Opiate Addiction and Recovery Management

Those who become addicted to opiates through prescribed medication for a legitimate medical condition like pain relief have a hard time accepting they have the same opiate addiction as someone who became addicted after using opiates they bought from a dealer to get high. There’s a difference in the original motivation to use opiates, but there’s no difference in the subsequent addiction to opiates. This resistance to be seen as an “opiate addict” is understandable given that there’s still a stigma attached to drug addiction. In treatment we remove the stigma and teach clients that addiction is a medical condition regardless how one becomes addicted. Opiate addiction and recovery management are basically the same for all who become addicted.

The differences are covered in the treatment plan. Each client in treatment has to deal with their individual emotional, social and psychological difficulties. The problems with which they present might have been caused by their addiction or they might have preceded their addiction. It’s a mistake, however, for a client to think that if they deal with their emotional problems they’ll be “cured” and won’t have to develop a long term recovery management plan. Those who come to treatment because they became addicted to prescribed opiates often think that if they’re detoxed, get it out of their system, then there’s nothing else to do except be more careful.

There’s not enough space in a blog post to go into the difference between physical dependence on a drug and drug addiction, but suffice it to say that addiction adds to physical dependence the element of mental obsession. Addiction alters the brain and, in a sense, rewires the brain in the region that has to do with pleasure-reward. Most people who use opiates/opioids for pain relief don’t become addicted, even if their body adapts to the medicine and they develop a physical dependence — they don’t crave the drugs when the pain is relieved, and they don’t usually take more than is needed to deal with pain. They might experience some withdrawal symptoms when they quit, but they don’t crave the opiates after there’s no good medical reason to use the medication. (read the link) 

When a person is addicted, though. it takes a long time for an opiate addict to get past the mental obsession that is a huge part of addiction. When the brain is wired to crave a drug as if it were a necessity, that obsession doesn’t leave immediately. There are social, environmental, emotional and psychological triggers that set off this craving, and until recovery is solid the recovering addict is in danger of relapse. The addict is in danger of relapse even after years of abstinence, although if the person is working a recovery management program the danger becomes less and less.

It’s only when a recovering addict stops doing anything to manage their susceptibility to active addiction that the person sets up almost certain relapse. It’s easy to forget what addiction was like if you go about your life as if it never happened. Over time the mind can play tricks and the addict tells herself that it’ll be different now that she knows what can happen if she uses opiates too often — the addict will experiment with a tablet here and there – when nothing terrible happens the person thinks it’s under control. What happens after that is active addiction returns and the mental obsession coupled with physical dependence once again controls the person and leads to bad consequences.

It’s not as important what motivates a person to start using opiates as it is that a person accepts their addiction and realizes that a recovery management program is necessary to avoid returning to addiction.