How To Administer Naloxone

Do you know how to administer naloxone?


Can Anyone Learn How To Administer Naloxone? 

How does one administer Naloxone? It seems difficult. Like an incredible amount of responsibility. It can be. Nevertheless, learning how to administer Naloxone might not be as hard as we think. Furthermore, knowing how to dispense Naloxone just might save someone’s life.

What if you could save someone from a heroin overdose? Would that be worth the responsibility of administering Naloxone? Heroin overdose statistics indicate that we need more people trained with Naloxone.

In this blog, Recovery By The Sea considers the following:

  • Explaining and defining Naloxone
  • Identifying reasons why we need Naloxone
  • Opioids and opioid use disorder
  • Long-term treatment options for opioid use disorder
  • Administering Naloxone

Explaining And Defining Naloxone 

Opioids occur naturally in the brain. They relieve and suppress pain. One who consumes opioids amplifies these effects in the brain. Naloxone interrupts this process. It forms a barrier in the brain. This barrier blocks the opioids from making contact with the opioid receptors.

Interfering with this process helps offset the symptoms of opioid overdose. Overdoses can prove fatal. Therefore, learning how to use Naloxone might save someone’s life. Each year, many people die from opioid overdoses. The world needs people willing to learn to use Naloxone.

Identifying Reasons Why We Need Naloxone

Just under 47,000 people died from opioid overdose in 2017. According to a July article from The Washington Post, about 70,000 people died from opioid overdoses in 2020. Statistics like these should grip us. We ought to balk when we read things like these.

Opioids slow down important processes in the brain and the body. Important processes like thinking, breathing, and heart rate. Consequently, opioid overdoses can leave people in comatose states. They do not breathe and their heartbeats become irregular. Left in this condition for too long, death can result. Naloxone can help prevent overdose deaths.

Opioids And Opioid Use Disorder

We’ve mentioned opioids frequently. But what exactly are opioids? Opioids influence the brain in the production of certain neurotransmitters. The neurotransmitter opioids effect the most is dopamine. Dopamine helps drive us toward things that we want. It motivates us.

Also, dopamine rewards us with good feelings whenever we get something that we desire. Opioids cause dopamine to linger in the brain for longer than normal periods of time. Hence the euphoric feeling that people report when taking opioids.

Opioids v. Opiates

Often, you might see the words “opioids” and “opiates” used as synonyms. While related, they do not mean exactly the same thing. Opiates occur in nature. They are byproducts of the opium poppy Papever somniferum. But opioids refers to both natural opioids (opiates) and synthetic opioids. Therefore, it encompasses a broader spectrum.

Examples Of Opioids 

When people hurt, they crave an end to it. We don’t like pain. We want it to end as soon as possible. Therefore, we can easily understand the attraction to opioids. They provide a quick, easy response to pain. And when used correctly, they can indeed do that. But when abused, opioids can have disastrous results.

Examples of opioids include:

  • Heroin
  • Fentanyl
  • Oxycodone
  • Hydrocodone
  • Codeine

As mentioned above, some opioids occur in nature. For example, morphine is a natural opioid. For years, doctors have used morphine during and after surgeries. Therein lies the double-edged reality of opioids. They work – and they work well. Perhaps they work a little too well.

Opioid Use Disorder

The more often a person abuses opioids, the more likely they risk developing opioid use disorder. Someone suffering from opioid use disorder has become dependent on opioids. If they quit, then they will incur withdrawal symptoms.

Opioid withdrawal symptoms include:

  • Anxiety
  • Irritability or anger
  • Pain and aches in the muscles
  • Abdominal cramps
  • Elevated blood pressure

Long-Term Treatment Options For Opioid Use Disorder

One need not live one’s life in subservience to opioid use disorder. Thankfully, treatment options do exist for opioid use disorder. One of the most prominent treatment options is medication for opioid use disorder (MOUD). You may also see this referred to as medication-assisted treatment (MAT). MOUD/MAT involves helping control opioid cravings with medication.

Other treatments might include partial hospitalization programs (PHP). Intensive outpatient programs represent a step down in intensity from PHP. Further down the treatment ladder are outpatient programs. Less restrictive than those are outpatient and aftercare programs.

Administering Naloxone

One administers Naloxone via the nose. Before administering, check for a pulse. Also, verify whether or not the person is breathing. Look for dilation (or lack thereof) in the pupils. If possible, tilt the head backward. Close one nostril. Insert the Narcan sprayer into the other nostril and depress the sprayer. Monitor the person’s breath and pulse. Repeat as needed. If you have the qualifications, begin CPR.

If you or someone that you love struggles with opioid addiction, call or contact Recovery By the Sea immediately.

Disclaimer: This article is not intended as medical advice. Consult a doctor and get proper training before attempting to use Naloxone. 


Why is Fentanyl So Dangerous?

What Is Fentanyl?

Fentanyl belongs to a class of drugs called opioids. Like other opioids, it has a legitimate medical use: easing pain. Opioids work by changing how the body responds to and deals with, pain. Fentanyl’s original purpose was to abate pain in cancer patients (1). Doctors will prescribe fentanyl to patients recovering from surgery, or to those experiencing chronic pain. Prescription fentanyl may appear under brand names such as Duragesic, Subsys, Ionsys, Actiq, and Sublimaze. These prescriptions may take the form of a dermal patch on the skin, an injection, or even lozenges.

Without A Prescription

On the street, fentanyl might be known as Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash, or TNT (3). Since fentanyl is 50 to 100 times stronger than morphine (2), a little goes a long way. For this reason, dealers will mix fentanyl with other drugs. It’s not unusual to see it combined with ecstasy (MDMA), cocaine, methamphetamine, or heroin. Buyers have no way to determine how much fentanyl is in their supply. Therefore, overdoses can be very common.

Where Is The Danger?

