30 Day Treatment Programs for Opioid Use Disorders
30 day treatment programs for Opioid Use Disorders are typically the first and very significant phase of treatment for most people who are addicted to these substances. Such programs can provide a complete, or nearly complete, withdrawal and detoxification process for people who are opioid addicted. However, an opioid addiction alters brain functioning and psychological functioning, making an extended period of treatment most effective. To be successful in maintaining gains made in withdrawal and detox, continued treatment after 30 day treatment programs is best medical practice.
A Closer Look at Opioids
Opioids are a category of drugs with a direct painkilling and euphoric impact upon human opioid receptors. Opioid receptors are found in the brain, nervous system, and various organs of the body. They bind to or ‘capture and hold’ drugs that have a morphine effect. Drugs that block pain receptors and consequently, the experience of pain, are said to have a morphine effect. These drugs also trigger the release of endorphins, or our bodies’ ‘natural narcotic’, the ‘painkiller’ hormone. In fact, the word endorphin is derived from the term endogenous morphine which means morphine that originates from within us. Opioids kill pain, sedate, and cause euphoria.
Opioids are used medically for pain by prescription only. They are highly addictive and any user—with a medical need or not—has a serious risk of becoming addicted. Opioids are the most controlled prescription medicines available in the U.S. because of their misuse, and pervasive diversion from legitimate medical practice. This class of drug includes those called opiates which are drugs derived from the opium poppy plant. An opioid classification also includes synthetic and semi-synthetic substances that have the morphine effect. Opioids include, but are not limited to:
While many opioids are legal substances when prescribed for medical needs, heroin is not. It is not considered to have a legitimate medical use in the US. There are also forms of opioids made illegally such as a type of fentanyl. It is illegal to make, sell, buy, and possess fentanyl made in illegal labs, for example. Also, it is illegal to sell, buy and possess legal opioids without a prescription and outside legally sanctioned methods of dispensing and possessing.
Withdrawal and Detox from Opioids
Due to the highly addictive nature of opioids, withdrawing from them on your own can be dangerous, and medical supervision is always advised. There is, for example, a high risk of hypertensive (blood pressure) crisis and cardiac problems. Also, severe dehydration is always a serious risk due to GI distress and the inability to keep liquids down.
Additionally, the symptoms of opioid withdrawal are severe, and those who attempt withdrawal without medical assistance are likely to resume use to ease those symptoms. While some who are addicted to opioids can fully withdraw from them in 30 day treatment programs, others have what is known as protracted withdrawal which involves withdrawal symptoms over an extended period.
The Timeline for Opioid Withdrawal
The timeline for withdrawal and detox from opioid use is generalized and individuals vary in their progress through the process. It is impossible to accurately predict how withdrawal and detox will be for you specifically. The substances you have used, the duration of use, and the amounts you have used, all impact the withdrawal and detox process. Your physical and mental health status apart from addiction also plays a role. While time frames can vary for withdrawal symptoms, everyone will experience similar stages of withdrawal. Common timeframes for these stages are given below. For example:
Withdrawal Onset and Acute Withdrawal—withdrawal usually begins within the first day after the last dose of opioid. Onset can be within a few hours and be sustained for the first 3-5 days after stopping use. Symptoms during this first phase typically include:
- Muscle aches and joint pain
- Excessive sweating
- Sleep and appetite disturbances
- Runny nose
These symptoms can be reduced and well managed with medical supervision, making the process far more tolerable and manageable than going ‘cold turkey’ without medical help.
Second Stage of Withdrawal
Opioid withdrawal’s second stage usually occurs 4-6 days after the last dose. There is an improvement in some symptoms such as muscle aches and pains, but they do continue. GI distress symptoms cause limited food and liquid intake, and some symptoms like diarrhea can improve, but only because very little has been ingested. Goosebumps and shivers are common as is anxiety, fatigue, and irritability. Most people liken these few days to a bout of the flu. A treatment setting can provide palliative care during the process to ease aches and pains, nausea, and vomiting, for example. These measures are comforting and make the process tolerable and manageable. Typically, around day 5, notable easing of distress is felt, although one continues to be unwell.
