25 Sep 2019

BY: mcare

Blogroll / Depression / Mental Illness / Treatment

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Stigma and Misconceptions of Mental Health Issues

A mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible.

Mental illnesses can affect persons of any age, race, religion or income. Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

Mental Health Stigma

Mental illness can strike anyone!  It knows no age limits, economic status, race, creed or color. During the course of a year, more than 54 million Americans are affected by one or more mental disorders.

Medical science has made incredible progress over the last century in helping us understand, curing and eliminating the causes of many diseases including mental illnesses. However, while doctors continue to solve some of the mysteries of the brain, many of its functions remain a puzzle. Even at the leading research centers, no one fully understands how the brain works or why it malfunctions. However, researchers have determined that many mental illnesses are probably the result of chemical imbalances in the brain. These imbalances may be inherited or may develop because of excessive stress or substance abuse.

It is sometimes easy to forget that our brain, like all of our other organs, is vulnerable to disease. People with mental illnesses often exhibit many types of behaviors such as extreme sadness and irritability, and in more severe cases, they may also suffer from hallucinations and total withdrawal.  Instead of receiving compassion and acceptance, people with mental illnesses may experience hostility, discrimination, and stigma.

Why does stigma still exist?

Unfortunately, the media is responsible for many of the misconceptions which persist in people with mental illnesses.  Newspapers, in particular, often stress history of mental illness in the backgrounds of people who commit crimes of violence. Television news programs frequently sensationalize crimes where persons with mental illnesses are involved.

Comedians make fun of people with mental illnesses, using their disabilities as a source of humor.  National advertisers use stigmatizing images as promotional gimmicks to sell products as well.

Ironically, the media also offers our best hope for eradicating stigma because of its power to educate and influence public opinion.

Common Misconceptions About Mental Illness

Myth: “People who need psychiatric care should be locked away in institutions.”

Fact: Today, most people can lead productive lives within their communities thanks to a variety of supports, programs, and/or medications.

Myth: “A person who has had a mental illness can never be normal.”

Fact: People with mental illnesses can recover and resume normal activities.  For example, Mike Wallace of “60 Minutes”, who has clinical depression, has received treatment and today leads an enriched and accomplished life.

Myth: “Mentally ill persons are dangerous.”

Fact: The vast majority of people with mental illnesses are not violent. In the cases when violence does occur, the incidence typically results from the same reasons as with the general public such as feeling threatened or excessive use of alcohol and/or drugs.

Myth: “People with mental illnesses can work low-level jobs but aren’t suited for really important or responsible positions.”

Fact: People with mental illnesses, like everyone else, have the potential to work at any level depending on their own abilities, experience, and motivation.

How You Can Combat Stigma

  • Share your experience with mental illness.  Your story can convey to others that having a mental illness is nothing to be embarrassed about.
  • Help people with mental illness reenter society.  Support their efforts to obtain housing and jobs.
  • Respond to false statements about mental illness or people with mental illnesses.  Many people have wrong and damaging ideas on the subject.  Accurate facts and information may help change both their ideas and actions.


MindCare Agency has the additional benefit of having an Advanced Psychiatric Nurse Practitioner on-site that can provide medication management services to clients that have been referred by their clinician and determined to be appropriate to receive medication. To be referred, a client must be consistently attending and participating in counseling. Once a client has shown a commitment to attending therapy, the clinician will complete a referral for review. If appropriate, the client will be scheduled for their initial medication evaluation.


*Please note: If a client drops out of counseling, the privilege of continuing on medication is forfeited. Counseling is a requirement that is strongly reinforced.


25 Sep 2019

BY: mcare

Addiction / Blogroll / Substance Abuse / Treatment

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Medication Assisted Treatment Options

What Medications are Available for Opioid Dependence?

Buprenorphine/Naloxone Commonly known as Suboxone, Buprenorphine/Naloxone (Bup/Nx) is a prescription opioid medication that is used to treat opioid dependence. At the correct dose, buprenorphine may suppress cravings and withdrawal symptoms and block the effects of other opioids. Buprenorphine is not new. It was first patented in 1969 and has been used in the U.S. to treat pain and in Europe to treat pain and opioid addiction for decades. Buprenorphine is a semi-synthetic opioid and is a partial agonist.

