Why is it hard to stop?

Opioids are synthetic or natural drugs that have certain unique effects on the brain and body. Opioids relieve pain and give a people a sense of well-being or euphoria by changing the body and brain chemistry. The first change many people notice is tolerance, or the need for more of a drug to get the desired effect.

Over time, the need for the drug becomes a powerful motivator to keep using, even when there is a strong desire to stop. When people need the drug to function normally, they are no longer using to feel good, but rather to avoid withdrawal symptoms and to stop feeling sick.

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Opioids and Pain

Some people with an opioid use disorder are also dealing with chronic pain. When this is the case, it is important to get adequate treatment for both conditions from a specialist trained and experienced in addiction and pain.

Doctors should work with you on other ways to relieve pain before they prescribe an opioid medication. Talk with your doctor about whether cognitive behavioral therapy, physical therapy, or other treatments such as massage or chiropractic might help with your pain. If you and your doctor decide you need opioid drugs to manage your pain, then this may influence your choice of MAT options.

Naltrexone and Pain Medications

People taking naltrexone can use non-opioid medications for pain. However, naltrexone can prevent opioid pain medications from working. People who are physically dependent on opioids need to stop all opioid drugs for at least 7-10 days before taking naltrexone to avoid bringing on withdrawal. If you need to take opioid medication for medical reasons while you are being treated with naltrexone, your prescriber can help you:

  • Let medical providers know you take naltrexone.
  • Stop naltrexone before you start taking a prescribed opioid medication.
  • Wait at least 7 days after the last dose of opioid medication before starting naltrexone again.

Warning: There is a high risk of overdose if people start using again after a period of treatment with naltrexone. Their tolerance lowers while they are free of all opioids. If they go back to taking amounts they were taking before treatment, it can be fatal. There is a high risk of overdose when people try to “override” naltrexone’s blocking effect by taking larger doses of opioids.

Why do people start using?

People try opioids for many reasons. Sometimes, when doctors prescribe opioid medications for pain, for one reason or another, some people may start taking more than is prescribed. Others are curious about the opioid high. When given a chance to try it, often through a friend or acquaintance, they do.

But not everyone who experiments with opioids gets addicted. It is not clear why some people become addicted and others do not. Research shows that addiction has a strong hereditary component. Other factors can increase a person’s chance of becoming addicted. People are more likely to start taking drugs if they are easily available or if family members, friends, or neighbors are also experimenting with drugs. Nearly all people with serious drug and alcohol problems start to use in their teens or early twenties. People who begin using before age 18 have an increased risk of addiction.

Research also links addictions such as alcoholism or injection drug use with a history of physical, sexual, and emotional trauma or abuse, especially during childhood. About two-thirds of adults in public treatment centers report a history of physical or sexual abuse.

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I have tried to quit so many times. I am thinking about trying prescribed medication. What kind of help can I get?