Outpatient Treatment for Opioid Use Disorder: A Path to Recovery with Crossroads
Opioid use disorder (OUD) is a chronic medical condition characterized by the inability to abstain from opioid use despite adverse consequences. It affects the brain and behavior, leading to significant health, social and economic challenges. Understanding opioid addiction is crucial for recognizing its impact and exploring effective treatment options.
OUD is a national public health crisis; opioid overdose effects include severe depression of the respiratory system, which can potentially cause respiratory arrest, coma and death. In 2023, according to the Centers for Disease Control and Prevention (CDC), approximately 108,000 people died from overdoses, with the vast majority involving opioids. That’s nearly 300 people dying from overdoses per day.
Understanding Opioid Addiction
Natural opioids, such as morphine, codeine, opium and thebaine, are made from the seed pods of the opium poppy plant. These natural substances are also known as opiates. Semi-synthetic opioids, such as heroin and the pain relievers oxycodone, hydrocodone and oxymorphone, are made in laboratories by chemically processing natural opioids. Synthetic opioids, such as fentanyl, are manufactured entirely in laboratories with no natural ingredients.
Opioids bind to mu-opioid receptors on the nerve cells in the brain and body to reduce pain and suppress coughs when used legitimately. Opioid dependence and withdrawal are characterized by nausea, mental confusion, drowsiness, severe sweats and constipation. It often occurs when drug use continues outside of the prescribed dosage, there is no longer a medical need or substance use continues despite awareness of adverse physical or mental side effects.
It’s essential to recognize that opioid addiction is a complex disease rooted in changes to the brain, not a moral failing. Gaining a deeper understanding can help reduce stigma and support recovery. Explore the Biology of Opioid Use Disorder to learn how addiction affects the brain, the Biology of Recovery to see how healing begins, and the Biology of Success to understand how long-term recovery is sustained.
Fentanyl’s Role in Opioid Use Disorder
Fentanyl has become a significant contributor to overdose deaths due to its potency. Fentanyl is an opioid that is 50 to 100 times more potent than heroin or prescription opioids. It is often used to adulterate or “cut” heroin, cocaine, methamphetamines and other “street drugs.” The drug is also frequently mixed with counterfeit prescription pills to increase potency or reduce costs. These mixtures can be lethal, as the precise dosage of fentanyl is hard to control. Even a small amount can cause respiratory depression, leading to an overdose.
Fentanyl only takes two milligrams to be lethal. By comparison, a sweetener packet found on a restaurant tabletop generally contains 1,000 milligrams per packet.
The Gold Standard for Treating Opioid Use Disorder
The American Society of Addiction Medicine (ASAM), the CDC, the World Health Organization (WHO) and the U.S. Surgeon General maintain that the gold standard of effective treatment for OUD is a combination of medication and behavioral therapies, known as medication-based recovery support. Medications commonly used for treatment include:
- Methadone: A long-acting opioid agonist that reduces cravings and withdrawal symptoms.
- Buprenorphine: A partial opioid agonist that helps alleviate withdrawal and cravings with a lower risk of misuse.
- Naltrexone: An opioid antagonist that blocks the euphoric effects of opioids.
These medications, combined with counseling and behavioral therapies, provide a comprehensive approach to the treatment of OUD.
Types of Buprenorphine
Crossroads offers several forms of buprenorphine for the treatment of OUD. Buprenorphine is available in tablet, sublingual film and long-acting injectable forms. Some brand-name forms of buprenorphine offered are SUBOXONE®, SUBLOCADE® and BRIXADI®.SUBOXONE: (Buprenorphine + Naloxone)
- When dosed properly, Suboxone rapidly treats the symptoms of withdrawal, even in fentanyl users.
- It works in the brain to prevent opioid effects (such as feelings of well-being or pain relief). It also decreases the desire to take opioids.
- It can be administered as a film strip or a tablet.
SUBLOCADE: (Buprenorphine Extended-Release Injection)
- After a brief period of stabilization with oral forms of buprenorphine, it is administered as a long-acting subcutaneous (applied under the skin) injection.
- It works in the brain to help control opioid cravings and block the effects that other opioids may provide.
- It is available as a once monthly extended-release, injectable dose.
- There is no clearly defined length of time for buprenorphine treatment. The longer it is taken, the less likely a patient will relapse.
BRIXADI: (Buprenorphine Extended-Release Injection)
- After a brief period of stabilization with oral buprenorphine, it is given as a long-acting subcutaneous injection.
- It functions in the brain to help manage opioid cravings and block the effects that opioids can produce.
- This injectable can be administered on a weekly or monthly basis.
- There is no clearly defined duration for treatment. The longer it is used, the less likely a patient is to relapse.
Opioid Use Disorder Support and Resources
Recovery from opioid addiction is possible, and you don’t have to face it alone. At Crossroads, we’re here to support you every step of the way with comprehensive care that includes medications, counseling, peer support and care management. Explore our full range of services today.
If you or someone you know is struggling with OUD, Crossroads is here to help with our 24/7/365 Patient Access Center and Instant Intake®. Contact us today to learn more about our outpatient treatment programs and how we can support you on the path to recovery.