Painkiller Rehabilitation and Treatment

This guide was written to provide an overview of the painkiller rehabilitation process as well as to offer helpful resources for persons recovering from painkiller addiction.

Suddenly stopping painkiller use is rarely a realistic first step in the recovery process. Many people abusing painkillers must gradually reduce their use in a process called tapering to avoid severe, potentially dangerous withdrawal symptoms. The appropriate time frame for opioid tapering varies by person and the medication(s) being abused. Even with tapering, painful withdrawal symptoms may occur. Withdrawal is part of the detox process and why medication-assisted treatment is often recommended from the start. Detoxification isn’t the same as treatment and isn’t sufficient on its own to help someone recover from painkiller addiction.

Behavioral therapy and/or counseling must be combined with pharmaceutical treatments as part of the recovery process. Therapy/counseling may be delivered individually and in group formats. A residential painkiller use disorder treatment program is routinely recommended for severe or long-term abuse. Opioid addiction is a complex health condition that often requires long-term treatment, which may include extensive outpatient counseling and self-help groups like Narcotics Anonymous or SMART Recovery.

For more information, read our guide to the rehab process.

Opioid-based prescription painkillers are Schedule II (2) controlled substances because they’re considered narcotics with a high potential for abuse but approved for medical uses. Schedule II substances include oxycodone, hydrocodone, fentanyl, codeine, morphine, hydromorphone, meperidine, and methadone. An estimated 53 million people aged 15-64 worldwide, or 1.1% of the global population, used opioids at least once in 2017, with about half using heroin and opium. The highest prevalence of nonmedical opioid use occurred in North America, with nearly 4% of the populations aged 15-64 misusing these drugs. Pharmaceutical opioids, including hydrocodone, oxycodone, codeine, and tramadol, were the primary concern. Opioids use in Australia and New Zealand was much higher than the global average, with prevalence also high in Asia.

Someone suffering from pain reliever use disorder becomes physically dependent and may continue using painkillers despite their commitment to stop. Fear of experiencing severe withdrawal symptoms may be a substantial block to quitting use, as well as fear of the pain returning. Slowly tapering use may help deter or dampen withdrawal symptoms, and admission to a detox program may be necessary. The chronic, neurobiological disease associated with opioid abuse can cause intense drug cravings and frequent relapse. The presence of a psychiatric disorder, such as depression, can significantly hinder treatment and its effectiveness if not adequately addressed. It can also increase the risk of suicide during the struggle to overcome addiction.

Detoxification is the body’s way of removing a harmful substance, which occurs after a person stops using the substance. If a person is tapering off opioid-based painkillers, they experience an ongoing detox process as they slowly withdraw from the drug. Even with tapering, a person may experience withdrawal symptoms, but withdrawal symptoms begin quickly and are more severe without tapering. The length and severity of withdrawal symptoms vary based on the painkiller(s) used, daily intake, frequency of doses, and how long the drug(s) were being abused. It can take days or sometimes weeks for withdrawal symptoms to subside. Opioid withdrawal can be dangerous, so it should only be done under a doctor’s care.

Everyone experiences painkiller withdrawal differently, and it further varies if more than one painkiller is being misused. The half-life of the drug(s) used and a person’s mental and physical health can impact how soon symptoms appear. A doctor may prescribe certain medications to help a person get through withdrawal.

The Food and Drug Administration approves medications for medication-assisted treatment (MAT) of opioid use disorders with treatment programs tailored to meet a person’s unique needs. Buprenorphine, methadone, and naltrexone may be used to treat oxycodone, hydrocodone, codeine, and morphine use disorders. Doctors may prescribe these medications to block the euphoric effects of opioids, normalize brain chemistry, relieve painkiller cravings, and reduce withdrawal symptoms. Clonidine or lofexidine may also be prescribed for medically supervised withdrawal. Each of these medications is effective when taken appropriately.

For more information about withdrawal, read our guide on Painkiller Addiction.

Painkiller addiction affects brain function and behavior, but it’s a treatable disease. Although no single treatment is right for everyone, counseling and behavioral therapies combined with medication-assisted treatment are effective at treating opioid-based painkiller use disorder and may even help some people maintain recovery. Buprenorphine, methadone, and naltrexone have proved to be safe and effective in combination with counseling and psychosocial support for the treatment of opioid dependence.

Within either an inpatient or outpatient setting, treatments such as detoxification services, behavioral therapies, and medication-assisted treatments are offered for varying lengths of time.

Inpatient treatment involves living full-time (including overnight) at a treatment facility for a set period of time. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to use and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and, thus, unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

Buprenorphine and methadone target the same areas of the brain as opioids to suppress withdrawal symptoms and reduce cravings. Naltrexone blocks the effects of opioids but should only be used after a person has detoxed. All three medications help reduce drug-seeking behavior and help individuals become more open to behavioral therapies.

Prescription painkillers effectively treat moderate to severe pain, but their opioid-based ingredients can be highly addictive, especially when misused. Opioids affect the reward center of the brain, causing some users to feel high, which may lead to abuse. Long-term use can cause a person to develop a tolerance that leads to taking higher and/or more frequent doses to receive the same effect. Tolerance can lead to dependence, which can lead to a painkiller addiction that’s difficult but possible to overcome.

Choosing a reputable rehabilitation center that combines medication-assisted therapy with counseling and behavioral therapies using an individualized approach can help people overcome their painkiller addiction. Treatment may include inpatient and/or outpatient programs and continuing care through long-term medication-assisted maintenance and self-help peer support groups to help ensure lasting recovery.

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.