As with other opioids, fentanyl alters how our brains respond to pain. A person under the influence of fentanyl might feel relaxed and mellow. They could experience some drowsiness and be sluggish. Fainting, nausea, and seizures are frequent side effects. Users often experience shortness of breath and can stop breathing altogether. Subsequently, the blood is deprived of an adequate supply of oxygen, a condition known as “hypoxia” (3). If a person remains in this state for too long, they could become comatose. During the COVID-19 pandemic, opioids like fentanyl have caused a tremendous spike in overdose deaths (4).

Is Treatment Available?

Absolutely. No two recovery journeys are exactly the same. Different treatments provide different results for different people. But recovery is always possible.

One option, Medication-Assisted Treatment (MAT), is a two-pronged approach to recovery. MAT combines the use of medication with counseling. In conjunction with medication, therapies like cognitive behavioral therapy (CBT) can provide a person with a holistic path to recovery (5). Another alternative might be partial hospitalization (PHP), a semi-structured method of recovery that allows for plenty of outside activities. However, a recovering person might require less regimented options. Intensive Outpatient (IOP) programs could involve extended group meetings, taking place either in the morning or evening. Recovering persons might opt for family therapy, or nonverbal therapies like art, music, or yoga. For a person interested in learning more about aftercare, resources on future relapse prevention are readily available.

Recovery Is A Lifestyle

Outpatient (OP) treatment might involve a once-a-week commitment to group meetings, individual meetings with a therapist, or life-skills training. Continuing support is available from aftercare options like Narcotics Anonymous, Alcoholics Anonymous. Other alternatives include Rational Recovery and faith-based programs like Celebrate Recovery. Recovery doesn’t end with the completion of a program. Or even several programs. Recovery never ends; it’s a lifestyle.

What’s Next?

If you or someone you love is struggling with fentanyl addiction, contact Recovery By The Sea now. Hope is real, and recovery is possible. Call us at 877-207-5033 now.


What Is Opioid Withdrawal Like – What to Expect

distressed man sitting on the floor suffering from opioid withdrawal

Ask anyone who’s ever gone through it and they’ll tell you– opioid withdrawal is an agony like no other. In fact, it wouldn’t be much of a stretch to say that opioid withdrawal is one of the most distressing conditions a human being can experience. Depending on the level of abuse, the symptoms associated with the abrupt cessation of opioid drugs can be so harrowing that it can be almost impossible to stop without extensive professional help.

Fortunately, there’s some good news to report as well, even in the face of an opioid epidemic that seems like it might never end. The good news is that anyone willing to accept help can stop using opioid drugs permanently and begin to recover. One of the keys to this success is knowing what to expect when you stop using opioid drugs abruptly. The information in this post will also be very helpful to the user’s family, friends, and other loved ones.

Opioid Drugs: Use, Abuse, and Why It’s So Hard To Stop

The pharmacology behind opioid addiction and withdrawal is extraordinarily complex, but the upshot is actually pretty simple. First, opioid drugs like heroin, morphine, oxycontin, hydrocodone, etc are extremely addictive and can send even the healthiest person into a hellish spiral in a very short amount of time.

The reasons for this are essentially twofold. First, opioid drugs induce an intense euphoria that many people spend years trying to recapture. Second, the withdrawal symptoms associated with opioid abuse (or even normal use) are probably the most grueling in the entire drug world.

To put it bluntly, stopping opioid drugs without professional help is so incredibly unpleasant that most people prefer the horrors of continued addiction to the experience of sudden withdrawal. And this ugly fact, as much as anything else, is the most powerful jet fuel of the opioid epidemic. Next, we’ll have a more detailed look at what happens to the user when opioids go away in a hurry.

Opioid Withdrawal: What To Expect To Start When You Finally Stop

Here’s the short version. When you stop using opioids abruptly, even after a fairly short amount of time, you will immediately start experiencing ugly and possibly life-threatening withdrawal symptoms.

Here are just a few of the symptoms you can expect to encounter when stopping opioid drugs without help:

  • Constantly high levels of anxiety
  • Extreme agitation, anger, and other negative emotions
  • Nausea/Vomiting
  • Deep, ongoing muscle pain
  • Flu-like symptoms such as fever, sneezing, runny nose, and diarrhea
  • Watery, itchy eyes
  • High amounts of sweating even in cool temperatures
  • Persistent insomnia
  • Painful stomach cramps
  • Significant increases in heart rate and blood pressure
  • Depression and/or suicidal ideation

Obviously, the intensity and duration of these symptoms depend on the person and their usage patterns. However, you will most likely feel intense physical, emotional, and mental discomfort for at least 3-4 days.

The physical symptoms typically decrease in severity significantly after between 7-10 days. And make no mistake about it– these will be among the worst– if not the absolute worst– 5-10 days of your life. Most people don’t make it that far. Moreover, even if opioid users can somehow endure these physical torments long enough, the depression, anxiety, and a sense of profound emptiness often continue for months.

Why Do it Alone?

Fortunately, it doesn’t have to be this way. If you or someone you love experiences this level of opioid withdrawal when they stop using, please find a medical detox facility immediately. Coming off of opioids will never be easy, but medical professionals can do a great deal to reduce your suffering or prescribe long term medications like Suboxone, methadone, or Naltrexone that will reduce your withdrawal symptoms and help ease you into recovery.

Managing Chronic Pain Without Opioids

black and white photo of man grabbing his neck in pain

The CDC estimates that more than 20% of U.S. adults experience chronic pain. Perhaps more significant is the fact that 8% of have high-impact chronic pain. (1) High-impact chronic pain is characterized as pain which lasts at least 3 months and comes with at least one major activity restriction. In other words, pain that someone lives with and has a significant effect on their life.

Risks of Prolonged Opioid Use

Since the dawn of modern medicine, opioids have been the traditional go-to for any serious pain. The options to relieve pain without opioids were quite limited. Aspirin and acetaminophen have been around since the late 19th century and were effective, but relatively short-acting and not nearly as effective for moderate to severe pain.

Opiate medications are still unsurpassed for effectiveness when it comes to severe short-term pain. But chronic pain patients have a unique predicament because they need solutions that are compatible with their lifestyle. What is effective for short-term pain may not be appropriate or even safe as a daily regimen for years. But until relatively recently, doctors did not have viable alternative non-opioid pain relief options for chronic pain patients. Even today, millions of chronic pain patients find themselves stuck in a vicious cycle.