Opioid Agonists are drugs that cause an opioid effect; i.e., heroin, oxycodone, hydrocodone, and methadone. Opioid Antagonists are drugs that block and reverse the effects of agonist drugs. Narcan® is an antagonist and is used to reverse heroin overdoses. Buprenorphine can act as both an agonist and antagonist. It attaches to the opioid receptors but only activates them partially, enough to suppress withdrawal and cravings, but not enough to cause extreme euphoria in opioid-tolerant patients.

When all available receptors are occupied with buprenorphine, no additional opioid effect is produced by taking more. This is called the ‘ceiling effect’. The antagonist property of the medication expels, replaces and blocks other opioids from the opioid receptor sites. Therefore, if the patient decides to misuse opioid drugs after taking buprenorphine, the effects can be blocked, depending on the dosage.

Alternately, if buprenorphine is taken too soon after other opioids, by an opioid-physically dependent patient, the buprenorphine can precipitate withdrawal. The ceiling effect, blocking ability, and the possibility of precipitating withdrawal contributes to buprenorphine having a favorable safety profile and helps lower the risk of overdose and misuse.

In October 2002 the FDA approved the first two prescription Buprenorphine medications for the treatment of opioid addiction; Subutex®* (buprenorphine) and Suboxone®* (buprenorphine/naloxone). Since 2009 the FDA approved generic Bup and Bup/Nx sublingual tablets, the brand-name Bup/Nx sublingual tablet Zubsolv®* and the Bup/Nx buccal film Bunavail™*. Both Suboxone and Subutex tablets were discontinued and replaced with Suboxone Film® – a Bup/Nx sublingual film.

The purpose of the addition of naloxone is to reduce the risk of misuse by injection. If the Bup/Nx combination is injected, the naloxone will help cause immediate withdrawal symptoms in opioid-physically dependent people. However, naloxone is poorly absorbed sublingually. Therefore, when taken as directed, very little naloxone enters the blood. Normally, patients are unaffected by the presence of it, and it is considered clinically insignificant.

*For more information on Bup/Nx go to www.naabt.org


Methadone Maintenance: Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives.

Individuals taking methadone to treat opioid addiction must receive the medication under the supervision of a physician. Initially, a person on the “clinic” must attend on a daily basis and receive their dosage of methadone in the presence of nursing staff. After a period of stability (based on progress and proven, consistent compliance with the medication dosage and negative urine drug screens or oral swabs), individuals may be allowed to take methadone at home between program visits. By law, methadone can only be dispensed through an approved opioid treatment program (OTP), which are highly regulated by the state and federal government.


The length of time in methadone treatment varies from person to person. According to the National Institute on Drug Abuse publication, the length of methadone treatment should be a minimum of 12 months. Some individuals may require treatment for years. Even if an individual feels that they are ready to stop methadone treatment, it must be stopped gradually to prevent withdrawal. Such a decision should be supervised by a doctor.


As with all medications used in medication-assisted treatment (MAT) methadone is to be prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.


Naltrexone for opioid AND alcohol use disorders: Naltrexone is a medication approved by the Food and Drug Administration (FDA) to treat opioid and alcohol use disorders. It comes in a pill form or as an injectable. The pill form of naltrexone (ReVia, Depade) can be taken at 50 mg once per day. The injectable extended-release form of the drug (Vivitrol) is administered at 380 mg intramuscular once a month. Naltrexone works by blocking the euphoric and sedative effects of drugs such as heroin and alcohol. It works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. If a person relapses and uses the problem drug, naltrexone prevents the feeling of getting high. People using naltrexone should not use any other opioids or illicit drugs; drink alcohol; or take sedatives, tranquilizers, or other drugs.


