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UK-CNS-Nalo-01409 | July 2024

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This health awareness website was created by Accord-UK Ltd and is intended for members of the general public.

Treating

OPIOID

ADDICTION

For someone wanting to overcome an opioid addiction, the GP is a good place to start –
they will discuss any concerns and may offer treatment, or refer to a local drug treatment
service. From medication-assisted therapies to self help tools, here we summarise the
various ways that opioid addiction can be treated.

Opioid withdrawal

and detox

Opiate detoxification (or ‘detox’ for short) is the process of removing opioids from your body and managing the withdrawal symptoms that come with it.

Detox is an essential part of treatment because it allows someone to break the physical dependence on opioids and start working on the psychological aspects of their addiction.1

Withdrawal symptoms can be extremely uncomfortable and range from mild to severe and can also be both physical and psychological.1

COMMON OPIOID WITHDRAWAL
SYMPTOMS INCLUDE:

Slow breathing

Trouble staying awake

Pinpoint pupils

Pale face

Blue nails and lips

Cold, clammy skin

Confusion and forgetfulness

Disorientation

Unpredictable mood swings

Low blood pressure

Chronic vomiting

People who experience mild or specific
symptoms of opioid withdrawal, like
diarrhoea, nausea/vomiting, or colic,
can receive symptom-based
treatment. This may involve
medications such as loperamide,
prochlorperazine, mebeverine, NSAIDs,
or paracetamol.2

Navigating

opioid withdrawal1

Embarking on the journey of opioid withdrawal can be challenging, but understanding what to expect can make the process more manageable. With proper care and support, you can successfully navigate through the stages of withdrawal.

 

 

The journey

THROUGH withdrawal

Day 1

The Journey Begins

The first day of withdrawal is usually the toughest. Intense cravings accompany a range of physical and psychological symptoms that can feel uncomfortable.

Day 2

Peaking Symptoms

On the second day, symptoms typically peak. Flu-like sensations, including a runny nose, sweats, nausea, and vomiting, may dominate. Anxiety, irritability, and insomnia can add to the discomfort.

Day 3

Signs of Improvement

As you reach day three, a glimmer of relief emerges. Though discomfort persists, there’s a noticeable improvement, and you’ll begin to feel more like yourself.

Day 4

Easing Up

Day four brings a further easing of withdrawal symptoms. While not entirely gone, they should be notably less intense than in the initial days.

Day 5

Turning the CorneR

By the fifth day, many people experience a significant improvement. Although mild symptoms like insomnia, anxiety, and irritability may persist for another week, the worst is behind.

Medicines for treating

opioid addiction

OPIOID SUBSTITUTION THERAPY

Opioid substitution therapy (OST) is a widely used and effective approach for treating opioid addiction.

It involves the prescription of medicines that can help someone to manage withdrawal symptoms and cravings once they have stopped taking the opioid they are addicted to.2

In the UK there are two main types of OST used to help treat opioid addiction: methadone and buprenorphine.3

TREATMENT DURING OPIOID DETOXIFICATION

When someone has stabilised on an OST the process of detoxification (detox) can begin. Detox involves carefully removing the OST from the body while safely managing withdrawal symptoms.1,2 It is a critical step on the journey to recovery from opioid addiction, but requires close monitoring and support.2

Some medications can be prescribed during detox to help reduce many of the symptoms experienced during withdrawal from opioids.

Some of the symptoms

that can be treated
during detox4

Cravings

Sweating

Shivering

Anxiety

Agitation

Nausea

Insomnia

Pain

Runny nose and eyes

Diarrhoea

Treatment for

preventing overdose

Anyone who takes an opioid can be at risk of an overdose. The effects of an opioid overdose are life-threatening – breathing slows down and can eventually stop altogether.

Naloxone is a medicine that can quickly reverse the effects of an opioid overdose and restore normal breathing to an individual experiencing a life-threatening situation.5

How naloxone

works

Naloxone works by binding to the same receptors in the brain that opioids bind to, blocking the opioid and reversing its toxic effects.5

Naloxone is a prescription-only medicine, so pharmacies cannot sell it over the counter.

However, drug treatment services can supply it without a prescription and anyone can use naloxone to save a life in an emergency.6

NHS Drug

Treatment Services

Receiving support for opioid
addiction is a crucial step
towards recovery, and the
NHS offers comprehensive
drug treatment services
designed to assist individuals
on their journey to a
healthier, more fulfilling life.

What are

Drug Treatment
Services?

Drug Treatment Services are a range
of supportive and personalised care
and treatment options to help people
overcome alcohol and drug addiction, including addiction
to opioids.

These services are delivered by a
team of healthcare professionals with
expertise in addiction treatment. The
approach is rooted in compassion
and understanding, focusing on the
unique needs of each person.

VISITING A DRUG TREATMENT

SERVICE FOR THE FIRST TIME7

During your first appointment, the
staff will ask you about your drug use.
They will also ask about your family
life, work, and housing situation.

You might be asked to provide
a sample of saliva or urine.

Staff will guide you through all
the treatment options suitable for you
and will also be able to let you know
about local support groups for drug
users and their families or carers.

