therapist for several years or longer.
- Interpersonal Therapy (IPT): Focuses on improving interpersonal relationships and social functioning.
Medication Management

- Narcan (Naloxone): Narcan is an opioid antagonist that blocks the action of opioids, helping to prevent overdose. It can reverse depressed respiration from opioid overdose and precipitate withdrawal syndrome.
- Naltrexone (Vivitrol): This medication works by blocking the euphoric effects of alcohol, helping to reduce cravings and prevent relapse. It is available as a daily pill or a monthly injection.
- Buprenorphine: Available as a dissolving tablet, cheek film, or extended-release injection. It helps reduce cravings and withdrawal symptoms.
Lifestyle and Self-Care
- Exercise: Regular physical activity can improve mood and reduce symptoms of depression and anxiety.
- Healthy Diet: Proper nutrition can positively impact mental health.
- Sleep Hygiene: Good sleep practices can help improve overall mental well-being.
- Mindfulness and Meditation: Techniques to help reduce stress and promote mental clarity.
Support Groups
- Peer Support: Groups of individuals with similar experiences can provide mutual support and understanding. The National Alliance on Mental Illness (www.nami.org) is one of the leading organizations in the country that offers free peer support groups.
- 12-Step Programs: Structured support groups for addiction recovery, such as Narcotics Anonymous (NA).
Alternative and Complementary Therapies
- Psychodrama: an experiential group therapy that has people re-enact real-life situations through role-playing, storytelling, and dramatic self-presentation.
- Art and Music Therapy: Creative therapies to help express emotions and reduce stress.
- Equine Assisted Therapy: A process that uses horses to help people meet their physical, mental, emotional, and spiritual health goals. Teaches emotion regulation, self-confidence, and responsibility, while helping reduce symptoms of depression, anxiety, or trauma.
- Yoga and Tai Chi: Mind-body practices that promote relaxation and stress reduction.
Hospitalization and Intensive Treatment
Medical Detoxification:
Medical detoxification may be necessary. Desert Star coordinates with a number of Detox facilities and hospitals as deemed clinically necessary. If referred to medical detox their medical team will monitor you for medical stability and safety until you are medically cleared. Their discharge team will then coordinate with Desert Star for admission to the program. The team at Desert Star will coordinate throughout your detoxification process.
Partial Hospitalization Programs (PHP):
An intensive outpatient program that provides structured treatment for up to six hours during the day up to five days per week.
Intensive Outpatient Programs (IOP):
An intensive outpatient program that provides structured treatment for up to three hours during the day up to four days per week.
If you or a loved one is struggling with Opiate dependance please know that there is help available. At Desert Star Addiction Recovery Center, we’re here to support you. We offer personalized care to help you live a life in long term recovery. Our personalized treatment includes supportive and structured group therapy three to four times a week, individual therapy sessions, access to medication management and case management. No matter what you are feeling right now there is hope! With treatment you can learn the tools need to navigate your life in Long Term Recovery.
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Get the help you need without putting your outside commitments on hold! We individualize treatment for every client and can combine groups from different programs to suit your unique needs. We offer varying levels of structure and support, from partial hospitalization to intensive outpatient to once-weekly outpatient groups.