Opioid Treatment in Houston via Telehealth
Opioids are powerful drugs used for treating pain. However, because of their ability to produce euphoria opioids are highly addictive and are subject to abuse.
Because of the difficulty involved in extricating patients from addiction, medical intervention is almost always necessary. Detoxification can involve serious withdrawal symptoms. These symptoms, however, may be mitigated by the use of opioid replacement medications such as SUBOXONE® Sublingual Film.
In addition to medication, patients undergoing detoxification should consider engaging in psychotherapy, group counseling and/or cognitive training in order to understand the complex factors that led to their addiction, and to prevent a recurrence.
Houston Suboxone Center treats patients suffering from opioid additions throughout the entire Greater Houston area, including Neartown - Montrose, University Place, Northside, East Downtown, Midtown, the Woodlands, Kingwood, Greater Heights, Cinco Ranch, Sugarland and other areas.
Candidates for Opioid Detoxification
While SUBOXONE is a very useful and often a lifesaving medication, it is also a powerful drug. In order for a patient addicted to opioids to successfully complete a program of detoxification, the individual must be educated about the addictive disorder and its remedy and be prepared to be follow the necessary protocol for success.
Mutual Transparency Between Patient & Provider
Patients entering an opioid detoxification program must fully inform medical personnel about:
- Pre-existing medical or psychiatric conditions
- Use of alcohol and medications, especially psychotropic medications
- Being pregnant or nursing
- Symptoms of opioid withdrawal
- Possibility of allergic reaction to suboxone
- Side effects of suboxone, the most frequent of which is headache
- The fact that the side effects usually subside soon
Patients beginning a detoxification program must be prepared to be completely compliant with the program's regulations. These will include:
- Agreeing to take prescribed dosages of medications at prescribed times
- Abstaining from alcohol, including foods or medicines with alcoholic content
- Keeping all medication away from children for whom ingestion may be fatal.
- Avoiding driving or using dangerous machinery temporarily
- Being careful to avoid sudden sitting or standing
Weaning from Opioids
It is important for patients addicted to opioids to be closely monitored as they go through the withdrawal process since there are both medical and behavioral issues to be dealt with.
There has been significant publicity concerning rapid detox programs. During some of these, the patient goes through early withdrawal under anesthesia while opiate-blocking medications are administered intravenously. There is no evidence, however, that rapid detox is more effective than any other method and there is some evidence that it is more dangerous since it has resulted in a number of deaths.
Being successfully weaned from opioids is a gradual, carefully planned process involving close medical observation.
Usually a patient can tolerate tapering by 10 percent of the original opioid dose per week. Some of the common symptoms of opioid withdrawal, such as anxiety, muscle aches, sweating, cramping, runny nose and anxiety can usually be effectively treated with a medication called clonidine which may be administered orally or through the application of a transdermal patch. Other medications may be used to control vomiting and diarrhea during the early detoxification process.
For some individuals, weekly tapering may prove to be too frequent. If serious side effects like hypotension occur, it may be necessary to slow the tapering process to monthly adjustments. Although symptoms of opioid withdrawal may continue for as long as 6 months, such symptoms will become much milder with the passage of time. During the weaning process, it is usually necessary for the patient to have ongoing counseling in order to confront behavioral issues as they arise. It is also frequently necessary for the recovering addict to be prescribed antidepressants or anti-epileptics in order to keep negative emotions and destructive behavior under control.
While patients are tapering from the drug they have abused, suboxone (a synthetic opioid) is administered to assist detoxification in two important ways:
- Alleviating withdrawal symptoms
- Preventing abused opioids from producing euphoria
Suboxone can be taken less frequently than the original addictive opioids in order to have the desired effect. During detoxification, suboxone will gradually be tapered as well.
Suboxone has a ceiling effect, meaning that increasing its dosage does not continue to increase its effect. As a result, it is far less likely than other opioids to be abused. It is less likely to be addictive than methadone and can be dispensed for patients to take at home.
Suboxone lessens the symptoms of withdrawal from heroin or opioid painkillers without supplying the euphoria that the original narcotic provided. Because of this, as the cravings for the original narcotic subside, the patient is less tempted to use more than the prescribed dose of suboxone.
Suboxone works best on patients with mild to moderate opioid dependence and can be less effective for detoxifying heavy drug users. Since addiction is a serious medical disorder of complex origins, patients may attempt to increase their dose of suboxone even though it doesn't intoxicate them. Positive attributes of this medication are that suboxone is less addictive and its withdrawal symptoms are less severe. A patient is less likely to suffer a fatal overdose of this medication.
The most difficult thing for a patient going through opioid withdrawal to remember may be that the process, while very uncomfortable, is not life-threatening. Like a bad case of the flu, it will pass. The length of the withdrawal period is variable and may last from a week to a month or longer, depending on the severity of the addiction. Symptoms of opioid withdrawal, which are lessened by the prescribed medication, may include:
- Cramping, diarrhea or vomiting
- Chills or shaking
- Runny nose, watery eyes
- Feeling extremely hot or cold
- Muscle aches and pains
- Insomnia, anxiety, irritability
Risks of Detoxification
The greatest risk for patients undergoing opioid detoxification is relapse. It is important for patients to be reminded that the difficult detoxification period will, in a relatively short time, lead to a longer, healthier life. Detoxification and withdrawls is a relatively safe process. The more acute danger is that a patient can potentially suffer a relapse which could result in a fatal overdose. This is because the patient's tolerance for the addictive drug after even a brief period of abstinence is greatly diminished. A much smaller quantity of the opioid than was previously tolerated may cause a fatal reaction.
The patient going through opioid detoxification should always be prepared to seek medical assistance immediately if an overdose is suspected. Signs of an overdose may include:
- Blurred vision
- Slurred speech
- Cognitive impairment
- Shallow breathing
- Pallor, blue lips or nails
- Sleepiness or lack of response
- Small pupils
- Slow pulse or heartbeat
It is also important for patients in a detoxification program to inform friends and family members that they are involved in such a program so that medical help will be sought by others if necessary.