Naltrexone for opioid use disorders: Naltrexone can be prescribed by any health care provider who is licensed to prescribe medications. It works by binding and blocking the opioid receptors in the brain and reduces cravings. It also decreases reactivity to drug-conditioned cues.  To reduce the risk of precipitated withdrawal, individuals are warned to abstain from illegal opioids and opioid medication for a minimum of 7-10 days before starting naltrexone. If switching from methadone to naltrexone, the patient has to be completely withdrawn from the opioids. Individuals on naltrexone may have reduced tolerance to opioids and may be unaware of their potential sensitivity to the same, or lower, doses of opioids that they used to take. If individuals who are treated with naltrexone relapse after a period of abstinence, it is possible that the dosage of opioid that was previously used may have life-threatening consequences, including respiratory arrest and circulatory collapse.


Naltrexone for alcohol use disorders: When used as a treatment for alcohol dependence, naltrexone blocks the euphoric effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment and avoid relapses. Naltrexone is not addictive nor does it react adversely with alcohol. Long-term naltrexone therapy extending beyond three months is considered most effective by researchers, and therapy may also be used indefinitely.



25 Sep 2019

BY: mcare

Addiction / Blogroll / Substance Abuse / Treatment

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Where to get Narcan Naloxone in Massachusetts?

Where to get Narcan/Naloxone in Massachusetts?

Local pharmacies may have Nasal Narcan for purchase with or without a prescription (Stop in or call to see if your specific pharmacy has it available)


Where to Get Naloxone in Massachusetts


Boston Public Health Commission, AHOPE

774 Albany Street

617-534-3967 or 617-534-3976

Boston (continued)

AIDS Action Committee

75 Amory Street, Jamaica Plain


Victory Programs, Drug User Health Project

29 Stanhope Street




Brockton Area Multi-Services, Inc.

The COPE Center 81 Pleasant Street



AIDS Action Committee 359 Green Street


Fall River

Seven Hills Behavioral Health 310 South Main Street



AIDS Support Group of Cape Cod 65 Town Hall Square, 2nd floor 774-763-6656 or 774-763-6657




Justice Resource Institute, Program RISE 1 Grant Street, Suite 100





Tapestry Health

277 Main Street, Ste. 404A



Tapestry 15A Main Street

413-315-3732 x1

Holyoke Health Center 230 Maple Street, lower level





AIDS Support Group of Cape Cod 428 South Street




Greater Lawrence Family Health Center, Prevention & Education Dept

100 Water Street



Lowell Community Health Center 161 Jackson Street


Lowell  House 555 Merrimack Street



Health Innovations, Inc Healthy Streets Outreach Program

100 Willow Street, 2nd floor


New Bedford

Seven Hills Behavioral Health 1173 Acushnet Avenue


North Adams


By appointment

413-443-2844 or 413-387-8676



16 Center Street, Suite 423

413-586-0310 x2



100 Wendell Avenue



Brockton Area Multi-Services, Inc.

7 Scobee Circle




AIDS Support Group of Cape Cod 336 Commercial Street, Unit #10

866-668-6448 or 508-487-8311


Manet Community Health Center Various locations in: Braintree, Hull, Norwell, Quincy, and Weymouth

Call for more information




North Suffolk Mental Health 265 Beach Street



Tapestry, La Voz

130 Maple Street, lower level



AIDS Project Worcester 85 Green Street

(Entrance in rear at 12 Plymouth Street)

508-755-3773 x27

Learn to Cope

Please go to www.learn2cope.org or call 508-738-5148 for meeting locations and times.


25 Sep 2019

BY: mcare

Addiction / Blogroll / Substance Abuse / Treatment

Comments: No Comments

What is Naloxone and How to Use it?

What is Naloxone and How to Use it?

Naloxone (Narcan) is a legal prescription medication that reverses an opioid overdose. It cannot be used to get high and is not addictive. The most common form of Narcan available is the nasal application of the medication. These rescue kits come with two doses, the reason for which will be explained below.

If an individual is found to have the signs of an opioid overdose as explained above, the first step is to call 911. Once 911 has been called, rescue breathing will most likely be necessary. This will ensure that oxygen continues to be circulated throughout the body, allowing a greater chance for survival. Nasal Naloxone should be administered after rescue breathing has been initiated. The medication comes in a box and includes three separate pieces that are joined together.

