Addiction, Opiate Use Disorder and Treatment
What is Addiction?
The American society of addiction medicine defines addiction as a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.
Addiction was first recognized as a disease in 1956 by the American Medical Association. Brain imaging studies from individuals who are addicted show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control; these changes alter the way the brain works, and may help explain the compulsive and destructive behaviors of addiction. Addiction is a relapsing disease of the brain that is chronic. This means simply that when taking drugs or drinking alcohol, those with the disease have a difficult time stopping the cycle, even if they desire to. Instead, the urge to continue taking their substance of choice overwhelms them, even if the substance is causing them harm.
You can characterize addiction by not only the inability to abstain from use for any significant length of time, but also an inability to manage the amount taken when using. There are additional symptoms that can include the loss of behavioral control, cravings, physical withdrawal, inability to recognize the problems caused by use and inability to manage functioning in areas of life.
What is Opiate Use Disorder?
Researchers have found that taking opioid medications for more than a few days increases your risk of long-term use, which increases your risk of addiction. The odds you'll still be on opioids a year after starting a short course increase after only five days on opioids. Opioid addiction is often mistaken as a result of a lack of control, however in reality, it is a complex disease. Medical treatment is required often because opioid addiction causes both physical and psychological changes to the brain. The first time a person uses an opiate, the drug impacts certain brain receptors and the cycle of addiction begins. When the cycle is ongoing, the brain begins to rely on opioids instead of its natural chemicals it produces. When the addiction develops, the person requires opiates to level off physical withdrawal symptoms, causing the individual to become more and more addicted. There are also psychological needs that are met using opioids, making it a multi-faceted and complex disease.
Opioids are dangerous because, in addition to eliminating acute pain and anxiety, opioids prevent the brain from coping with the mild stress and pain associated with everyday living. Taking opioids causes structural and functional changes in reward, survival, and affect-processing centers of the brain. There are hundreds of different opioids, but these are a few of the most addictive: Fentanyl, Oxycodone (OxyContin and Percocet), Hydrocodone (Vicodin), Morphine, Heroin and Fentanyl-analogs (fentanyl not produced in a licensed laboratory and sold on the street)
Suboxone© helps reduce withdrawal cravings and symptoms while restoring the balance of the brain circuits affected by addiction, leading to improved healing. Our focus at Brockton Recovery Medical Associates, P.C. is on providing patients with comprehensive care and support as they seek recovery from addiction. Our dedicated treatment staff, as well as on-site lab services, electronic prescriptions sent directly to the pharmacy of our patient’s choice and access to other resources help provide our patients with the most convenient access to care.
Approved by the FDA for clinical use in 2002, buprenorphine (Suboxone©) has been proven to be effective in the treatment of opioid addiction. A long-acting medication that when dosed daily, prevents cravings and withdrawals for 24 hours or more.
Suboxone© is composed of two active ingredients- buprenorphine and naloxone. Buprenorphine interacts with opioid receptors in the brain to elicit relief from cravings and to manage the physiological symptoms of withdrawal. Naloxone is an opioid receptor blocker or antagonist and blocks opioid receptors when they are consumed and diminishes the “reward” and acute reinforcing effects from dopamine.
Buprenorphine is a partial agonist which activates the opioid receptors in the brain, but to a much lesser extent than full agonists. It has a “ceiling effect”. This means that as you continue to take more of the medication, the effects do not continue to increase. Unlike commonly misused opioids, buprenorphine can control withdrawal symptoms without being used to “get high”. Additionally, it blocks other opioids from attaching to the receptors in the brain.
Suboxone© treatment can help to control withdrawal symptoms and ease your journey towards recovery. Treatment of opioid dependence is important to reduce long-term health and social consequences, and to improve the well-being and social functioning of the persons affected. Our objective is to treat and rehabilitate persons and reduce their dependence on illicit drugs; minimize the occurrence of mortality; and improve overall social functioning.