The Third Stage of Withdrawal
Usually, by the time a week has passed, physical symptoms have markedly decreased, but one feels physically drained and exhausted. At this point, psychological symptoms are typically more prominent such as anxiety, fear, mood swings, depression, and cravings, but also occasional queasiness and poor appetite continue. It is common for sleep to still be problematic, too. Many will experience this stage of withdrawal for about 30 days until they hit another milestone of symptom improvement.
As you can see from this rough sketch of an opioid withdrawal timeline, many people can spend most, if not all, of their 30 day treatment programs completing this initial phase of treatment. For that reason, it is important that everyone pursuing recovery from opioid addiction understand a longer course of treatment may be necessary to sustain abstinence after detox.
Detox Facilities and Programs
Some drug treatment programs offer only withdrawal and detox services. These are valuable resources, and programs that specialize in just this stage of treatment can be very effective. However, detox is not a complete treatment. Immediate follow up in an inpatient or residential rehab that specializes in recovery from opioid addiction is recommended.
In rehab, one will receive treatment for other significant symptoms of addiction such as emotional, mental, and behavioral aspects of the illness that can cause a relapse. Detox programs prepare you for the rest of your treatment. You can enter a rehab program physically in a healthier state, and with greater mental clarity to best benefit from treatment. Some inpatient and residential opioid rehabs will offer detox in their facilities, but you should inquire about whether a medically supervised detox is available each time you contact a new rehab. When you enter rehab after a detox, you will usually find treatment stay options of 30, 60, and 90 days. You and your care providers can best determine what is indicated for you.
What to Expect of an Opioid Treatment Program
Any center in the US that provides an opioid treatment program is governed by federal, state, and local laws. This ensures expertise, safety, legal handling of controlled substances, and quality control. For example, there are accreditation and certification processes specifically for opioid treatment programs—from detox, to 30 day treatment programs, and beyond.
A federal department called the Division of Pharmacologic Therapies (part of the Substance Abuse and Mental Health Administration or SAMHSA) is responsible for overseeing the accreditation procedures for programs that treat opioid addictions and use opioid medications in withdrawal processes as well as maintenance recovery. Because controlled substances are often used in various stages of opioid addiction treatment, controls are important for patient safety. They are also important in maintaining legal compliance for the handling and administration of such medications.
Other provisions under federal law mandate that:
- Opioid treatment programs, or OTPs, shall provide adequate medical, counseling, vocational, educational, and other assessment and treatment services. Consequently, an opioid treatment program will employ a staff with a range of education, training, and expertise. They should all have the background, licensing or certifications required by law to practice.
- OTPs must have medical supervision, and participants must have initial and periodic medical exams and monitoring. This requirement speaks to addiction as a medical illness with potentially severe health risks.
- OTPs must maintain current policies and procedures that reflect the special needs of patients who are pregnant. Pregnant women, fetuses, and newborns are at risk for life-endangering consequences of maternal opioid use, and should always be medically treated by medical staff with expertise in prenatal care during opioid addiction and addiction treatment.
- OTPs shall establish and maintain a recordkeeping system that is adequate to document and monitor patient care. This system is required to comply with all Federal and State reporting requirements relevant to opioid drugs approved for use in the treatment of opioid use disorder. All records are required to be kept confidential in accordance with all applicable Federal and State requirements. Due to the cultural stigma attached to opioid misuse and all addictions, privacy and confidentiality are recognized as serious concerns for participants.
Getting the Right Help
Getting the right help for an Opioid Use Disorder, or any other addiction, is vital to your success in becoming and staying substance free. And, because addiction has hit epidemic proportions in the US, there are a great many programs available. Just a cyber search for help can open up an avalanche of information from countless programs offering treatment. When you, or a loved one, is opioid addicted, your life is overwhelmingly stressful. It is a very difficult time to be faced with a vast amount of information to sort through as you seek help. Many people recall their search for help as a painful and frightening process. They needed care immediately, but were simply confused and overwhelmed by the sheer amount of information, and various options. We can help you navigate that search, free of charge.
It is crucial that you remember an Opioid Use Disorder requires specialized care, and that you may be facing a long term treatment to maintain a sustained recovery. Detox services and 30 day treatment programs are valuable resources. However, no one can predict your exact treatment needs before you are in a program. Rely on your professional caregivers to help guide you to the next best step for you after completing a milestone such as detox or a 30 day course of addiction related therapies. This best ensures the investments you make in your health and future are well protected, and that you stand the greatest chance of the substance-free, happy and successful life you and your family deserve.