People can begin to become opiate tolerant after just a week of use. Over longer periods, they not only experience withdrawal if they stop, but the same amount of opioid medication no longer delivers the same relief. Doctors, increasingly aware of opioid abuse are often reluctant to prescribe more medication. The chronic pain patient may find themselves running out of prescribed medications too early for a number of reasons. Then the panic sets in. They are faced with a terrible dilemma. Suffer until their next doctor visit? Or seek opioids in whatever form they can find them on the black market.

Alternatives to Traditional Opioids

To call this an imperfect situation is an understatement. Between opioid side-effects like constipation, withdrawal symptoms and tolerance, it’s a lot to endure. The demand for better solutions for chronic pain patients has been present for decades. Acupuncture, therapeutic massage and chiropractic have been helpful supplementals. But science is finally delivering a diverse array of options for chronic pain patients to relieve pain without opioids. Here are just a few.

  • Long-acting non-steroidal anti-inflammatory drugs (NSAIDS) and COX-2 Inhibitors
  • Select Anticonvulsants (e.g. Pregabalin, carbamazepine)
  • Select Antidepressants (e.g. Tricyclics and SNRIs)
  • Topical Agents (e.g. Lidocaine, Capsaicin, topical NSAIDS)
  • Corticosteroid injections
  • Transcutaneous Electrical Nerve Stimulation (TENS)

We are even beginning to see non-opioid pain relief for post-surgical pain. A new generation of local anesthetics such as Exparel (bupivacaine liposome) has shown a lot of promise in this area. Medical science still hasn’t eliminated the need for opioid medications. There is a good possibility we won’t transcend opiates entirely for decades, if ever. There may also be circumstances under which doctors still feel an opioid medication is the best option for a chronic pain patient. We have now seen many thousands of chronic pain patients successfully relieve pain without opioids. As always, you should follow your doctor’s guidance. But be aware that non-opioid pain management is a reality and more and more professionals are informed about the issue. If you are a chronic pain patient who is tired of being opioid-dependent, give us a call to discuss the options for care.

Opioid Tolerance – What You Need to Know

pill bottle on a table spilling out

At one level, the concept of opioid tolerance seems fairly straightforward. Over any significant period of time, continued use of opioid drugs inevitably reduces the body’s autonomic response to the medications and higher doses are needed to achieve the same effect. Depending on the user’s situation, this decreased efficacy can result in long-term physical/psychological dependence, massive changes in brain chemistry, and death.

You can think of this as the ‘common sense’ conception of opioid tolerance. This is what we have learned through personal experience, pop culture, and the increased coverage of the opioid epidemic in nearly every media format on the planet. But while this description is fine as far as it goes, the fact is that it just doesn’t go far enough. In the following sections, you’ll find the accurate and in-depth information that the current opioid crisis requires.

What Exactly Is Opioid Tolerance

As most people know, opioid drugs are frequently used to treat moderate to severe pain in the clinical setting. Opioid drugs are one of the most popular recreational drugs in the United States as well, with some 230,000 people dying from opioid overdoses between 1999 and 2018. Significantly, there were approximately four times more opioid deaths in 2018 than occurred in 1999.

Increased tolerance to specific aspects of opioids has been the driving force behind these avoidable deaths. That’s why it is critical that we acquire a deeper understanding of the mechanisms involved in the development of drug tolerance.

The exact pharmacology that animates increased levels of tolerance is extraordinarily complex. Fortunately, we can formulate a very revealing summary of tolerance development without digging too deep into the human body’s complicated metabolic processes. Here are the three things that concerned persons need to know about this form of tolerance development:

  • Broadly speaking, opioids have two classes of effects on the human body– pain relief or analgesia and negative side effects like nausea, gastrointestinal difficulties, and suppression of respiratory functioning.
  • Increased tolerance to the desired analgesic effects happens very rapidly, while tolerance to the unpleasant side effects of long-term opioid use happens at a much slower rate. This is one of the keys to gaining a more nuanced understanding of the phenomenon of tolerance– the need/desire for the euphoric analgesic effects of opioids will still be there long after the body starts to resist them. Couple this certainty with the much slower development of negative side effects and it becomes clear why increased tolerance is unavoidable for anyone who uses opioids for an extended period of time.
  • These first two facts lead us to a troubling but eye-opening conclusion. Simply put, the notions of both decision and choice begin to fall out of the opioid equation once users cross a certain dosage threshold.

Going Forward

As you can see, opioid tolerance and the tragic consequences that so often accompany it are undeniable physiological facts. As such, it will happen to anyone who uses opioid drugs for an extended period of time, regardless of the reasons behind their initial use. In other words, opioid drugs don’t care why someone started using them.

Whether the person is a recreational user ‘chasing the dragon’ of narcotic euphoria, or a cancer patient trying to increase their quality of life, they will come to need substantially higher doses to achieve the original effect and be exposed to the myriad dangers involved in opioid addiction. We will make little progress in the opioid battle until we internalize and apply this more nuanced conception.
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What is Lean? The Highly Addictive Codeine Drink

Codeine Cough Syrup used in Lean

What is Lean? 

Lean or Purple Drank is a drink made from a mixture of Codeine cough syrup, soda, and sometimes hard candy and/or alcohol. The Codeine cough syrup used is a prescription opioid medication which is typically prescribed for illnesses such as Strep Throat and severe colds or flus. The codeine acts as both a cough suppressant as well as pain relief for symptoms. Unfortunately abuse has become widespread and street prices for Codeine cough syrup can be as much as $200 per bottle. 

Codeine is an opioid, similar to Morphine. It is weaker but like all opioids, regular abuse leads to tolerance and addiction. Further concern lies in the fact that with Lean, the amount used in the drink can be up to  25x the recommended dose and thus can lead to overdose. Codeine cough syrup that also uses Promethazine, a strong antihistamine, can cause further issues. Promethazine is another central nervous system depressant. In combination with codeine, promethazine can slow breathing to the point of complete respiratory arrest. This is particularly troubling due to the high amounts of the syrups used in Lean drinks. 

