SARA

According to the National Institute on Drug Abuse (NIDA), people believe at first that they can stop using drugs on their own, but after several attempts and returning to drug use, many don't succeed in long‑term abstinence. They spend time making sure that they continue to keep a level of drug in their system in order to avoid the intense withdrawal symptoms.

Misuse of opioid prescription painkillers and/or heroin may cause changes in the chemistry of the brain, which can lead to opioid dependence. Like other chronic diseases, opioid dependence can be treated. One option for treatment is to use medication, counseling, and behavioral therapy together.

Opioid dependence may not be able to be cured, but it can be treated and managed. As most chronic diseases, drug dependence also has both physiological and behavioral components. Incorporating both medication and changes in behavior may be helpful in treatment.

Not everyone who uses drugs (prescribed or otherwise) becomes dependent. Risk factors for dependency may include genetic or environmental factors, behavioral issues, or other conditions, such as anxiety and depression.

No. Buprenorphine and methadone are prescribed or administered under monitored, controlled conditions and are safe and effective for treating opioid addiction when used as directed. They are administered orally or sublingually (i.e., under the tongue) in specified doses, and their effects differ from those of heroin and other abused opioids. Heroin, for example, is often injected, snorted, or smoked, causing an almost immediate "rush," or brief period of intense euphoria, that wears off quickly and ends in a "crash." The individual then experiences an intense craving to use the drug again to stop the crash and reinstate the euphoria. The cycle of euphoria, crash, and craving—sometimes repeated several times a day—is a hallmark of addiction and results in severe behavioral disruption. These characteristics result from heroin’s rapid onset and short duration of action in the brain.

Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.

In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.

Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum, and some opioid-addicted individuals continue to benefit from methadone maintenance for many years.