Follow these steps to prepare for nasal administration:

Step 1: Remove everything that has color. There are three caps that need to be removed and depending on the brand of medication, the color may be different.

Step 2: Hold spray device and screw it to the top of the plastic delivery device.

Step 3: Screw medicine gently onto the delivery device.

Step 4: Spray half of the medicine up one side of the nose and half up the other side. Naloxone may work immediately but can take up to eight minutes to have an effect. If there is no change after 3 to 5 minutes, the second dose should be used. Continue rescue breathing until the individual begins to breathe on their own or help arrives. It is extremely important for the individual to go to the hospital for medical attention regardless of how they are feeling.

The effect of naloxone will last for approximately 30 to 90 minutes in the body. Because most opioids last longer than 30 to 90 minutes, the naloxone may wear off before the effects of the opioids wear off. A person can go into an overdose again. This depends on several things, including the following: the quantity and purity of opioids used; the presence of other drugs, like alcohol/benzo’s; how well the liver works to filter out the drugs and if the individual uses again after the naloxone is administered. Naloxone administration can be repeated without harm.

***Please note that naloxone causes withdrawal to occur. When the individual regains consciousness, they may be extremely angry as a result of this. Often times, they have a desire to use again immediately. It is important that the individual does not use again after receiving naloxone so that an overdose does not re-occur. If possible, remain with the individual until Emergency Medical Services arrive to transport them to the hospital.  

Local pharmacies may have Nasal Narcan for purchase with or without a prescription (Stop in or call to see if your specific pharmacy has it available)

Read: Where to get Narcan/Naloxone in Massachusetts?

25 Sep 2019

BY: mcare

Addiction / Blogroll / Featured / Substance Abuse / Treatment

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Opioid Overdose Prevention and Education


What is an overdose and why does it happen?

An overdose happens when a toxic amount of a drug or combination of drugs overwhelms the body. An individual loses the ability to cope with the drug, which may result in serious health risks including death. Opioid overdoses occur when an individual has such a large quantity of opioids in their system that they become unresponsive to stimulation and/or breathing is inadequate. This happens because opioids fit into specific receptors that also affect the drive to breathe. If breathing is impaired, oxygen levels in the blood decrease causing the victim’s lips and fingers to turn blue. The lack of oxygen eventually stops other organs like the heart and then the brain. This leads to unconsciousness, coma, and death. Brain damage starts to begin within three to five minutes without oxygen. With opioid overdoses, surviving or dying depends solely on breathing and oxygen.

Overdose Risk Factors

  • Using alone
  • Reduced tolerance
  • Mixing drugs with opioids, especially alcohol/benzo’s
  • Surviving a past overdose
  • Change in drug quality or source
  • Injection techniques
  • Major medical illness
  • Depression/mental illness
  • Fentanyl
  • Using in a new place
  • Overdoses that occur among many in clusters

Loss of Tolerance

Tolerance: When repeated use of a substance leads to the need for increased amounts of the substance to produce the same effect. Periods of abstinence can reduce tolerance and increase overdose risk.

Loss of Tolerance: This occurs when someone sustains a period of abstinence after long-term use. When someone loses tolerance and then takes the opioid drug again, they can experience serious adverse effects, including overdose, even if they use an amount that caused them no problem in the past.

Periods of abstinence may include the following: 1.) Re-entry into the community after a period of incarceration; 2.) Completion of detox; 3.) Long periods of not using whether in treatment or recovery.

Who Overdoses?

The following list includes some of the most likely individuals at risk for overdose:

1.) Experienced users, usually not “new users;”

2.) Injecting for over five to ten years;

3.) Someone who has overdosed in the past and has survived;

4.) Anyone who uses opioids for long-term management of chronic pain;

5.) Someone who has a legitimate medical need for analgesia, but has also been identified as having a suspected or confirmed history of substance abuse, dependence or non-medical use of prescription or illicit opioids;

6.) Someone who has been discharged from emergency medical care immediately following opioid intoxication or poisoning;

7.) Individuals who have a major mental health condition in addition to a substance use disorder; and

8.) Someone who is intentionally wanting to overdose.