Additional concerns come into play when alcohol is mixed into a Lean cocktail. Adding alcohol increases the change of respiratory depression. This can lead to organ damage, coma, or death due to the reduced oxygen flow to the brain. 


Other Names for Lean

  • Purple Drank
  • Sizzurp
  • Syrup
  • Dirty Sprite 
  • Purple Lean
  • Purple Tonic
  • Texas Tea
  • Memphis Mud
  • Drank

Lean in Pop Culture

Codeine cough syrup has been abused by people for years but in the past few decades Lean was popularized in pop culture through songs and interviews with musicians. It became particularly prominent in the hip hop community and is reported to be the reason for Lil Wayne’s ongoing hospitalizations for seizures. Bow Wow recently shared about nearly dying from Lean addiction and the late Mac Miller also spoke of his struggles with addiction to Lean in 2013. Even Justin Beiber has sung about the drug, leading to a dangerous growth in popularity and curiosity. 


Side Effects of Lean 

The name “Lean” comes from the tendency to lean or be off balance when the drink is consumed. Lean can produce the feeling of euphoria associated with opioids but it can also have very negative consequences, especially in the amounts used in Lean. These include: 

  • Nausea and vomiting
  • Hallucinations
  • Extreme sedation
  • Wheezing
  • Respiratory depression or trouble breathing
  • Loss of coordination
  • High body temperature
  • Severe constipation
  • Itchy skin
  • Seizures
  • Dizziness
  • Loss of consciousness 
  • Changes in heart rhythm
  • Night Terrors

Long-term Health Issues Associated with Lean 

  • Seizures
  • Irregular Heart Beat
  • Liver damage
  • Trouble breathing
  • Urinary Tract Infections
  • Weight gain
  • Tooth decay

Codeine Overdose Symptoms

Early treatment can save a life. If you or someone else experiences these signs or symptoms after consuming Codeine or any other opiate, call 911 immediately: 

  • Nausea or vomiting
  • Hallucinations
  • Blue fingernails and/or lips
  • Trouble breathing
  • Blurred vision
  • Confusion
  • Weak pulse
  • Low blood pressure
  • Seizures
  • Loss of consciousness

Withdrawal from Codeine

Like all opiates, addiction to codeine can lead to significant withdrawal symptoms when the user tries to quit. Codeine is considered a fast-acting opiate, so withdrawal symptoms can start as soon as 12 hours after last use. The symptoms can be severe enough to require medical intervention in the form of a professional detox center. Symptoms of Withdrawal include; 

  • Muscle aches
  • Sweating
  • Agitation
  • Watery Eyes
  • Runny nose 
  • Headaches
  • Insomnia 
  • Anxiety
  • Nausea
  • Vomiting
  • Abdominal Cramps 
  • Diarrhea
  • Dehydration
  • Fever

Withdrawal symptoms also carry the risk of complications. For example, lung infections caused by vomiting or severe dehydration caused by vomiting and diarrhea. Severe dehydration can lead to problems of its own such as seizures. 

Detoxing from codeine addiction is best done in a clinical environment where the patient can safely come off the drug with medical supervision. In a clinical setting, like Harmony Recovery Group’s centers, doctors can prescribe medication to support the patient through the detox and withdrawal process, reducing symptoms and cravings. Furthermore, trained professionals can put a plan in place that includes therapy, group support and tools to promote long-term recovery. 


Seeking Help

We hope this article has helped you better understand what Lean is and the risks associated with Codeine abuse. If you or a loved one are struggling with Lean, codeine or any substance addiction, please reach out. 

Call us today and find out how we can help. 



Myths About Medication Assisted Treatment (MAT)

Medication Assisted Treatment for Opioid Addicts

At Harmony Recovery Group, we offer Medication Assisted Treatment (MAT) plans that help patients to manage opiate cravings in the long-term and help them build a new life in sobriety. However, there are many myths and misconceptions about Medication Assisted Treatment that we would like to clear up. 

Firstly, many types of Medication Assisted Treatments exist, encompassing medications like Suboxone, Subutex, Methadone, Vivitrol, and Naltrexone. 

In our facilities we use Suboxone, which we consider the safest option for an assisted recovery. Suboxone works because it binds to the same receptors as opiates in order to reduce withdrawal symptoms and cravings. It binds 7x stronger than morphine. Because of this, patients are unable to abuse opiates with Suboxone because they will have no effect due to the binding effect on the receptors. 

Suboxone use reduces the risk of relapse significantly. Studies have shown that Suboxone reduces the risk of relapse by 3x compared with other forms of MAT such as Vivitrol and Naltrexone. And those forms of treatment have a 3x reduction in relapse compared to going cold turkey. Compared to non-medication assisted treatment, there is a 75% improvement in retention rates in sobriety programs. 

We spoke with Dr. Jill Thompson, Board Certified Doctor in Addiction Medicine and our Medical Director at our facility Midwood Addiction Treatment, to discuss the common myths and misconceptions around Medication Assisted Treatment. 


Myth: “Medication Assisted Treatment is Just Legal Heroin”

Beuprenorphine, the primary ingredient in Suboxone, is not heroin. It is made a different way. Narcotics like Oxycontin, Hydrocodone and other opiates are called Full Agonists whereas Buprenorphine is a Partial Agonist. Even though Buprenorphine binds to the same receptors that narcotics do, it acts very differently. For example:

1. You can never become tolerant to Buprenoprhine.

With any other narcotic the more you take it, the more you start to need. A dose that once created a feeling now feels like nothing at all because you develop tolerance to it.  With Buprenorphine you are always on the same dose and you never need to go up in dosage. Jill says, “For example, I had a patient who was on the same dose for 17 years. Unfortunately he passed away in a car crash a few years ago but we had never once changed his dose the entire time I treated him.”

2. Buprenorphine has what’s called a Sealing Effect

This means you cannot take more and more of the medication and get higher and higher. As Jill says, “Your receptors become saturated at a certain dose and that’s it. You can’t take more and more and feel euphoric like you can with opiates.” 