You will be assigned a keyworker
who will be able to support you
throughout your treatment journey.

Your keyworker will work with you
to create a treatment plan based
on your personal circumstances.

The personal

treatment plan7

The personal treatment plan may include a number of different treatments and strategies. These may be given while living at home or as a hospital inpatient.

Opioid

SUBSTITUTION
therapy (OST)

Medical treatment may be
prescribed for people with
opioid dependence.

Detoxification

support

Drug treatment services can also provide guidance and medical support for people undergoing opioid detoxification.

Talking

therapies

Talking therapies can include cognitive behavioural therapy (CBT), which may help someone to understand how their thoughts and feelings affect their behaviour.

Self-help

The keyworker will have information on local support groups such as UKNA (UK Narcotics Anonymous), which can be helpful to some people.

Reducing

risk

Drug treatment services may also provide testing and treatment for hepatitis or HIV infections, as well as help to reduce other risks associated with opioid misuse.

IF THE OPIOID-RELATED
PROBLEMS ARE SERIOUS OR
COMPLICATED, THE PERSON MAY
BE REFERRED TO A RESIDENTIAL
DRUG REHABILITATION SERVICE.

Drug

rehabilitation

Drug rehabilitation, often called rehab, is a drug treatment programme that is given in a residential setting so that experienced medical care can be provided 24/7.

Rehabs usually involve complete abstinence from opioids, and an intensive combination of medical, therapeutic, and supportive interventions to help with the physical, psychological, and social impacts of addiction.8

What drug

REHABILITATION
involves9

Rehab often involves three types
of treatment or therapy:

 

 

MEDICAL DETOXIFICATION

In some cases, rehabilitation begins with medical detoxification to safely manage withdrawal symptoms under medical supervision

PSYCHOLOGICAL THERAPIES

Rehabilitation can include individual and group counselling, and may involve a variety of psychological therapies such as cognitive behavioural therapy

HOLISTIC THERAPIES

Sometimes holistic therapies such as music therapy, yoga and meditation are included in the rehab programme to help people reconnect with old hobbies or introduce them to new activities

A typical day

in rehab10,11

Morning

Routine

A HEALTHY BREAKFAST

A GROUP MEDITATION SESSION

GROUP THERAPY

Lunch

Break

ALLOWING TIME FOR
REST AND RECOVERY

Afternoon

activities
might include

ONE-TO-ONE THERAPY

BOOK STUDIES FOR OPIOID ADDICTION

ONGOING PERSONAL PROJECTS

WORK SESSIONS WITH OTHER RESIDENTS

DOMESTIC TASKS OR GARDENING

How to find your

local REHABILITATION
centre

UK Addiction Treatment Centres: offers a range of private addiction treatment and rehabilitation services. They can be contacted directly for information on available programs.

Visit the UK Addiction Treatment
Centres website

 

NHS Rehab Services: the NHS does not provide residential rehab, but it is sometimes possible to be referred to a private service for free or subsidised residential rehabilitation. However, there can be a very long waiting list and patients must meet strict
eligibility criteria.

Rehab-Online Directory: Rehab-Online provides information on rehabilitiation and can help you
locate rehabilitation services near you.

Visit the Rehab-Online website

Self-help

methods

Self-help involves someone taking an active role in their own recovery journey. It may not replace professional treatment, but self-help tools can be valuable for some people.

Therefore, understanding when self-help tools can be beneficial and when medical assistance is necessary is crucial for effective recovery.

DO I NEED HELP?

This is a question that only we can answer ourselves, but acknowledging the need for help is a courageous first step in overcoming opioid addiction.12

Visit the section:

Understanding opioid addiction

…to learn about the typical signs of an opioid addiction.

For more information:

Narcotics Anonymous UK

…provides a useful list of questions that can be asked to help identify an addiction.



There are many different ways that self-help can be achieved, and a wide variety of digital tools and online resources are available to provide information and allow people to self-manage their recovery from opioid addiction.14











IS MEDICAL HELP NEEDED?

If experiencing severe withdrawal symptoms or struggling to manage addiction alone, seeking medical help is essential.13

The section:

Opioid withdrawal and detox

…describes some of the common symptoms of withdrawal from opioids.

Some examples of

self-help tools
available online




TALK TO FRANK16

Provides honest information, help, and advice about drugs, including opioids.

You can call the free Frank helpline on:

0300 1236600

CLICK HERE TO FIND OUT MORE

SMART Recovery15

Offers a set of proven tools and techniques to help people decide if they have an addiction and for
self-directed recovery.

CLICK HERE TO FIND OUT MORE

Breaking Free17

Offers a confidential wellness and recovery support program, including a companion mobile application.

CLICK HERE TO FIND OUT MORE

SUPPORT

GROUPS

Self-help doesn’t have to be a task that is faced alone. Embarking on the journey to recovery from opioid
addiction is a courageous step, and having a
supportive community can make all the difference.

In the UK, various support groups offer understanding, encouragement, and shared experiences to empower individuals on their path to recovery.

