As with other morphine-like narcotics, Percocet® (oxycodone and acetaminophen) addiction treatment begins with detoxification (detox). This first step removes the drug from the body. There are two types of detox:
The first is emergency detox, which is used in an overdose situation. This procedure uses an injectable opioid antagonist to block the effects of the drug chemically. Because an overdose of Percocet can be fatal, this is a life saving procedure. Other concerns are the Tylenol contained in Percocet. Someone who takes too much will be at risk both for narcotic overdose and liver damage from acetaminophen poisoning.
The second is a slower detox in a controlled setting, either in an inpatient treatment facility or under the close supervision of a physician. This involves simply stopping the drug (abstinence) and addressing withdrawal symptoms as they occur. Diarrhea and insomnia are sometimes treated, and Catapres (clonidine) is usually prescribed to help manage symptoms. Rapid detox can be performed on an inpatient basis in as little as three days.
After the patient has been ‘cleared’ of the drug, the next steps are all designed to maintain abstinence. These fall under three broad categories:
- Initial counseling and education
- It is considered standard treatment to educate patients about their drug, its effects and the consequences of addiction. This is best accomplished with both standard information and information specific to their drug of choice. The initial counseling is designed to familiarize the patient and therapist with individual concerns and problems. This may be concurrent with detox and extend as an inpatient.
- Behavior modification
- Consists of therapy (usually individualized) that attempts to train addicts into another mode of behavior. Called cognitive behavioral therapy, this model teaches life strategies meant to help avoid destructive behaviors. It may address underlying issues to discover motivations for abuse behavior. This form of therapy is short (weeks) to long (months) term.
- Group therapy
- This includes formal sessions while in rehab and informal meetings like Narcotics Anonymous (NA). Some patients will come to rely on outpatient meetings as their only long term treatment option.
There is no one-size-fits-all that will guarantee a path to recovery. The best results come from a combination of therapy, monitoring, and periodic evaluation by a professional. Support is a key element in the initial stages of recovery and remains so long term. Many addicts will require significant changes over broad areas of their lives to have any chance at success.
Current medical understanding of addiction treats it as a chronic disease state that requires continuous treatment. This would be akin to high blood pressure or diabetes – these diseases, along with addiction, can be treated, but not cured.
Addicts remain at risk for relapse to some degree for the rest of their lives. For this reason, success rates depend on when you measure them. The use of opioid blocking agents – drugs that prevent the ‘high’ of opioids – has been shown to have a greater than 50% abstinence rate at 6 months.1 Other programs claim an even higher rate. These are called medication-assisted therapy and require the involvement of either a physician or a psychiatrist specializing in opiate addiction.
Overall success rates are difficult to measure. Those who leave outpatient programs cannot easily be tracked. NA, for example, relies on anonymity to attract those that need help. Also, because treatment length varies, someone who leaves a program early, without competing it, isn’t counted as having ‘undergone treatment’ and then isn’t counted as a failure in the statistics. This makes recovery statistics unreliable. Success does seem to depend on the length of active treatment (longer is better) and the use of medications to prevent relapse (with at least three months of monitored use).
photo by Klaus Post