3. Unlike opiates, it is nearly impossible to overdose on Buprenorphine.

The only reported incidents of overdose have been when the medication was mixed with high amounts of other medications such as Benzodiazepines. There is no known case of overdose from Buprenorphine on its own. 


Other MAT medications, like methadone do not have this protection against tolerance nor the sealing effect, making them quite different from the safety of Suboxone. For example, with methadone, a patient can become tolerant and need higher doses and they can also take higher doses and become high. 


Myth: People Who Use MAT Aren’t Actually Clean

This simply isn’t true. What is your definition of “Clean?” Does it mean not getting high? Not getting altered or impaired? Being able to function in everyday life? If the answer to these questions is “yes”, then people on MAT are in fact Clean and Sober. 

Dr. Jill puts it this way: “There is a difference between addiction and dependency. Addiction encompasses having a physical and psychological craving for something that is so strong you will do anything to get it. Dependency is the same as if you were a Diabetic and had to take insulin everyday. You are dependent on your insulin for your disease. Yes, someone who is using Suboxone in their MAT program is dependent on it, but it is the same as any medication out there to treat chronic illness. You still have to go to meetings, you still need to do the work, but you have help in managing your condition.” 

Because Suboxone does not impair patients and the sealing effect means there is no way to take more and feel altered, they can get a job, they can concentrate, and they can function as normal. 

Taking a pill once a day for your medical condition does not mean you are not clean. 


Myth: Medication Assisted Treatment is a Lifelong Commitment 

Many people think that if they start taking MAT, they will never be able to get off of it. The truth is, with the exception of using it in Detox for a week to get off of drugs, Suboxone is not a short-term fix but it is not a life-long commitment either. You can come off of it if you want to. 

As Dr. Jill says, “People are very different and this is a very individualized thing. The phrase “longer term” will be different for different people. Some people may want to come off in a year or two, some people may want to be on it for the rest of their lives. At this point in time, we do not know of any reason people cannot stay on it indefinitely.” In fact, the FDA recently released a statement saying that they advocated using Suboxone for indefinite treatment. However, if patients do want to come off of it, they certainly can. 

If and when you want to come off the medication, it’s important to reduce the dose in a slow and controlled manner. When people decide to skip their dose at random or get off on their own, this creates a very high risk of relapse. If the medication reduction is down systematically with a trained professional, you should not run the risk of relapse. This is because with careful tapering, you won’t be feeling bad or noticing you are withdrawing from it. Dr. Jill suggests patients plan on committing 6-12 months to tapering off slowly and safely.


Myth: Suboxone Causes Precipitated Withdrawal

This is a common misconception among opiate users and is not true. Buprenorphine, the active medication in Suboxone, has been around for decades. But, in the early 2000’s Buprenorphine was approved for use in drug treatment. At the time its brand name was Subutex and it was purely made of Buprenorphine. 

Unfortunately heroin users realized that it could be abused and began to liquify it and inject it. In this manner, a user can in fact get high from Buprenorphine. But, it’s most important use to users was the drug’s ability to stave off withdrawal. If a heroin addict is going to run out of heroin they will typically go into withdrawal within 6-12 hours. With Buprenorphine (brand name Subutex), they won’t go into withdrawal for 2-3 days. 

When Subutex began to flood the streets for this purpose, the manufacturer changed the formula to include Naloxone. Thus, the combination was named Suboxone.  

As most people know, Naloxone is the medication that can stop an overdose. It works intravenously by immediately removing all the heroin left on the body’s receptors. However, Naloxone only works when injected. If Suboxone is administered orally, as intended, the small amount of Naloxone is inert and will not have this effect.

Now, if a heroin user tries to shoot up Suboxone, the Naloxone is fully effective. The user will go into immediate, precipitated withdrawal. This means that all the withdrawal symptoms a user would experience over 48 hours happens in the next two hours. 

No Need To Fear Suboxone

Heroin users are often afraid of Suboxone, thinking they will go into immediate withdrawal if they take it. This is absolutely false. If taken as recommended, orally, Suboxone will block cravings and prevent withdrawal symptoms. In the case that there is heroin in your system, the Suboxone will knock it off and bind to receptors instead, because it is much stronger. If you try to use heroin on top of Suboxone, you will feel nothing because the Suboxone binds that much tighter. That is why it is so effective in preventing cravings. The Naloxone in the pills is simply to prevent intravenous abuse on the street level. It is completely inactive in pill form. 

In the end, choosing the type of treatment for your needs is a very personal choice that should be made with the guidance of a trained professional. We hope this cleared up some of the myths around Medication Assisted Treatment. If this sounds like the right fit for you, or if you are seeking any type of substance abuse treatment, please contact us today. We are here to help. 


Using Buprenorphine for Pain Relief

Buprenorphine for Pain Relief | Recovery By The Sea

Using Buprenorphine for Pain Relief– Buprenorphine is most commonly used in medication-assisted treatment (MAT) to help people reduce or stop the use of heroin or other opiates. However, current research has also found that buprenorphine-naloxone (Suboxone) may also provide relief for opioid-dependent patients suffering from chronic pain.

How Buprenorphene Works

Buprenorphine works by mitigating withdrawal symptoms when a person dependent on opioids discontinues use. Buprenorphine has a specific mechanism of action that makes it desirable for treating opioid dependence and possibly chronic pain.

Buprenorphine has a high attraction to specific opioid receptors that are responsible for pain relief. It remains attached to these receptors for a longer time than other drugs, and as a result, has a prolonged effect.

However, despite this affinity, it acts only as a partial agonist. This means that it prevents opioid withdrawal symptoms, but its effects are less potent than other opioids. Also, and perhaps most critically, buprenorphine does not act on opioid receptors that cause feelings of euphoria.

Moreover, the drug does not induce a “high,” meaning that it has a much lower potential for addiction than other opioids.


