Opioid Misuse

• Diagnosing
• Risk Factors

• Signs and Symptoms
• Prevention

• Treatment Plans
• What is MOUD

In medicine, addiction to this drug class is called opioid use disorder — a chronic, relapsing brain illness causing increased mortality and morbidity rates.

People with an opioid addiction may misuse prescribed medications, use diverted opioid medications, or illicitly purchase heroin. Like other substance use disorders, OUD also seriously impacts the brain and is often caused by a complex combination of psychological, genetic and environmental factors.

• Childhood trauma
• Changes in the brain due to medical drug use
• Genetic predisposition
• Growing up in a high-stress environment

• A family history of substance abuse disorders
• Low socioeconomic status
• Negative social influences
• Unstable employment

• Racial or ethnic background
• Pre-existing mental health issues, including anxiety or depression
• Unstable or low-income housing

There are various ways you can reduce exposure to opioids to reduce OUD successfully. It includes:

• Checking out prescription drug monitoring programs
• Following state prescription drug laws
• Educating providers about opioid prescribing guidelines and facilitating conversations between doctors and patients about the benefits and risks of opioids
• Introducing quality improvement programs to implement recommended and safer prescribing practices
• Adding management strategies in health insurance plans, including quantity limits, drug utilization reviews, and prior authorization
• Educating patients about the safe storage and disposal of prescription opioids
• Creating awareness and sharing resources about the risks of OUD
• Discussing the emotional and mental toll of overdose on patients and loved ones

Opioid use disorder is typically a relapsing brain disorder; thus, patients tend to have different types and durations of treatments.

Before the Treatment

Before starting the treatment, doctors must identify the following:

• Treatment Goals
• Conditions for Changing or Stopping Treatment
• Therapeutic Contingencies for Failure to Meet Treatment Goals

• In-patient care
• Out-patient treatment

• Partial hospitalization
• Residential programs

• Medication-Assisted Treatment (MAT)

• Adjusting the Frequency of Office Visits
• Conducting Drug Tests
• Discussing Patients’ Concerns about Side Effects and Their Support Network

• Monitoring Patients’ Adherence to Medication
• Providing Supportive Counseling
• Referring to Psychiatric and Medical Care (if not directly provided)

Opioid addiction can create long-term damage to one’s brain because it is a chronic medical condition. Fortunately, early treatment can help people avoid some long-term health problems associated with opioid addiction. 

Withdrawal requires more than willpower. It takes effort to break oneself free and escape the cycle of relapse and detox. It may be a long-term process, but counseling and medications can help people quit their addiction to opioids.

For people aiming to reduce or stop the use of opioids, multiple evidence-based approaches are available to do it safely. One of the safe and most effective approaches involves Medications for Opioid Use Disorder (MOUD).

Dr. Alarcon is certified by the American Board of Addiction Medicine. As such, he is qualified to play a vital role in helping opioid addicts withdraw from the use of drugs and regain a normal life.  

Since opioid addicts have multiple reasons to use the drug, treating the patient is one of the most effective ways when the patient is ready to withdraw the use of opioids in the face of life circumstances and other competing needs.

For many patients, Dr. Alarcon’s evidence-based MOUD treatment has been effective in:

• Reducing opioid use
• Reducing the risk of transmitting infectious disease
• Minimizing the chances of an overdose-related death
• Supporting people who wish to reduce or stop using drugs
• Increasing the chances that a person will not continue using drugs

Dr. Alarcon and other MOUD physicians often prescribe methadone and buprenorphine to people who wish to seek help in reducing or stopping the use of opioids.

Methadone, a synthetic opioid agonist, helps eliminate withdrawal symptoms and relieves drug cravings. It comes in a pill and liquid form. Patients take methadone daily, and it is only available at licensed treatment centers.

Buprenorphine, a partial opioid agonist, binds to the same opioid receptors, but activates them less intensely. It reduces drug cravings and withdrawal symptoms.