What are opioids?
Opioids are Schedule II prescription drugs used for the treatment of short-term and chronic pain. Common examples include:
History of opioids and their effect on health in the US
During the early 1980s, opioids became the drug of choice for short-term pain management. Early marketing by drug companies supposedly guaranteed (without evidence) that opioids were not addictive and were generally safe to use. Eventually, the prescription of opioids began increasing as physicians were reassured that the risk of addiction to prescription opioids was low.
In the 1990s, drug companies began to release prescription opioids that were approved for long-term chronic pain management. This was a turning point for the opioid epidemic, as more of the population began to gain access to opioids in larger quantities. More over-the-counter opioid medications became available.
In 2017 the United States Department of Health and Human Services declared a public health emergency and announced a strategy to combat the ‘Opioid Crisis’. On average, about 130 Americans die from opioid overdose per day.
How do opioids and opiates work?
An opioid is a chemical such as Fentanyl that resembles opiates in its pharmacological effects. Opiates are naturally occurring (from the opium poppy) drugs such as heroin, morphine, and codeine. It is illegal to use opioid and opiate substances without a prescription. The pain-killing effects of opioids and opiates are due to:
- Decreased perception of pain.
- Decreased reaction to pain.
- Increased pain tolerance.
Side effects & dependence
Opioids can also help with cough suppression, which can be both an indication of opioid administration or an unintended side effect. The side effects of opioids include:
- Respiratory depression
- A strong sense of euphoria.
Opioid dependence can develop quickly, leading to severe withdrawal syndrome when a patient stops the drug suddenly. Morphine-like opioids are well known for their ability to produce euphoria, motivating some to use opioids recreationally. This behavior often leads to addiction.
In 2013 between 28 and 38 million people used opioids recreationally. Opioids work by binding to opioid receptors which are found principally in the central , peripheral nervous system, and the gastrointestinal tract. These receptors mediate both the psychoactive and the somatic effects of opioids. Opioids are among the world’s oldest known drug types—with evidence that the therapeutic use of the opium poppy predates recorded history.
How does drug addiction form?
The word ‘addiction’ stems from a term called neuroadaptation. Neuroadaptation is the body’s ability to continue to perform properly when something new, such as a drug or substance, is introduced. The body will start adjusting itself to compensate for the newly introduced substance.
One of the chemicals that our body self produces and releases are known as ‘endorphins’. They are our body’s ‘natural opioids’ and work to appropriately keep our bodies balanced. Endorphins are also known as ‘feel-good hormones’ and have important effects on our bodies. Endorphins are the body’s natural anti-depressant, they also regulate our body’s, sleep functions, pain management, weight management, blood pressure, etc.
Every person produces endorphins in their body. The body’s individual scale of endorphin production is determined by a variety of factors such:
- Internal stimuli
- Physical exertion
- Physical disorders
- Intellectual stimuli
When an individual takes any narcotic drug, the opioid will bind to the neuroreceptors in the central nervous system. A receptor is a protein within the body that allows chemicals such as endorphins or opiates to attach to it. When the chemical attaches to the receptor, the body will create some type of response. In this case, after taking an opioid, the chemicals will bind to opioid receptors and reduce the perception of pain while increasing euphoria.
When the opioid’s effects are gone, the endorphins will return to their baseline levels before you exposed yourself to the drug. Individuals that develop an opioid dependency will, over time, start to overwhelm the body’s natural response to produce endorphins. This means that overuse of the opioid will cause an individual’s body to stop creating its natural scale of endorphins, while also increasing the number of receptors that the endorphins could bind to.
As an individual increases the use of an opioid, more and more receptors are produced, while fewer endorphins are naturally released. The individual will then require greater doses of the opioid to satisfy this unregulated number of receptors. If the individual does not continue to meet this new demand and decides to stop taking opioid drugs, they will begin to experience unpleasant symptoms, known as opioid withdrawal symptoms.
This means that the individual is now opioid-tolerant or dependent and will start to crave more opioids, to try and get the same effect from them. Unless, of course, the endorphin-receptor balance is restored.
This develops into a vicious, constant cycle with increasing dosages and abuse. As more receptors are produced, the individual requires greater doses of opioids/narcotics to achieve their ‘balance’.
