Opioid Treatment Programs: Expectations, Challenges and Resources
News of the opioid crisis in the United States has been in the headlines for years. Opioid abuse and overdoses have devastated families and communities across the country.
According to the Department of Health and Human Services (HHS), synthetic opioid overdoses in the United States claimed the lives of 48,006 people in the 12 months ending June 2020. An estimated 10 million people abused prescribed opioids during this time.
For people with opioid use disorder (OUD), programs are available to help provide treatment with medication and therapy. Known as opioid treatment programs, they can also teach strategies to help you achieve your individual goals.
Some programs are for those under 18, while others are for adults only. You may benefit from an inpatient program centered on supervised detoxification. Or, an outpatient program may better suit your needs.
The costs of opioid treatment programs also vary widely. Some take Medicaid and federal military insurance, while others only accept private health insurance or self-pay.
What’s most important to understand is that finding an opioid treatment program can not only improve your quality of life. It can also save you from a fatal overdose.
Opioid treatment programs vary, but generally include:
- a review of your medical history
- a review of your history of opioid use
- a physical exam
- drug testing
You will also meet with a counselor to discuss an individualized treatment plan and review program policies and expectations.
Treatment programs typically involve the supervised use of medications to help:
- decrease opioid cravings
- treat withdrawal symptoms
- block the effects of other opioids
- reduce the risk of overdose and death
Programs also often include some type of behavioral therapy.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that medications for OUD are safe and effective when used appropriately and should be offered to anyone with OUD.
Youyou will probably be able to receive advice along with your medication. You can choose if you want to pursue this.
The three drugs approved by the Food and Drug Administration (FDA) for OUD are:
Both methadone and buprenorphine are opioids. But when used under medical supervision, they can help treat severe withdrawal symptoms and cravings experienced by people with TOU who use other opioids, such as oxycodone and hydrocodone.
A 2021 report from the National Institute on Drug Abuse (NIDA) suggests that methadone and buprenorphine are equally effective in treating OUD. But the best results often depend on the duration of the treatment.
Naltrexone is not an opioid, unlike the other two drugs. It is also used to treat alcohol use disorder as it can effectively lessen the effects of alcohol and opioids. By interfering with the “high” of opioids and alcohol, naltrexone decreases cravings for these substances.
Interventions such as cognitive behavioral therapy (CBT) can help stop opioid use. CBT aims to change the way you think about a situation, to dispel unrealistic and unnecessary thoughts. It helps you feel different and makes your behavior healthier and more realistic.
Because OUD is often associated with other health conditions, some treatment programs offer other services, such as treatment for alcohol use disorders and other substance use disorders. substances. Some people who inject substances also share needles, so some programs include testing for HIV, hepatitis B, and hepatitis C, and treatment if needed. Some programs also offer harm reduction services, such as providing safe injection equipment or needle exchanges.
You may also benefit from screening and treatment for mental health issues, including:
Outpatient vs inpatient
Opioid treatment programs can be outpatient or inpatient.
In an outpatient program, you will live at home but regularly attend a treatment program in a hospital, clinic, or other location. People often go there every day at first.
An inpatient program will require you to stay in a hospital or residential treatment facility. You‘ll be there overnight for a period of weeks or months.
Your options may depend on the severity of your OUD and the programs available in your area.
A residential or hospital program may be preferable for people with a history of overdose or other mental health issues. These programs are more expensive than outpatient programs.
If your OUD is severe, an inpatient program may also be the best option. This can help you deal with intense withdrawal symptoms at first, which can lead to a better outcome.
Outpatient treatment programs offer more flexibility at a lower cost and may be better for some people.
To make the best decision, talk with the people running the programs. Here are some useful things to inform staff:
- how long have you been using
- what you are currently using
- when you last used
- if you have ever overdosed
- what treatments you have tried in the past, including drug and non-drug therapies
- how you reacted to previous treatments
You can also consider involving family members or close friends in the decision. While it’s not the best option for everyone, some find comfort in the support of loved ones.
Cost is one of the biggest barriers for many people to enroll in and complete an opioid treatment program. But that’s not the only challenge. Some barriers are based on the availability of programs in a given community, while others have more to do with perceived stigmas around substance use.
The costs of opioid treatment can be prohibitive for many people. A 2018 report from the Kaiser Family Foundation noted that one year of inpatient OUD treatment costs a person more than $16,000. Some programs greatly exceed this figure.
Outpatient costs vary greatly depending on the medications and the amount of behavioral therapy involved. A 2021 NIDA report estimated that a year of daily methadone outpatient treatment and integrated support services could cost more than $6,500.
Insurance coverage for opioid and other drug treatment programs has expanded in recent years. Many programs are covered, at least in part, by Medicare, Medicaid, or private insurers. The Affordable Care Act (ACA) has listed treatment for substance use disorders as one of 10 essential health benefits that must be included in all health insurance plans sold on health exchanges. health insurance or provided by Medicare.
OUD is a problem in cities, suburbs and rural areas. But urban areas generally have better access to health services than rural areas.
In a 2017 report, Centers for Disease Control and Prevention (CDC) researchers noted that people in rural areas tend to be older, sicker, and in many cases poorer than the general public. These are all factors that can influence the use and abuse of opioids. There are fewer treatment programs within reach for many people living in rural areas of the United States.
A few pervasive stigmas surrounding OUD can prevent people from accessing and completing treatment.
A common belief is that drugs such as methadone or buprenorphine are just drugs that will replace one addiction with another. But these drugs act differently on the brain. When used as part of a licensed and supervised OTP, they are remarkably effective in dealing with OUD.
There is also a widespread opinion among the general public that OUD reflects a flaw in someone’s character. A 2017 national survey suggested that 3 out of 4 people believe people with OUD are responsible for the condition themselves. According to
This stigma can be a barrier to seeking and receiving effective care.
But public perception may change. A recent study in Virginia found that
For many people, OUD is one of many health conditions that require treatment. If youIf you live with multiple health conditions, it may be more difficult to find a program that will provide you with all the services you need.
For example, treating OUD but not depression may leave a person vulnerable to resuming opioid use. If you have a concurrent condition, talk to health care professionals about the kind of comprehensive services they offer.
The opioid crisis claimed the lives of
If you or a loved one need services, don’t delay. Contact and find out what programs exist in your community and if it would be affordable and effective for the person in need.
To find treatment programs in your area, see the SAMHSA Opioid Treatment Program Directory. You can also search for local treatment programs listed by HHS.