When you are opiate dependent an increasing need to get drugs (that are very expensive) on a daily basis will have a dramatic effect upon your income, your ability to maintain your job, your home life, your relationships and your health.
If you have decided to do something about your drug use, we offer treatment options which aim to help you work towards regaining some structure in your life and eventually to stop using opiates.
How do I get treatment?
Once you have decided to do something about your problem, you may have a sense of urgency to be seen by someone immediately. However, treatment cannot begin until a full assessment is carried out.
Someone will always see you for an assessment as soon as possible. Generally, from when your referral is taken, assessment and treatment will start within 2 to 4 weeks. This will depend on how busy we are and also on your individual needs.
Your information will be dealt with confidentially; this will be explained to you in more detail when you are seen.
How do you assess my problems and needs?
The first assessment is confidential and will last about one hour. A detailed assessment of your history and your past and current drug use will be taken, as well as an assessment of your motivation to address your drug taking behaviour. We will discuss with you the various treatment options that are available and which treatment may be best suited to you.
It is also important at this stage to talk to you about the various health risks associated with opiate use, particularly if you have been using drugs intravenously. You will be offered overdose prevention and management and safer injecting information. You will also be offered blood-borne virus screening and support. We strongly encourage you to accept these interventions, but it is your choice whether to or not.
Withdrawal symptoms
A person who is opiate dependant can experience physical withdrawal symptoms when trying to stop; these can include symptoms such as:
- agitation
- anxiety
- muscle aches
- runny nose
- sweating
- yawning
- insomnia
These symptoms will reach their peak 12 to 24 hours after your last dose (and include flu like symptoms such as abdominal cramping, diarrhoea, goose bumps, nausea, vomiting and dilated pupils between 36 and 72 hours after the last dose). They will have subsided substantially after 5 days.
Physical and psychological dependence on opiates can develop quickly within a relatively short period of continuous use (2-10 days) (ref NICE 2007).
Dependence makes it very difficult to stop drug use - and this together with the fact that it is illegal can result in your life becoming chaotic and unmanageable quite quickly.
Methods of treatment available
To help you to move away from illicit drug use, opiate substitution using methadone or subutex / suboxone may be offered, preferably for a short period of time (detox) but sometimes for longer periods. This is offered along with problem solving and coping skills, relapse prevention and motivational work towards achieving a drug-free lifestyle choice.
Substitute prescribing
This is offered as a means of reducing harm and stabilising your lifestyle. It aims to benefit you by:
- reducing the use of illicit opiates
- reducing the risk of death and disease
- reducing involvement in crime
- improving your well being and future possibilities
Substitute prescribing is suitable for people who want to stop using opiates altogether, wish to reduce their consumption of opiates, or who currently have adverse circumstances (eg are homeless, pregnant or offending as a result of their drug use).
It is likely to be a better option than detox if you have been addicted for longer periods of time, if you often inject or if you have high levels of drug use.
Subutex detoxification treatment
This treatment is suitable for individuals who are motivated to come off opiates and whose circumstances are stable and conducive to staying off opiates. Younger users, people with a low level of drug use who have used drugs for a shorter period of time, and those who rarely inject opiates would also be suitable for this method of treatment. It is better if you do something about your drug use and get help sooner rather than later.
Detoxification using Subutext may range from 12 days to 36 days depending on what is right for you.
Naltrexone
Naltrexone is an opiate blocker. This means that if you use any form of opiate whilst you are taking Naltrexone you will experience no effect - Naltrexone blocks the receptors in the brain that would normally respond to opiates.
Naltrexone is a recommended treatment for anyone who has finished a substitute prescribing programme or has stopped taking opiates and is wishing to stay clean. It is highly recommended, particularly in the early stages of being opiate free.
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