As noted, buprenorphine is often combined with naloxone in the form of a drug called Suboxone. Naloxone is a short-acting, opioid antagonist. When combined with buprenorphine, naloxone can neutralize the potentially dangerous effects of other opioids, including sedation and respiratory depression, without preventing pain relief.

Side Effects

Although not nearly as severe as other opioids, both buprenorphine and Suboxone can have adverse side effects, including the following:

  • Stomach and back pain
  • Blurred vision
  • Constipation

  • Difficulty with sleep
  • Mouth numbness
  • Headache

More severe side effects, including difficulty breathing or swelling of the mouth or tongue, require prompt medical attention. Importantly, combining buprenorphine with the use of other drugs like benzodiazepines can be fatal.

Buprenorphine for Pain: Research

In a 2017 review, researchers examined the efficacy of buprenorphine for the management of chronic pain. They analyzed more than two dozen randomized controlled trials involving five buprenorphine formulations.

Overall, the researchers found that 14 studies suggested that buprenorphine in any formulation was useful for the treatment of chronic pain. More specifically, 10 of 15 studies revealed that transdermal buprenorphine (skin patches) were effective, and two of three studies showed that buccal film (film placed between gum and cheek) was also effective.

However, only one study indicated that either sublingual (under the tongue) or intravenous buprenorphine was useful for the treatment of chronic pain. Importantly, no serious adverse effects were reported in any of the studies, indicating that the use of buprenorphine is safe.

In 2014, researchers published a review that examined the effectiveness of sublingual buprenorphine for the treatment of chronic pain. They found that sublingual buprenorphine was, indeed, efficacious.

Researchers suggested some potential benefits of buprenorphine, including the following:

  • Increased effectiveness in treating nerve pain
  • Ease of use among the elderly and in renal impairment
  • Less immunosuppression compared with morphine and fentanyl
  • Ceiling effect for respiratory depression when administered without other depressants
  • Less development of tolerance
  • Antihyperalgesic effect

Buprenorphine for Pain Relief | Recovery By The Sea

Treatment for Hyperalgesia

Due to buprenorphine’s binding properties, it’s believed that it may be able to help those who suffer from opioid-induced hyperalgesia. Opioid-induced hyperalgesia is defined as sensitization caused by exposure to opioids. The condition is hallmarked by a paradoxical response in which a patient using opioids for pain relief could become more sensitive to painful stimuli.

Prescribing Buprenorphine for Pain
In the U.S., buprenorphine is being used to treat chronic pain, and Suboxone is sometimes prescribed off-label for this purpose. Also, the transdermal buprenorphine patch is available for the treatment of severe chronic pain.

Suboxone Abuse and Addiction

Suboxone, when used as directed and under the supervision of a physician or addiction specialist, can be an effective tool for helping a person discontinue opioid use. In some cases, it may also help manage pain.

Suboxone, however, like any opioid-based drug, has some potential for abuse. It can be purchased illicitly, and those with legitimate prescriptions can still become dependent. While the drug does not induce the same euphoric high as other opiates, if used in large quantities, it can have psychoactive effects.

If the drug is tampered with, this can result in a condition known as precipitated withdrawal. This condition may occur if a person crushes the drug and snorts it or liquifies it for injection. Naloxone is an opioid overdose-reversal drug that is used in Suboxone as a deterrent against abuse.

When used orally, naloxone is inactive. However, if the drug is tampered with, the naloxone would become active and, in theory, cause the person to go into instant withdrawal from opioids. Also, one could surmise that it would be likely to neutralize buprenorphine’s already minimal rewarding effects.

That said, instances of abuse still do occur. People that abuse Suboxone or buprenorphine alone say they will swallow, snort, or inject the drug in an attempt to intensify the effects. Suboxone is more apt to be abused by those addicted to relatively small doses of other opioids.

So, although the naloxone should make abuse less likely, it does appear that Suboxone could potentially cause a high when snorted. A rewarding high would be more likely in those who are “opioid-naive,” meaning individuals who don’t regularly use opioids and are not currently on a buprenorphine treatment program.

Signs of Suboxone Dependence

When someone is dependent on Suboxone, they may not exhibit significant symptoms, unless he or she is going through withdrawals. This may be the first sign there is a problem.

Several common behaviors may be associated with a drug dependency, and the following signs may indicate that someone you know has a problem:

  • Doctor-shopping for drugs
  • Isolation from family and friends
  • Drowsiness or insomnia
  • Deception/manipulation of others

  • Obsessiveness over obtaining and using the drug
  • Stealing or frequently borrowing money
  • Lack of interest in activities once considered enjoyable
  • Neglect of essential responsibilities, such as work, school, or family

Abuse and dependence do not necessarily equal addiction. Addiction is a condition also characterized by compulsive drug-seeking in spite of adverse consequences that result. In fact, it is possible for a person to become emotionally addicted to a substance even without a particularly strong chemical dependence.

Suboxone Addiction Side Effects

Buprenorphine for Pain Relief | Recovery By The Sea

Suboxone addiction can lead to several side effects, including the following:

  • Nausea
  • Vomiting
  • Diarrhea
  • Slurred speech

  • Impaired coordination
  • Insomnia
  • Sweating
  • Depression

  • Drowsiness
  • Small pupils
  • Impaired memory
  • Erratic moods and behavior

Also, the abuse of Suboxone can result in significant risks to one’s health, such as central nervous system (CNS) depression and overdose. Due to the presence of naloxone, Suboxone overdose is uncommon. Most cases of overdose and respiratory distress tend to manifest when the drug is used in combination with other depressants or psychoactive substances, such as alcohol or benzodiazepines.

Treatment for Opioid Addiction

Buprenorphine is a drug used primarily for the treatment of opioid addiction. It is often found as the combined medication, Suboxone, which also consists of naloxone. However, doctors sometimes prescribe Suboxone or stand-alone buprenorphine for pain.

Buprenorphine alone has a relatively low potential for abuse and addiction compared to other opioids. Suboxone may be even more abuse-deterrent. That said, abuse still does occur, and when an opioid is involved, there is always the possibility that a person will become dependent and psychologically addicted.