Some examples of

UK support groups for opioid addiction

UK Narcotics Anonymous:18

SMART Recovery Online Meetings:19

Sober Recovery20

UK Narcotics Anonymous:18

Narcotics Anonymous is a community of people who support each other. They hold regular free group meetings both online and face-to-face throughout the UK, helping addicts to stop taking drugs, get well and change the quality of their lives.

CLICK HERE TO FIND OUT MORE

SMART Recovery Online Meetings:19

SMART Recovery promotes choice in recovery by holding online training programmes and mutual-aid meetings for people recovering from addiction to drugs including opioids.

CLICK HERE TO FIND OUT MORE

Sober Recovery20

Sober Recovery hosts a community of more than 175,000 people through online discussion forums for drug and alcohol users, and their friends and family.

CLICK HERE TO FIND OUT MORE

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References

  1. UK Addiction Treatment Centres. (2023). Opiate withdrawal | Opioid detox treatment. [online] Available at: https://www.ukat.co.uk/detox/drug/prescription/opiate/ [Accessed July 2024].
  2. NHS Lanarkshire Guidelines (2022). Opioid Dependence. [online] Available at: https://rightdecisions.scot.nhs.uk/nhsl-medicines-guidance/joint-adult-formulary/chapter-4-central-nervous-system/drugs-used-in-substance-dependence/opioid-dependence/ [Accessed July 2024].
  3. Public Health England (2021). Part 1: introducing opioid substitution treatment (OST). [online] GOV.UK. Available at: https://www.gov.uk/government/publications/opioid-substitution-treatment-guide-for-keyworkers/part-1-introducing-opioid-substitution-treatment-ost [Accessed July 2024].
  4. National Collaborating Centre for Mental Health (UK) (2008). Drug Misuse: Opioid Detoxification – The NICE Guideline [online] PubMed. Leicester (UK): British Psychological Society (UK). Available at: https://www.ncbi.nlm.nih.gov/books/NBK50622/ [Accessed July 2024].
  5. National Institute on Drug Abuse (2022). Naloxone drug facts. [online] National Institute on Drug Abuse. Available at: https://nida.nih.gov/publications/drugfacts/naloxone [Accessed July 2024].
  6. Department of Health and Social Care (2016). Widening the availability of naloxone. [online] GOV.UK. Available at: https://www.gov.uk/government/publications/widening-the-availability-of-naloxone/widening-the-availability-of-naloxone [Accessed July 2024].
  7. NHS (2022). Drug addiction: getting help. [online] nhs.uk. Available at: https://www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help/ [Accessed July 2024].
  8. Rehab-Online. (2024). Rehab-Online - UK’s leading Directory of Rehabilitation services. [online] Available at: https://rehab-online.org.uk/ [Accessed July 2024].
  9. UK Addiction Treatment Centres. (2024). Opiate rehab | Opioid addiction treatment | UKAT. [online] Available at: https://www.ukat.co.uk/rehab-treatment/drug/prescription/opiate/ [Accessed July 2024].
  10. UK Addiction Treatment Centres. (2024). Rehab treatment | Addiction treatment for alcohol & drug. [online] Available at: https://www.ukat.co.uk/rehab-treatment/ [Accessed July 2024].
  11. Rehab-Online. (2020). FAQs - Rehab-Online. [online] Available at: https://rehab-online.org.uk/faqs/ [Accessed July 2024].
  12. Narcotics Anonymous World Services, Inc (2009). Am I an Addict? [online] Available at: https://www.na.org/admin/include/spaw2/uploads/pdf/litfiles/us_english/IP/EN3107.pdf [Accessed July 2024].
  13. World Health Organization (2010). Self-help strategies for cutting down or stopping substance use – A guide. Available at: https://iris.who.int/bitstream/handle/10665/44322/9789241599405_eng.pdf?sequence=1 [Accessed July 2024].
  14. Torbay and South Devon NHS Foundation Trust. (n.d.). Drug and alcohol Self-management tools. [online] Available at: https://www.torbayandsouthdevon.nhs.uk/services/drug-and-alcohol-service/self-management-tools/ [Accessed July 2024].
  15. UK Smart Recovery. (2019). UK Smart Recovery. [online] Available at: https://smartrecovery.org.uk/ [Accessed July 2024].
  16. Frank (2019). FRANK. [online] Talktofrank.com. Available at: https://www.talktofrank.com/ [Accessed July 2024].
  17. Breaking Free Online. (n.d.). Breaking Free Online | Recovery Program for Alcohol & Drugs. [online] Available at: https://www.breakingfreeonline.com/ [Accessed July 2024].
  18. UKNA. (n.d.) Narcotics Anonymous in the UK. [online] Available at: https://ukna.org/ [Accessed July 2024].
  19. UK SMART Recovery. (n.d.). About Online Meetings. [online] Available at: http://smartrecovery.org.uk/online-meetings [Accessed July 2024].
  20. Sober Recovery. (n.d.). Drug Rehabilitation | Drug Addiction Treatment Center | Alcoholism | Addiction Mental Health | Directory Substance Abuse Detox Programs | SoberRecovery. [online] Available at: https://www.soberrecovery.com [Accessed July 2024].