The scale increase in the number of endorphin/opioid receptors is now associated with a ravenous bio-physical and neuro-chemical hunger called cravings. Unless the endorphin receptor balance is restored to its original state, the addict is doomed to a life of pain, severe withdrawal, relapse, and dependency. Immediate cessation of drug use will cause withdrawal.
What are the symptoms of opioid and opiate withdrawal?
The symptoms and management of opioid withdrawal may start just a few hours after the last dose of any short-acting opioid drugs, and around 30 hours after the last dose of any long-acting opioid drug abuse. These opiate withdrawal symptoms contain a few different stages. Symptoms of withdrawal scale from mild to severe, across early and late periods.
When going through opiate withdrawal, a patient will begin to experience a combination of the following signs and acute withdrawal symptoms:
- Stomach aches
- Muscle spasms
- Runny nose
- Constricted pupils
- High blood pressure
The combination of extreme anxiety with an underlying depressive disorder can cause patients to respond by overcorrecting their attempts to self-medicate. In many cases the underlying depression can result in acute desperate actions and effects that could be life-threatening, sometimes resulting in death. Abrupt discontinuation of opioids can often cause more problems.
The symptoms of withdrawal timeline vary on the individual substance abuse or substance use disorders. With any short-acting opiates such as Percocet, OxyContin, oxycodone, etc. opiate withdrawal will most likely start 4 – 12 hours after the last dose. With a long-acting opiate such as methadone, Subutex, or Suboxone, onset of withdrawal symptoms will start around 30 hours after the last dose.
The following symptoms are considered to be ‘early’ in the withdrawal process and can include:
- Watery eyes
- Running nose
- Vomiting and diarrhea
- General body pain
- Intense anxiety
- Elevated heart frequency
- High blood pressure
- Elevated sugar levels
The ‘late’ withdrawal process will start within 2 – 4 days of the last dose of opioids and will include:
- Severe opiate and drug craving
- Severe fluctuation of blood pressure
- Elevated heart rate
Depending on the specific opioid being used, as well as the general medical health of the patient, withdrawal from opioids can be aggravated or create other complications.
The stigma around opioid addiction
The stigma surrounding opioid drug addiction can be very challenging and put tremendous pressure on patients and their families. There exists a negative and incorrect viewpoint that those who are opioid -dependent are in fact addicted and cannot get help, or they must stay at a traditional rehab center for weeks and maybe months at a time. The stigma also stems from the fact that the patient may have been using illicit substances to get high.
Some even think they must go through a long detoxification period with a lot of pain and suffering, or remain dependent on replacement medications like methadone or suboxone. Oftentimes, these patients do not have the proper support from friends and family, or on the other hand, they are given ineffective home remedies.
Together, all of these experiences can cause patients abusing opioids to feel a lot of pressure, and depression, believing that they do not deserve help. With ANR, treating opioid dependency and addiction using modern medicine is the only way to address the dependency at its core without suffering.
Opioid substance addiction and treatment of opioid withdrawal
Evidence shows that opioid addiction is a medical condition that occurs when the body’s natural endorphin system is unable to balance itself. Opioid addiction symptoms come about because the endorphin system gets used to exposure to external opioids. This is because opioids are made to mimic the body’s natural endorphins.
This disorder must be treated medically, to help restore the balance of the body’s endorphin system. Opioid addiction has very little to do with addictive personalities or behaviors. In fact, many addictive tendencies arise due to the mental health of patients attempting to cope with their opioid dependency or opioid addiction.Opioid addiction is primarily a physical disorder — not a mental one.
Only the ANR treatment, which was established by Dr. Andre Waismann, has been shown to treat opioid ‘addiction’ or dependence, by medically regulating the chemical imbalance and treating opioid use disorder.
What is the best treatment for opioid withdrawal management?
Currently, ANR treatment is the only medical treatment for opioid use that is shown to restore the endorphin-receptor balance in individuals with opioid use disorders. While many forms of long-term rehabs or other treatment options attempt to alleviate the adverse effects of withdrawal from opiates, the ANR treatment targets the physiological mechanism behind dependency, attacking the issue at its roots.
While most simple detox treatments can take weeks to take effect, ANR allows patients a full recovery in just a few days, so that they can enjoy healthy living without risks of further withdrawal symptoms or relapse.