What are the signs of an overdose?

Overdoses rarely occur immediately as television and movies would have one to believe. They usually occur between one to three hours after the drug is used.

Signs of overdose, which often result in death if not treated include the following:

Face is extremely pale and/or clammy to the touch, body is limp, fingernails or lips have a blue or purple cast, the person is vomiting or making gurgling noises, he/she cannot be awakened from sleep or is unable to speak, breathing is very slow or stopped, and heartbeat is very slow or stopped.

What is the “death rattle”?

Because opioids depress respiratory function and breathing, a telltale sign that a person is in a critical medical state is the “death rattle” – an exhaled breath with a very distinct, labored sound coming from the throat.

Emergency resuscitation will be necessary immediately, as it almost always is a sign that the individual is near death.

The “Good Samaritan” Law

From 2002-2008, 4500 Massachusetts residents died from opioid-related overdoses. Most of these deaths could have been prevented. In most cases, if 911 is called quickly, the victim will survive, but fear of police involvement and criminal prosecution prevents many people from calling for help. In fact, studies show that over 50% of individuals interviewed reported that they did not call 911 during an overdose for this very reason. On August 2, 2012, the Good Samaritan Act was signed into law.

What this law does: PROTECT people from prosecution for possession of controlled substances when calling 911, SAVE lives and give people who use opioids a chance to get help for their addiction, and INCREASE the likelihood that witnesses will call 911 during an overdose. The law does not interfere with law enforcement securing the scene at an overdose, prevent prosecution for drug trafficking, or prevent prosecution for outstanding warrants.

Preventing Overdose

Effective treatment of opioid use disorders can reduce the risk of overdose and help a person who is misusing or addicted to opioids attain a healthier life. Evidence-Based practice for treating opioid addiction is the use of FDA-approved medications (Methadone, Buprenorphine, Vivitrol), along with counseling and other supportive services. Naloxone, an antidote to opioid overdose, is also available without a prescription.

25 Sep 2019

BY: mcare

Addiction / Blogroll / Substance Abuse / Treatment / Uncategorized

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The Opioid Epidemic

In March 2014, the Governor of Massachusetts declared a public health emergency due to the growing abuse of opioids including prescription synthetic opioids as well as Heroin. Since that time, the number of overdose deaths in the United States has, for the first time, surpassed the number of deaths caused by motor vehicle accidents.

Massachusetts reported 1,282 confirmed opioid overdoses in 2014 and 1,379 in 2015.  The Center for Disease Control reports that the number of overdose deaths since 1999 has quadrupled in the United States. They estimate that between 2000 and 2014 approximately half a million people died from drug overdoses. That is approximately 78 Americans per day. Overdoses from prescribed opioid pain medication appear to be the driving factor in the 15-year increase in overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. has also quadrupled as well despite there being no change in the amount of pain that Americans report.

Why is Opioid Use So High?

Accessibility and availability of inexpensive Heroin have also played a role in the number of deaths that have been taking place across the country. Massachusetts, like many states in the U.S., has developed a task force dedicated to the prevention, intervention, treatment, and recovery of this disease.

The Massachusetts Department of Public Health collects overdose death data to track the progression of the opioid crisis and target services to especially hard-hit communities.

The following report contains both confirmed and estimated data through June 2016. The number of confirmed cases of unintentional opioid overdose deaths for 2015 represents an 18% increase over 2014, and the 2014 number represents a 41% increase over cases for 2013. Based on the data available as of 06/30/2016, The Department of Public Health estimates that there will be an additional 47 to 67 deaths in 2014 and 107 to 150 deaths in 2015, once these cases are finalized. For the first 6 months of 2016, the number of confirmed cases of unintentional opioid overdose deaths was 488, with an estimated additional 431 to 509 deaths. Current estimates for the first 6 months of 2016 are higher than the first 6 months of 2015.

(This information is taken from the following website: http://www.mass.gov/eohhs/gov/departments/dph/stop-addiction/current-statistics.html).