Recovery By The Sea offers comprehensive programs comprised of services beneficial to the recovery process. These services include, but are not limited to, the following:

If you or someone you love is addicted to opioids, contact us today! Discover how we help people break free from the shackles of addiction for good!

>>>READ THIS NEXT: Snorting Hydrocodone

The Three Stages of Opiate Withdrawal

Stages of Opiate Withdrawal | Recovery By The Sea

Opiates are highly addictive painkillers commonly abused through both prescription and illicit use. Opiates are naturally-occurring compounds found in the opium poppy and include morphine, codeine, and thebaine.

“Opioids” is the more common term now used for all natural and semi-synthetic (e.g., Oxycontin and heroin) and fully-synthetic (e.g., Fentanyl) drugs that work on opioid receptors in the brain. For the purposes of this article, the terms “opiate” and “opioid” may be used interchangeably.

Due to the addictive quality of opiates, the use of these drugs may lead to tolerance, dependence, and withdrawal. Tolerance develops as a result of the brain’s propensity to reduce the effects of certain substances in response to repeated exposure. Increased tolerance often compels people to use a substance more frequently and in higher amounts, an action that can rapidly lead to dependence.

Dependence is a condition that occurs over time as the brain adjusts to the presence of a substance and eventually becomes unable to function without it. When a person then tries to discontinue use, they encounter highly unpleasant withdrawal symptoms while the brain and body attempt to re-establish equilibrium.

Opiate withdrawal occurs in three stages. A person who has developed a dependence on opiates may start to encounter withdrawal symptoms within 6-12 hours after their last dose.

How Long Does Opiate Withdrawal Last?

Some symptoms of opiate withdrawal may onset within hours after the last dose, and others may occur later in the withdrawal process and continue for a week or more. Psychological symptoms, such as anxiety, depression, and cravings, may persist for weeks or even months after discontinuing use.

Medical detox generally lasts between 5-6 days, depending on the severity of withdrawal symptoms. During this time, a person detoxing from opiates will encounter three different stages of withdrawal. These stages are distinguishable based on the types of symptoms experienced, their severity and how long they are expected to persist.

Timeline for Stages of Opiate Withdrawal

The exact timeline for opiate withdrawal varies between individuals depending on the drug used, method of administration (e.g., oral ingestion, injecting, snorting, or smoking), how long the drug was used and how much of it. Other factors, such as a history of trauma, co-occurring mental health disorders, biological and environmental factors, and whether or not a person receives medical care during detox, can also influence the length and intensity of symptoms a person experiences during opiate withdrawal.

The general timeline for opiate withdrawal can be divided up into three stages: early, peak period, and late withdrawal.

Three Stages of Opiate Withdrawal

Stage 1: Early Withdrawal (6-30 hours)


Stages of Opiate Withdrawal | Recovery By The Sea

The first stage of withdrawal typically begins within 6-12 hours after cessation of use for short-acting opiates such as heroin, and within 30 hours for long-acting prescription opiates such as oxycodone.

Those who are undergoing the early stage of withdrawal will begin to encounter a set of uncomfortable physical and psychological symptoms. Symptoms that manifest during this time can generally be expected to worsen over the next 24-48 hours.

Early withdrawal symptoms may include the following:

  • Bone and muscle pain
  • Insomnia
  • Sweats
  • Loss of appetite
  • Rapid heart rate

  • Runny nose
  • Watery eyes
  • Increased blood pressure
  • Anxiety
  • Fever

Stage 2: Peak Period (72 hours)

Peak withdrawal symptoms may be expected to onset about 72 hours after the last use of the drug. It is within this stage that symptoms are at their most severe, reach their peak, and can persist for up to five days after they begin.

Many of the symptoms experienced during this period are flu-like and can result in dehydration and a loss of appetite. For a person to keep their strength during this time, it is essential to maintain satisfactory levels of hydration and nutrition. Solid foods and some fluids may be difficult to consume, and therefore those undergoing withdrawal should drink plenty of water and eat softer foods or take liquid nutritional supplements.

Late withdrawal symptoms may include the following:

  • Stomach cramps
  • Diarrhea
  • Nausea
  • Vomiting

  • Depression
  • Goosebumps
  • Chills
  • Intense drug cravings

Stage 3: Late Withdrawal (72+ Hours)

It is in this final stage of opiate withdrawal that physical symptoms and some of the more severe psychological symptoms will begin to subside. But instead of being in the clear, the person undergoing withdrawal and those supporting him or her will need to be cautious and watch for persisting symptoms. The first few days following the general cessation of symptoms still require monitoring and gentle and patient care.

Opiate abuse and addiction can be complicated and may be associated with psychological or emotional needs that make maintaining addiction recovery more challenging beyond the intense initial stages of withdrawal. While the flu-like symptoms, aches and pains, and other physical effects of withdrawal will have likely subsided by this point, drug cravings and persisting feelings of restlessness, anxiety, depression, and insomnia may still linger.

The length of time a person experiences these persisting symptoms can vary between individuals. While detox is the first step need to overcome opiate addiction, additional care is usually required to help the person sustain abstinence from drug use.

There are multiple treatment options that may be beneficial following detox, including psychotherapy, counseling, medication-assisted therapy (MAT), and group support as recommended based on the unique needs of the individual. If you are investigating which treatment options may be most appropriate or necessary following detox, coordination with a trained addiction treatment specialist may be indispensable to determine what course of treatment will be best for you or your loved one.

Medications for Opiate Withdrawal

Stages of Opiate Withdrawal | Recovery By The Sea

Many people are suspicious of the idea of using other prescription drugs to help treat the symptoms of opiate withdrawal. However, experts have found that medication-assisted therapy (MAT) can prove beneficial for many people undergoing opiate detox.

In fact, rather than serving as a total replacement for an opiate or opioid drug, certain FDA-approved medications, such as buprenorphine, naltrexone, and Suboxone, can be used to ease psychological cravings and withdrawal symptoms commonly encountered by those with a dependence on opioids.

Health providers may prescribe medications as necessary to provide a safer and more beneficial experience that will support a person as they endure the stages of detox. Additional treatment may also be needed to address the emotional aspects of the addiction, including co-occurring disorders such as anxiety or depression.

