Email: clinicinfo@supremehcws.com
Address: 12401 MIDDLEBROOK ROAD, SUITE 190 GERMANTOWN, MD 20874
Care of Those Suffering from Addiction & Substance Use Disorders
Opioid Use Disorder (OUD)
Opioids produce high levels of positive reinforcement, increasing the odds that people will continue using them despite negative resulting consequences. Opioid use disorder is a chronic lifelong disorder, with serious potential consequences including disability, relapses, and death. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:
- Taking larger amounts or taking drugs over a longer period than intended.
- Persistent desire or unsuccessful efforts to cut down or control opioid use.
- Spending a great deal of time obtaining or using the opioid or recovering from its effects.
- Craving, or a strong desire or urge to use opioids
- Problems fulfilling obligations at work, school, or home.
- Continued opioid use despite having recurring social or interpersonal problems.
- Giving up or reducing activities because of opioid use.
- Using opioids in physically hazardous situations.
- Continued opioid use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids.
- Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
- Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.
While opioid use disorder is like other substance use disorders in many respects, it has several unique features. Opioids can lead to physical dependence within a short time, as little as 4-8 weeks.2 In chronic users, the abruptly stopping use of opioids leads to severe symptoms, including generalized pain, chills, cramps, diarrhea, dilated pupils, restlessness, anxiety, nausea, vomiting, insomnia, and very intense cravings. Because these symptoms are severe it creates significant motivation to continue using opioids to prevent withdrawal.
Alcohol Use Disorder (AUD)
Alcohol use disorder (AUD) is a medical condition described as an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It includes the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and an informal term, alcoholism. It is considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.
The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery. The national survey shows that about 14.1 million adults ages 18 and older had AUD in 2019. Among youth, approximately 414,000 adolescents ages 12–17 had AUD during this timeframe. (https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder).
Types of Treatment for AUD
Several evidence-based treatment approaches are available for AUD. One size does not fit all and a treatment approach that may work for one person may not work for another. Treatment can be outpatient and/or inpatient and be provided by specialty programs, therapists, and doctors.
Medications
Three medications are currently approved by the U.S. Food and Drug Administration to help people stop or reduce their drinking and prevent relapse: naltrexone (oral and long-acting injectable), acamprosate, and disulfiram. All these medications are non-addictive, and they may be used alone or combined with behavioral treatments or mutual-support groups.
Behavioral Therapies
Behavioral treatments, also known as alcohol counseling or “talk therapy,” provided by licensed therapists are aimed at changing drinking behavior. Examples of behavioral treatments are brief interventions and reinforcement approaches, treatments that build motivation and teach skills for coping and preventing relapse, and mindfulness-based therapies.
Mutual-Support Groups
Mutual-support groups provide peer support for stopping or reducing drinking. Group meetings are available in most communities, at low or no cost, at convenient times and locations—including an increasing presence online. This means they can be especially helpful to individuals at risk for relapse to drinking. Combined with medications and behavioral treatment provided by health professionals, mutual-support groups can offer a valuable added layer of support.
Substance Use Disorder (SUD)
Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. Individuals with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day-to-day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.
People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.
Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effect of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.
When someone has a substance use disorder, they usually build up a tolerance to the substance, meaning they need larger amounts to feel the effects.
According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:
- To feel good — feeling of pleasure, “high” or “intoxication.”
- To feel better — relieve stress, forget problems, or feel numb.
- To do better — improve performance or thinking.
- Curiosity and peer pressure or experimenting.
In addition to substances, people can also develop addiction to behaviors, such as gambling (gambling disorder).
People with substance use and behavioral addictions may be aware of their problem but not be able to stop even if they want and try to. The addiction may cause physical and psychological problems as well as interpersonal problems such as with family members and friends or at work. Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.
Symptoms of substance use disorder are grouped into four categories:
- Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use.
- Social problems: substance use causes failure to complete major tasks at work, school, or home; social, work or leisure activities are given up or cut back because of substance use.
- Risky use: substance is used in risky settings; continued use despite known problems.
- Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance).
Many people experience substance use disorder along with another psychiatric disorder. Oftentimes another psychiatric disorder precedes substance use disorder, or the use of a substance may trigger or worsen another psychiatric disorder.
Treatment
Effective treatments are available, however, only about one in four people with opioid use disorder receive specialty treatment. Medication-assisted treatment (MAT) is an effective treatment for individuals with an opioid use disorder. It involves use of medication along with counselling and behavioral therapies. Brain chemistry may contribute to an individual’s mental illness as well as to their treatment. For this reason, medications might be prescribed to help modify one’s brain chemistry. Medications are also used to relieve cravings, relieve withdrawal symptoms, and block the euphoric effects of opioids.
Treatment typically involves cognitive behavioral approaches, such as encouraging motivation to change and education about treatment and relapse prevention. It often includes participation in self-help programs, such as Narcotics Anonymous. MAT has been shown to help people stay in treatment, and to reduce opioid use, opioid overdoses and risks associated with opioid use disorder.
Three FDA-approved medications are commonly used to treat opioid addiction:
Methadone – Prevents withdrawal symptoms and reduces cravings in people addicted to opioids. It does not cause a euphoric feeling once patients become tolerant to its effects. It is available only in specially regulated clinics.
Buprenorphine – Blocks the effects of other opioids, reduces, or eliminates withdrawal symptoms and reduces cravings. Buprenorphine treatment (detoxification or maintenance) is provided by specially trained and qualified physicians, nurse practitioners and physician assistants (having received a waiver from the Drug Enforcement Administration) in office-based settings.
Naltrexone – Blocks the effects of other opioids preventing the feeling of euphoria. It is available from office-based providers in pill form or monthly injection.
The National Institute on Drug Abuse (NIDA) emphasizes that these medications do not substitute one addiction for another. The dosage of medication used in treatment does not get a person high, it helps reduce opioid cravings and withdrawal. It helps restore balance to the brain circuits affected by addiction.
Why wait for help any longer? Call our facility now to request treatment for addiction and substance abuse patients. (855) 208-0890