25 Sep 2019

BY: mcare

Addiction / Blogroll / Featured / Substance Abuse / Treatment

Comments: No Comments

Types of SUD’s (Substance Use Disorders)

Alcohol Use Disorders

Alcohol dependence is a chronic disease that requires medical and behavioral interventions to treat. For many people, drinking alcohol is nothing more than a pleasant way to relax. People with alcohol use disorders, however, drink to excess, endangering both themselves and others. For most adults, moderate alcohol use – no more than two drinks per day for a male and one for a female and older people – is relatively harmless. Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence. Individuals with severe alcohol problems get the most public attention, but even mild to moderate problems can cause substantial damage to the individual, their families, and the community.

What is Alcohol Abuse?

Alcohol abuse is a drinking pattern that results in significant and recurrent negative consequences. For example, alcohol abusers may be unable to fulfill major school, work, or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated, and they may have relationship problems related to their drinking.

People with alcoholism – technically known as alcohol dependence – have lost control of their alcohol use. It does not matter what kind of alcohol is being consumed, or even how much: Alcohol Dependent individuals oftentimes unable to stop drinking once they start. Alcohol dependence is characterized by tolerance and withdrawal symptoms if drinking abruptly stops. Withdrawal symptoms, depending on the severity are life-threatening. They can include nausea, sweating, restlessness, irritability, tremors, hallucinations and seizures.

The Impact of Alcohol Abuse

While some research suggests that small amounts of alcohol may have beneficial cardiovascular effects, there is widespread agreement that heavier drinking can lead to health problems. Short-term effects include memory loss, hangovers, and blackouts. Long-term problems associated with heavy drinking include stomach ailments, heart problems, cancer, brain damage, serious memory loss, and liver cirrhosis. Heavy drinkers also markedly increase their chances of dying from automobile accidents, homicide, and suicide. Although men are more likely than women to develop alcoholism, women’s health suffers more, even at lower levels of consumption. Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression or anxiety. Alcohol problems do not just hurt the drinker. Partners and children of heavy drinkers may face family violence; children may suffer physical and sexual abuse and neglect and develop psychological problems. Women who drink during pregnancy run a serious risk of damaging their fetuses. Relatives, friends, and strangers can be injured or killed in alcohol-related accidents and assaults.

When to Get Professional Help

Individuals often hide their drinking or deny they have a problem. Signs of a problem include having friends or relatives express concern, being criticized about the quantity, feeling guilty about drinking and thinking about cutting down, but being unable to do so, or needing a drink to steady nerves or relieve a hangover. Often times, individuals will initially attempt to treat themselves. In rare cases, with the support of friends and family, this is possible. However, those with alcohol dependence usually cannot stop drinking through willpower alone. Many need outside help. They may need medically supervised detoxification to avoid potentially life-threatening withdrawal symptoms, such as seizures. Once stabilized physically, many need help resolving psychological issues associated with their drinking.

Treatment Options

There are several approaches available for treating alcohol problems. Treatment is individualized, which means that it is based on the specific needs of the individual. These approaches include cognitive-behavioral therapy, coping skills development and management, and motivational enhancement therapy*.

Additionally, individuals may benefit from using self-help programs such as Alcoholics Anonymous (AA). These therapies have been proven to be effective. They help individuals to increase their motivation to stop drinking, identify circumstances that trigger drinking, learn new methods to cope with high-risk drinking situations, and develop social support systems within their own communities.

*See the Medication Assisted Treatment MAT for an explanation of an additional tool that can be used to treat alcohol use disorders.

Opioid Use Disorder

Opioids are a class of drugs that include the illicit drug heroin as well as the licit prescription pain reliever’s oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.

Opioids are chemically related and interact with opioid receptors in the brain and nervous system to produce pleasurable effects and relieve pain. If an individual uses an opioid regularly for a short period of time, they can become dependent.

Once an individual is dependent on an opioid, the absence of it causes extremely painful withdrawal symptoms. It is due to the withdrawal that the vicious cycle of this chronic disease continues as introducing an opioid back into the system causes almost immediate relief. Examples of opioid withdrawal include yawning, watery eyes, goosebumps, nausea, vomiting, diarrhea, stomach cramps, body aches, and pains and insomnia to name a few.

