simple>
Feeling sad or depressedNausea or vomitingMuscle achesWatery eyes or runny noseDilated pupils, goose bumps, or sweatingDiarrheaYawningFeverInsomnia (not being able to sleep)
How is opioid use disorder treated? " � Treatment involves 3 key pieces: medicines, counseling, and support groups. � �
- Medicines " � The medicines used to treat opioid addiction reduce drug cravings and can also keep you from getting high if you do use drugs (table 1). Medicines play a big part in helping people overcome addiction. When used the right way, they are safe and effective, and they do not get you high. Some people prefer to go to counseling and support groups but not take medicines. Those people are more likely than people who take medicines to start using drugs again.
- Addiction counseling " � People with addiction work with a counselor to better understand their addiction. They learn new ways to lead their life that do not involve drugs.
- Support groups " � In support groups, people with addiction share their experiences with each other. The most common of these groups is Narcotics Anonymous (also called NA). Some people like but others dislike the role of God or a "higher power " � in NA. There are other groups that do not have that as a focus.
When you are first getting off opioids, you might need to be treated in a hospital. While there, doctors can give you medicines to help prevent withdrawal symptoms. This makes getting off drugs easier. Afterward, you can keep taking medicines to help you to stay off of drugs. � �
Some people cannot stop using drugs even with medicines, counseling, and support groups. People who have an especially hard time staying off drugs sometimes do well with a treatment called "contingency management. " � As part of this treatment, you get a reward for staying off drugs. The reward can be money or small prize, such as movie tickets. Often you must prove that you are drug-free by giving urine samples that are tested for drugs. � �
Other types of therapy can help for specific situations. An example is family therapy, which can be especially helpful for children or teens with addiction. � �
What do I need to look out for? " � People with opioid use disorder can have dangerous effects from using opioids, or even die, if they use too much or mix opioids with other drugs or alcohol. The risk of this is especially high in people who stop or cut back on opioid drugs, and then increase their use again. � �
What are signs of an opioid overdose? " � Signs of an opioid overdose are: � �
- Extreme sleepiness
- Slow breathing or no breathing at all
- Very small pupils (which are the black circles in the center of your eyes)
- Very slow heart beat
What can I do to prevent someone from dying of a drug overdose? " � If you think someone is having a drug overdose, call an ambulance (in the US and Canada, dial 9-1-1). � �
People who overdose on opioids are treated with a medicine called naloxone. This medicine is given as a shot. It works by blocking the effects of opioids, and it can prevent death from an overdose. People without medical training can safely give naloxone to a person who overdosed while they wait for emergency help to arrive. � �
If you or someone in your house uses opioids or is trying to stop using them, you might want to keep naloxone at home. Naloxone is now available in the US and some other countries as a device (brand name: Evzio) that makes it possible for anyone to give the shot. Ask your doctor about getting a prescription for naloxone. Methadone treatment centers might also be able to provide it. � �
Be prepared to deal with an overdose. Know what the signs are. If you do get naloxone to use at home, read the instructions ahead of time and always know where it's kept. � �
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 95131 Version 3.0 � �
Release: 22.8 - C22.206 � �
� � 2014 UpToDate, Inc. All rights reserved. � �
� �
table 1Medicines to treat opioid use disorderView Largetable 1Medicines to treat opioid use disorder
Medicine name
How used
How it works
Comments
Buprenorphine and naloxone
(brand names: Suboxone, Zubsolv)
Suboxone: Film that melts under your tongue (lime flavor)
Zubsolv: Tablet that melts under your tongue (menthol flavor)
This medicine eases drug cravings and helps prevent withdrawal symptoms. It also blocks the effects of opioids, so you cannot get high even if you use drugs.
May cause burning or tingling under tongue.
Contains naloxone, which prevents misuse of the drug.
Methadone
(brand names: Dolophine, Methadose)
Tablet or liquid that you swallow
Dissolving tablet is added to fruit juice or water before swallowing
This medicine eases drug cravings and helps prevent withdrawal symptoms. It also makes it less likely that you can get high.
People taking methadone must go to a clinic every day or every few days to get their medicine. This medicine comes in different strength pills and liquids. Taking too much can be dangerous. Make sure you know what the medicine looks like and what dose you are supposed to take.
Naltrexone
(brand names: ReVia, Vivitrol)
Pill that you swallow or shot that you get each month
This medicine blocks the effects of opioids, so you cannot get high even if you use drugs.
It helps people who have completely stopped using drugs to stay off of them.
Naltrexone can also help reduce cravings for alcohol. It should not be started until the person has been free of opioids for a while.
Methadone and buprenorphine are strong medicines that can cause harm or even kill. If your doctor prescribes one of these medicines for you, never take more than the prescribed dose. Do not share your medicines and do not take medicines not prescribed to you. Keep these medicines away from children and pets. If you or someone else begins breathing slowly or cannot be woken-up easily after taking these medicines, it could be a sign of a dangerous reaction. Get emergency medical help right away. Carefully read the patient guide that comes with each of these medicines.
Graphic 95109 Version 2.0
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