Getting Help for Opiate Withdrawal And Addiction

Willingness and motivation to take the first steps toward quitting opiates is one of the most significant points of progress in recovery, and, fortunately, it is not an endeavor that has to be undertaken alone. Withdrawing from addictive substances such as opiates can be a stressful and even potentially dangerous process.

Whether you or a loved one are struggling with opiate addiction, there is help available Recovery by the Sea employs trained and compassionate staff who offer resources and tools vital to recovery. We are dedicated to helping people in desperate need of treatment to achieve abstinence and develop skills that will help them maintain long-term sobriety and wellness.

Contact our specialists today to discuss opiate addiction treatment options. Discover how we help people free themselves from the clutches of addiction and learn how to foster healthy and fulfilling lives!

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Opiate Drugs and Addiction

Opiate Drugs and Addiction | Recovery By The Sea

Opiate Drugs and Addiction – Opiates are intoxicating, potentially addictive substances that occur naturally and have painkilling and depressant properties. All opiates are classified as controlled substances in the United States.

Opiates Defined

Opiates are compounds procured from the opium poppy, Papaver somniferum. They have potent medicinal properties and are used for pain relief, cough suppression, antidiarrheals, and sedation. The three main alkaloids derived from opium include the following:


Morphine is the most abundant compound in opium and has also been the most commonly used for medical purposes. Morphine is used primarily to manage pain and has also been essential for deriving many semisynthetic medications, such as hydromorphone.

Heroin is also derived from morphine and is chemically similar. Heroin is technically classified as a semi-synthetic opiate, as there are synthetic processes involved in producing the heroin that is sold on the streets.


Codeine is an alkaloid found in lesser concentrations than morphine, but it is also an important compound used to derive other semi-synthetic pharmaceuticals. In addition to analgesia, codeine is used as a prescription cough suppressant.


Thebaine is considered to be the most toxic of the opium compounds, but it is used to produce important semi-synthetic medications, such as oxycodone and hydrocodone.

Opioids Defined

The term “opioid” refers to any compound, natural or synthetic, that binds to opioid receptors in the brain and body. These receptors are proteins in the brain, spinal cord, and digestive tract that interact with compounds produced naturally in the body (endogenous opioids). Opioids not created in the body that may be consumed, injected, snorted, or inhaled act on the same receptors and induce similar effects, albeit much more intense.

What Are Semi-Synthetic and Synthetic Opioids?

As noted, in addition to natural opiates, there are semi-synthetic and synthetic opioids. If a substance is entirely synthetic, it is technically an opioid and not an opiate.

Semi-synthetic opioids are partially derived from opium alkaloids. Synthetic opioids, though, are completely human-made. Still, these drugs all act on the brain and body in the same way as opiates, and also all have a high potential for physical dependence and addiction.

Semi-synthetic opioids include the following:

  • Hydrocodone
  • Oxycodone
  • Hydromorphone
  • Oxymorphone
  • Buprenorphine

Fully synthetic opioids include tramadol, fentanyl, and methadone.

It’s important to point out that there is no distinction in the many of risks associated with these drugs. Morphine, heroin, and synthesized opioids all pose similar risks for users. The most significant risks involve extremely potent opioids such as fentanyl, which even in tiny amounts can result in rapid, life-threatening overdose.

Addiction to Opiate Drugs

Risks of using opiates or opioids include physical dependence and addiction due to the way in which they interact with opioid receptors in the central nervous system. All forms of opioids and opiates, whether natural or synthetic, attach to opioid receptors, induce pain relief and sedation, and create a sense of intense well-being or euphoria.

Opiate Drugs and Addiction | Recovery By The Sea

Effects of Opioid Abuse and Addiction

Common side effects of opioid use include the following:

  • Fatigue
  • Constipation
  • Breathlessness
  • A sense of elation
  • Bronchospasms

  • Chemical dependence
  • Nausea
  • Vomiting
  • Confusion
  • Slurred speech

  • Chest pain
  • Depressed respiration
  • Loss of consciousness
  • Coma
  • Death

Dependence occurs as the body becomes accustomed to the presence of certain substances, and can no longer function normally without them. As a result, people who could previously control their use begin to engage in compulsive drug-seeking behavior in an attempt to forestall highly unpleasant withdrawal symptoms that manifest as a result of drug discontinuation.

Withdrawal Symptoms

Some of the common withdrawal symptoms associated with discontinuing the use of opioids include the following:

  • Intense cravings
  • Nausea
  • Vomiting
  • Stomach pain

  • Cold sweats and chills
  • Diarrhea
  • Anxiety and agitation
  • Muscle tension

  • Shaking or quivering
  • Sleep disturbances
  • Enlarged pupils
  • Body aches and pains


The following are signs of an opioid overdose and should be considered a medical emergency. If someone you know is experiencing these signs/symptoms, call 911 immediately.

  • Awake, but unable to communicate
  • Very slow, shallow, labored, or stopped breathing
  • Pulse (heartbeat) is slow, erratic, or not there at all
  • Cyanosis (bluish skin tone, especially lips or fingernails in lighter skinned people, grayish or ashen skin tone in darker skinned people)
  • Choking sounds or gurgling noise (sometimes referred to as the “death rattle”)
  • Vomiting
  • Body is very limp
  • Face is very pale or clammy
  • Unresponsiveness to outside stimulus
  • Loss of consciousness or coma

Treatment for Addiction to Opiate Drugs

Opioid addiction is a very serious disease, and those suffering are urged to seek professional help as soon as possible. Recovery By The Sea specializes in the treatment of addictions related to opiate drugs and other substances using a comprehensive approach to mental and physical wellness.

Our evidence-based services include those vital to the recovery process, such as behavioral therapy, individual, family, and group counseling, support groups, aftercare planning, and more.

If you or someone you love is struggling with an addiction to opiate drugs, please contact us today to discuss treatment options. Discover how we help people free themselves from the chains of addiction and live long, healthy, and satisfying lives!

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