The ANR procedure explained
The ANR procedure itself lasts approximately four to five hours and requires the patient to be hospitalized for about 30 hours. The medical work-up and procedure itself currently take place at DeSoto Memorial Hospital in Arcadia, Florida.
The first step of the hospitalization is admission to the ANR unit of the hospital. During this time, patients undergo full laboratory work-up and clinical examination to prepare the individual for their medically assisted treatment. The medical evaluations from our healthcare team include but are not limited to:
- Blood pressure
- Liver functions
- Kidney functions
- Blood count
- Electrocardiogram, etc.
Pre-medication will be administered to patients during this period as well, to provide a comfortable transition into the procedure state. Once preparations are completed, the patient will be placed under deep sedation and will be monitored for a period of 4 – 5 hours by a staff of intensive care nurses and anesthesiologists.
During the procedure,, the body’s opioid receptors are cleansed and blocked in an individualized manner using naltrexone. This is done only after a review and analysis of the patient’s specific receptor status, and a thorough and intense medical evaluation—which provides a procedure tailored to the individual.
During the procedure, only after the patient is fully sedated, medication is administered to induces the onset of withdrawal symptoms in the patient while they are asleep. This allows the patient to be cleansed of any opioid substances in their system, without suffering the pain associated with the symptoms of opioid withdrawal. This process will continue until the patient is balanced and there is no longer a need for sedation.
The first stage of recovery begins immediately after the patient is awakened. The patient will continue to be evaluated and will be given recovery guidelines to adhere to. Continued adjustments to their endorphin-receptor balance can be made during this time, if required. The day after the procedure, patients are encouraged to shower, eat and gradually start moving around to regain their strength. Once deemed appropriate by the medical staff, patients will be discharged from the hospital, which in most cases occurs in the afternoon of the second day.
After hospitalization patients are asked to remain in the area for about two days after hospital discharge. During this time their recovery will be monitored by ANR treatment expert. They will also discuss health topics and receive recovery and optimization guidelines. Patients will be assisted to develop a proper nutritional plan, improve their intellectual stimulation and slowly develop an exercise routine as their body continues to return to its natural rate of endorphin production. Patients can then return home, free of opioid dependence, and can enjoy their own balanced endorphin system without any physical dependence.
ANR Clinic location & inpatient setting
As with any opioid treatment center, the location of the treatment options and the distance from a person’s home can be very important. Most treatment centers require an extensive stay that can take one to two weeks or even months to complete. Including going and returning from the patient’s home to the center or facility.
Due to the effectiveness and speed of the ANR Treatment, the patient only needs a one-time stay of just a few days with our clinical experts. This is enough to detox from opioids, rebalance the system and begin the path to a new life.
People from all over Florida, other US states, and even as far as Europe, Asia and South America come to our health care treatment center in Florida. Patients are treated with a short stay of just a few days. This includes the 30 hours of hospitalization, medical supervision, patient education, and an additional two days of recovery.
Unlike most rehab or opioid detoxification centers that often use walk-in clinics, ANR Clinic only performs its treatments in a state-of-art intensive care unit of a qualifying hospital, with a full range of on-site medical resources and support departments .
DeSoto Memorial Hospital (DMH) is a 49-bed acute-care facility which provides our patients with a confidential and intimate setting for their procedure. DMH has earned top scores in both quality and patient satisfaction. The hospital has also been recognized several times for their commitment to patient safety and quality by the Agency for Health Care Administration (AHCA) and CMS. The ANR Clinic has partnered with DeSoto Memorial Hospital to provide opioid drug patients with a medical center that boasts high-end medical technology to guarantee maximum care and comfort. DMH has dedicated a unit and specially trained staff specifically to be used for the ANR procedure, to help patients undergoing treatment and recovery from procedures.
Together, with the important partnership of DeSoto Memorial Hospital, and our 30 years of experience treating close to 25,000 patients, the ANR Clinic provides the most effective treatment and care available in the world today.
About the author
Dr. Waismann identified the biological roots of opioid dependency and has successfully treated more than 24,000 patients that were struggling with opioid addiction. Throughout his career, he has lectured and educated health professionals in dozens of countries around the world.