Inpatient Rehab for Opioid Addiction Treatment

Author: Sy Shaffer

Opioid use disorder (OUD), along with other substance use disorders (SUD), are complex mental health conditions that can negatively affect all aspects of your life and ability to function.¹ Due to these complexities and the pervasive consequences, inpatient opioid addiction treatment could be the best choice to reach stable recovery.
In this article:

How Addictive are Opioids?
What is an Inpatient Opioid Rehab?
Therapy Treatment Options for Opioid Addiction
Benefits of Inpatient Opioid Rehab
Do I Need Inpatient Opioid Rehab?
How to Choose an Inpatient Treatment Center

How Addictive are Opioids?

Opioids, both prescription and illegal, are highly addictive substances. They bind to opioid receptors in the reward system of the brain, which causes a release of dopamine, resulting in intense feelings of pleasure. Other areas of the brain “remember” this pleasurable feeling associated with opioid use, something known as conditional associations.

These conditional associations are responsible for opioid cravings and continued use in pursuit of those same euphoric feelings. As such, opioid misuse can hijack the brain’s reward system by making opioids more rewarding than natural dopamine-releasing activities like eating food or having sex, causing people to seek out and use opioids despite negative effects in their life.

As opioid use continues, the opioid receptors become less responsive, and more of the substance is required to elicit pleasurable feelings. This increased tolerance often leads to repeated, increasing exposure to opioids, which then causes drug dependence, where you feel withdrawal symptoms when not taking the substance.

Opioids include both prescribed medications and non-medical substances. Opioid medications are usually prescribed to treat pain, and their addictions and misuse potential can be determined by their designation as Schedule II under the US Drug Enforcement Administration (DEA)’s schedule. This means these opioids have a high potential for abuse and an accepted medical use in FDA-approved medications. These include:

Codeine
Fentanyl
Morphine
Oxycodone
Oxycontin

Non-medical opioids include heroin, a Schedule I drug with high potential for abuse and no accepted medical use, and illicitly manufactured fentanyl. Opioids are also classified as a form of narcotic and can be defined as a central nervous system (CNS) depressant. ^3,4

What is an Inpatient Opioid Rehab?

Inpatient rehab is a 24/7 comprehensive treatment. These facilities provide counseling, medication management, meals, and lodging and are highly structured.² Programs can range from 30-90 days or even longer, depending on your needs, and every rehab has its own approach to treatment.

Some rehabs specialize in certain demographics, such as faith-based programs, facilities for LGBTQ+ individuals, or programs that have a holistic approach. Further, some facilities are more upscale than others and include more amenities and privacy. You can discuss which options would be best for you with your healthcare provider.

Regardless of the type of inpatient rehab you choose, research shows that the most effective treatment includes:¹

Examination and appropriate treatment for medical conditions
Strict routine that helps you focus on recovery
Understanding that addiction is a complex illness that affects the brain, behavior, and ability to function
A continually updated and individualized treatment plan to ensure needs are routinely met
Evidence-based behavioral therapies
Medications, as needed, during detox or for addiction management
Treatment for co-occurring mental health diagnoses
Monitoring of substance use
Employment counseling
Aftercare planning for long-term recovery

When you first enter an inpatient rehab for OUD, you will first be evaluated so providers can determine the extent of your opioid use. This evaluation will be used to create an individualized treatment plan for you that will include the types of services and therapies you’ll be provided during inpatient rehab. For example, if you are at risk of experiencing withdrawal complications from ceasing opioid use, your treatment plan may include medical detox before beginning therapy and counseling.

Medical Detox for Opioid Addiction Treatment

After your intake assessment, your treatment team may decide you need medical detox before beginning your treatment programming. Medical detox involves round-the-clock medical care and medications to alleviate opioid withdrawal symptoms and cravings. When you stop taking an opioid, you may experience unpleasant and painful withdrawal symptoms that can include but are not limited to:³

Agitation
Anxiousness
Body aches
Cravings or a strong desire to use
Gastrointestinal issues (i.e., nausea, vomiting, diarrhea)
Increased blood pressure, heart rate, internal temperature
Insomnia
Irritability
Running nose
Sweating

These symptoms can range from mild to severe and can last for several days, with some psychological symptoms lingering for months. Depending on the opioid, you may experience these withdrawal symptoms as early as 8 hours (e.g., heroin) or 36 hours (e.g., methadone) after you stop taking the substance.⁵

For a lot of individuals, the thought of experiencing these symptoms without medication or assistance can be scary. Withdrawing from opioids can result in severe physical, physiological, and psychological effects, but medical detox can help ease these symptoms.⁵ Depending on your treatment plan and program, you may receive methadone or buprenorphine to relieve your withdrawal symptoms, as well as any adjunctive medications to treat individual symptoms, such as anti-nausea medications.

Therapy Treatment Options for Opioid Addiction

Once you complete detox and your withdrawal symptoms have resolved, you’re ready to begin therapy. Most inpatient opioid rehab centers offer evidence-based behavioral therapies to help you understand and address your opioid use disorder. Such therapies help you build new skills and thought patterns to help maintain sobriety and reach long-term recovery. These therapies can include:¹

Cognitive Behavioral Therapy (CBT), which helps you become aware of how your emotions and thought patterns are tied to addictive behavior
Dialectical Behavioral Therapy (CBT), which helps you integrate the opposing concepts of accepting yourself as you are and working to change certain behaviors and thought patterns
Contingency Management Interventions/Motivational Incentives, which provide rewards in exchange for your positive behaviors, such as meeting goals
Family Behavior Therapy, which helps you and loved ones address behaviors and co-occurring issues in your home or daily environment

Additionally, some treatment centers may offer holistic treatment modalities, such as mindfulness practice, yoga, creative arts therapy, and acupuncture, which can complement your treatment plan and help aid in recovery.