The Impact of Opioid Addiction

A significant factor that has contributed to the increased number of individuals using opioids, is the rate in which prescription opioids have been prescribed. In 2012, 259 million prescriptions for opioids were written, which is more than enough to provide each American with their own bottle of pills. Once an individual becomes addicted, they attempt to obtain the prescription medication from the Doctor repeatedly. Eventually, the Doctor realizes what is taking place and stops prescribing the medication. At this point, an individual may either “Doctor shop,” “Emergency Department surf,” or attempt to purchase the opioid pain medication illegally.

The street value of prescription opioids is so expensive, and the desperation to “get high” or avoid withdrawal is so great that many individuals try Heroin. Four in five new heroin users start out misusing prescription painkillers.

*See Opioid Epidemic and Prevent Opioid Overdose for more education and information

When to Get Help

Individuals that seek treatment early on in their addiction have a better chance for success in achieving sobriety. Therefore, the earlier an opioid use disorder is identified, the better. Most opioid users will require detoxification from the opioid. This is most commonly done at a detox center where medications are used to decrease the discomfort experienced during the withdrawal process. Therapy is recommended immediately.

Treatment Approaches

There are several approaches available for treating opioid dependence. Treatment is individualized, which means that it is based on the specific needs of the individual. Treatment approaches include cognitive-behavioral therapy, coping skills development and management, and motivational enhancement therapy. Additionally, individuals may benefit from using self-help programs such as Narcotics Anonymous (NA). These therapies have been proven to be effective. They help individuals to increase their motivation to stop using, identify circumstances that trigger use, learn new methods to cope with high-risk situations, and develop social support systems within their own communities. Due to the chronic relapsing nature of opioid dependence, medication-assisted treatment (Buprenorphine/Naloxone, Methadone, Vivitrol) is often necessary to assist an individual in the recovery process. Medication-assisted treatment alone does not work, but when joined with counseling and psychosocial support, it is extremely effective.


*See the Medication Assisted Treatment section for an explanation of the additional tools that can be used to treat opioid use disorders.

Cocaine Related Disorders

Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant. Individuals can snort cocaine powder through the nose, or rub it into their gums. Others dissolve the powder in water and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball. Another popular method of use is to smoke cocaine that has been processed to make a rock crystal (also called “freebase cocaine”). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack.

The Impact of Cocaine Use

The short-term health effects of cocaine include extreme happiness and energy, mental alertness, hypersensitivity to light, sound, and touch, irritability, paranoia—extreme and unreasonable distrust of others. Some people find that cocaine helps them perform simple physical and mental tasks more quickly, although others experience the opposite effect. Large amounts of cocaine can lead to bizarre, unpredictable, and violent behavior. Cocaine’s effects appear almost immediately and disappear within a few minutes to an hour. How long the effects last and how intense they depend on the method of use. Injecting or smoking cocaine produces a quicker and stronger but shorter-lasting high than snorting.

Some long-term side effects of cocaine depend on the method of use and include the following:

  • Snorting: loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.
  • Consuming by mouth: severe bowel decay from reduced blood flow.
  • Needle injection: higher risk for contracting HIV, hepatitis C, and other bloodborne diseases.

Cocaine overdose

An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. An overdose can be intentional or unintentional. Death from overdose can occur on the first use of cocaine or unexpectedly thereafter. Many people who use cocaine also drink alcohol at the same time, which is particularly risky and can lead to overdose. Others mix cocaine with heroin, another dangerous—and deadly—combination. Some of the most frequent and severe health consequences leading to overdose involve the heart and blood vessels, including irregular heart rhythm and heart attacks, and the nerves, including seizures and strokes.

Treatment Approaches

Behavioral therapy may be used to treat cocaine addiction. Examples include cognitive-behavioral therapy, contingency management, or motivational incentives—providing rewards to patients who remain substance-free, residential treatment—drug-free residences in which people in recovery from SUD’s help each other to understand and change their behaviors, and Narcotics Anonymous (NA) or Cocaine Anonymous (CA). While no government-approved medicines are currently available to treat cocaine addiction, researchers are testing some treatments.

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