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How effective is treatment for opioid addiction?

The scourge of the opioid addiction crisis has left the nation reeling. According to the National Institute on Drug Abuse (NIDA), over 115 people die every day in the U.S. after overdosing on opioids such as oxycodone, hydrocodone, morphine, fentanyl and heroin.

How did the opioid crisis come about?

According to NIDA, the trouble began in the late 90s, when pharmaceutical companies told the medical community that opioid painkillers were associated with low rates of addiction. In response, healthcare providers increased the rate of prescription. In reality, prescription opioids are easily misused and frequently cause addiction. Overdose rates started to increase. In 2015, over 33,000 Americans died from opioid overdoses.

Some facts about opioid addiction in the United States:

  • Between 21 and 29 percent of those prescribed opioid medications for chronic pain misuse those medications.
  • Between 8 and 12 percent of those who misuse opioids prescribed for chronic pain are later diagnosed with an opioid use disorder.
  • Between 4 and 6 percent of those who misuse opioid painkillers end up transitioning to heroin, which is chemically similar.
  • Around 80 percent of heroin users began using the drug after misusing prescription opioids.
  • Between July 2016 and September 2017, opioid overdoses rose by 30 percent in 45 states -- 70 percent in the Midwestern region.

The suffering is real and, although many strategies are being tried, people addicted to opioids need effective treatment options.

Is opioid addiction treatment effective?

The goal of drug addiction treatment is not only to stop drug abuse but also to return the person to a functioning, productive life within their family, workplace and community. The good news, according to NIDA, is that most people who become involved in drug treatment are able to stop using drugs, decrease criminal activity, and improve their social, psychological and occupational functioning.

That said, not all treatment programs are equally effective. Success depends in part upon the extent and nature of the person’s problems, but also upon the appropriateness and quality of the treatment program and especially on the quality of interactions between the person and the treatment providers.

Poor quality, non-evidence-based programs may be ineffective. Worse, they could actually put the addict at risk for overdose. Some programs even risk neglect, physical and sexual abuse, and death among patients, so you should carefully investigate any treatment program you are considering.

One thing to understand is that addiction is a chronic disease in which relapse is not only possible but likely. This is because addiction’s symptom recurrence rate is similar to other chronic illnesses with both physiological and behavioral components.

For example, between 30 and 50 percent of those treated for Type I diabetes relapse after treatment. For hypertension and asthma, the relapse rate is between 50 and 70 percent. For drug addiction, the relapse rate is between 40 and 60 percent. That said, the severity of the behavior is likely to be lower during a relapse than it was before treatment.

Unfortunately, many people assume that relapse means that addiction treatment was ineffective. In truth, addiction treatment often requires ongoing evaluation and modification like other chronic diseases.

In summary, appropriate, quality addiction treatment is generally effective, although people may experience relapses. These are to be expected and managed via ongoing evaluation of the disease and corresponding modifications in treatment as you would expect from any chronic illness.

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