Your mental health clinician may also assist with addressing other mental health disorders, such as depression, bipolar disorder, or panic disorder. Additionally, group therapies will help you develop social support and help you feel more connected to others with similar experiences. Making these connections can also help you build a recovery support network.

Medication-Assisted Treatment

Some individuals may be candidates for medication-assisted treatment (MAT) to manage their opioid addiction and prevent relapse while seeking further treatment. In these cases, MAT can complement a treatment plan that consists of behavioral therapy, as the medication makes it possible for you to focus and learn recovery skills.

Methadone

Methadone is an opioid medication that is prescribed and administered under the supervision of a specialized doctor and facility.¹ It is an effective medication to treat opioid addiction and is sometimes used during the detox process, as well. Methadone has a gradual onset of action, which produces a more stable level of the substance in the brain. This gradual onset does not produce the same rush that other opioids may elicit, dampening or suppressing the euphoric effects.

Methadone also markedly reduces the desire to use opioids. Research has shown that methadone in combination with behavioral treatments, such as CBT, is more effective than either treatment separately.¹ Research has also suggested that methadone treatment increases participation in therapy and decreases drug use and criminalized behavior.

Buprenorphine

Buprenorphine is also an opioid medication prescribed and administered under the supervision of a specialized doctor and facility.¹ It has also been shown to be an effective medication to treat opioid addiction and is also sometimes used in detox. Similar to methadone, buprenorphine does not provide a rush and can dampen or suppress the euphoric effects of other opioids.

Buprenorphine can effectively decrease the desire to use opioids. It is a partial agonist, meaning it will not produce the same euphoric effects as other opioids. Additionally, it has a ceiling effect, which means its potentially dangerous effects like respiratory depression plateau at moderate doses, significantly reducing the risk of overdose.

Naltrexone

Naltrexone is a synthetic opioid antagonist, meaning it blocks opioids from binding to receptor sites, thereby preventing its euphoric effects.¹ Naltrexone has recently become an approved medication for opioid addiction. It diminishes cravings for opioids, as well as alcohol.

Suboxone

Suboxone is a combination of two medications: buprenorphine, which reduces cravings, and naloxone, which prevents you from feeling the effects of opioids. Suboxone is only used to treat OUD addiction, and the medication tends to be prescribed for periods of less than a year, though individuals can take the medication at home, unlike methadone. Suboxone can help deter misuse of this medication because if someone injects it, they will immediately go into opioid withdrawal.

Benefits of Inpatient Opioid Rehab

Receiving treatment at an inpatient opioid rehab can have many benefits due to the comprehensive, 24/7 environment. Some of these benefits include:

Safe, structured, and controlled environment
Help with withdrawal
Access to specialists in the treatment of OUD and co-occurring disorders
Access to resources and aftercare planning
Supportive network and peer groups
Opportunities to learn more about your addiction and triggers
An environment completely focused on your recovery
The ability to form new habits and learn new skills
Limited contact with outside individuals and other external triggers

Do I Need Inpatient Opioid Rehab?

There are many treatment options for opioid addiction, so it is natural to wonder if inpatient opioid rehab is right for you. Inpatient rehab can be helpful for those who have a co-occurring disorder, such as mental health conditions, or who have acute or long-term opioid use disorders. It can also be helpful for those who have a limited support system to encourage recovery.

The main goal of treatment is to help you return to a level of productive functioning.¹ Research shows that many individuals who receive inpatient treatment for an extended period:

Reduce their criminal activity
Improve their occupational functioning
Improve their social and psychological functioning

A lot of individuals find that inpatient rehab provides structure, routine, and a break from their patterns of use. This supportive space can assist you in developing skills that you will then be able to transfer to your everyday life.

How to Choose an Inpatient Treatment Center

When considering treatment options for opioid addiction, it is vital to consult with a provider, whether that is your primary care physician or a treatment specialist. Your provider can assist you in determining what level of care may best fit your needs.

There are many things to consider when you compare opioid addiction treatment centers. The main factors you may consider are the following:

Location (e.g., close to home or traveling to)
Environment (e.g., views of the beach or mountains)
Cost
Length of treatment

Additional considerations include:

Reputation and accreditation of the center
Specialties that the center providers
Amenities and features
Therapeutic orientation (e.g., CBT, DBT, etc.)
Overall treatment outcomes of the center
Ability to access additional services and/or follow-up services

You will also want to consider more personal factors, such as:

Your physical health and any existing medical conditions that need care
Your responsibilities and how they will be taken care of (e.g., work and childcare)
Your ability to take time off of work
Your level of engagement in services
Your ability to follow program rules

Help is available for your substance use disorder. Our treatment specialists can be contacted at 800-994-1867Who Answers? 24/7 to help you find the right opioid addiction treatment for you.

Resources

National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition)
Wu, L.-T., Zhu, H., & Swartz, M. (2016). Treatment utilization among persons with opioid use disorder in the United States. Drug and Alcohol Dependence, 169, 117-127.
National Institute on Drug Abuse. (2018). Prescription CNS depressants drug facts
National Institute on Drug Abuse. (2020). What classes of prescription drugs are commonly misused?
Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment.