Drug Addiction Treatment Programs

[callout title="What Does the Life of A Heroin Addict Look Like?"]
<p>For a person with a heroin addiction, life revolves around use of the drug. A person like this might become secretive, concerned about money, and willing to skip work and family obligations in order to get drugs. Physical signs include track marks, frequent sedation, clouded thinking, and flu-like symptoms between drug doses.</p>
[/callout]

There is a <a href="http://www.drugfreeworld.org/drugfacts/heroin/i-ll-just-try-it-once.html" target="_blank" rel="noopener">high addiction potential associated with heroin</a>. For this reason, it can be a very slippery slope between use, abuse, and addiction. At the outset, however, it is important to understand the important distinction between <a href="http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence" target="_blank" rel="noopener">physical dependence and addiction</a> to heroin. After a sufficient period of regular use, a person will become physically dependent on heroin. Physical dependence on heroin develops when, over time, a person requires a greater amount of this opiate to experience the desired pleasurable effects.

[quote]Withdrawal is an additional hallmark of physical dependence. When a person ceases to use heroin or significantly reduces the familiar amount, uncomfortable symptoms can set in.[/quote]

<img class="alignright size-full wp-image-33516" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/09/signs-of-heroin-use.jpg" alt="signs of heroin use" width="375" height="300" />The withdrawal symptoms associated with heroin can be so painful that some users will want to quit heroin but then continue to use it just to avoid those symptoms. There is no absolute timeline to follow as the onset of physical dependence depends on numerous factors, including the person's physiology and the amount of heroin consumed over time. A person who becomes dependent on heroin is <a href="https://www.nlm.nih.gov/medlineplus/ency/article/002861.htm" target="_blank" rel="noopener">6-20 times more likely to die</a> compared to a person in the general population.

[callout]
<h2>Physical and Psychological Signs of Heroin Addiction</h2>
The physical and psychological signs of heroin addiction are synonymous with its side effects. There are different types of side effects related to heroin use, including common side effects, severe (atypical) side effects, and overdose symptoms.
<h3>Short-Term Side Effects</h3>
According to the <a href="http://www.drugabuse.gov/publications/research-reports/heroin/what-are-immediate-short-term-effects-heroin-use" target="_blank" rel="noopener">National Institute on Drug Abuse</a>, the following are some of the common short-term side effects that may occur after heroin use:
<ul>
 	<li>An initial euphoric rush</li>
 	<li>Nausea and vomiting</li>
 	<li>Flushed skin</li>
 	<li>Severe itching</li>
 	<li>Slowed heart rate (after initial rush)</li>
 	<li>Drowsiness for hours</li>
 	<li>Heaviness of limbs</li>
 	<li>Clouded thinking</li>
</ul>
<h3>Atypical Side Effects</h3>
Some users may experience an atypical reaction to heroin. The possible reactions have mainly been discovered through a review of hospital reports. In some cases, the reaction was persistent, lasting until the next day and sometimes even longer. It is possible that the heroin in these cases had been adulterated; heroin distributers may add in other chemicals that can be poisonous and result in a release of a “bad batch”into a community. It is important to understand the possibility of consuming adulterated heroin, which can lead to a more severe presentation of side effects.According to the <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5432a1.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a>, the following symptoms represent possible atypical reactions to heroin:
<ul>
 	<li>Palpitations</li>
 	<li>Anxiety</li>
 	<li>Shortness of breath</li>
 	<li>Tremors</li>
 	<li>Headache</li>
 	<li>Chest pain</li>
</ul>
<h3>Overdose Signs</h3>
A severe reaction to heroin use will require medical attention, as will a heroin overdose. Toxicity levels of heroin may be related to the purity of the heroin or the presence of poisonous additions. Whether due to toxicity or purity, the following are common <a href="https://www.nlm.nih.gov/medlineplus/ency/article/002861.htm" target="_blank" rel="noopener">signs associated with a heroin overdose</a>:
<ul>
 	<li>Bluish lips and/or nails</li>
 	<li>Disorientation</li>
 	<li>Shallow breathing or difficulty breathing</li>
 	<li>Delirium</li>
 	<li>Pinpoint pupils</li>
 	<li>Muscle spasticity</li>
 	<li>Low blood pressure</li>
 	<li>Drowsiness</li>
 	<li>Weak pulse</li>
 	<li>Coma</li>
</ul>
<h3>Withdrawal Symptoms</h3>
Withdrawal can occur as a sign of physical dependence in regular heroin users or, in some cases, after a binge or a period of heavy use. Although there is no set timeline, <a href="http://addictions.about.com/od/dailylifewithaddiction/a/What-To-Expect-From-Heroin-Withdrawal.htm" target="_blank" rel="noopener">heroin withdrawal symptoms</a> will typically begin 6-12 hours after heroin was last used, then peak within 1-2 days, and usually subside over the course of 5-7 days. In some instances, individuals may not realize that someone they care about has been using heroin. However, if they have knowledge that withdrawal symptoms are present, they will often become aware of the extent of the heroin use problem.The following are some of the more common withdrawal symptoms related to heroin:

[columns count="2"]
<ul>
 	<li>Bad mood or dysphoria</li>
 	<li>Insomnia</li>
 	<li>Depressed feelings</li>
 	<li>Yawning</li>
 	<li>Drug cravings</li>
 	<li>Body aches (particularly in the back and legs)</li>
 	<li>Anxiety</li>
 	<li>Diarrhea</li>
 	<li>Irritability</li>
 	<li>Runny nose</li>
 	<li>Restlessness</li>
 	<li>Nausea and vomiting</li>
</ul>
[/columns]

It is not accurate or helpful to say that heroin use can be obvious, but this particular drug is associated with numerous side effects that a person in good health will not display. Initially, a concerned person may be able to dismiss the signs as the flu or a bad mood. However, with ongoing heroin use, the side effects will persist.
Even a single dose of heroin can be fatal in some cases, and continuous use is effectively a dangerous game of chance. <a href="/heroin-treatment/physical-dangers/">The physical side effects of heroin use should never be ignored</a>, as the presence of these symptoms provides a solid indication that there is a need for recovery treatment services.

[/callout]

<h2>Behavioral Signs of Heroin Addiction</h2>
When heroin use becomes a priority, a person's entire universe shifts to revolve around this drug. For this reason, there are bound to be observable changes in the person's life. Often, despite the many problems heroin use causes, a person who is in the grip of addiction will continue to prioritize the drug over important obligations and relationships. The following are some typical <a href="http://www.thefix.com/content/how-do-i-know-if-someone-addicted-heroin" target="_blank" rel="noopener">behavioral signs related to heroin</a> abuse that can alert concerned individuals that there is a need for treatment:

[columns count="2"]
<ul>
 	<li>Presence of drug paraphernalia</li>
 	<li>Changes in behavior</li>
 	<li>Use of street slang related to heroin</li>
 	<li>Missing valuables or money</li>
 	<li>“Track marks”on the body</li>
 	<li>Legal troubles</li>
 	<li>Lying and secretiveness</li>
 	<li>Chipping (intermittent heroin use)</li>
</ul>
[/columns]

There are numerous ways that people who abuse heroin will change their behavior. Mood changes include erratic and/or aggressive behavior, depression, and withdrawal from friends and social events. New friends may emerge—ones who may show the physical signs of heroin abuse (including track marks) as well as a tendency to use street slang associated with heroin use.

There are numerous nicknames for heroin, including <em>junk, smack, dope, H, black tar</em>, and <em>white</em>. The use of heroin is sometimes referred to as <em>skin-popping</em> (injecting), <em>chasing the dragon</em> (trying to get a heroin high), and <em>speed-balling</em> (using a combination of heroin and cocaine).
Heroin users tend to interact with other heroin users or illicit drug users.

The cost of heroin abuse tends to rise as the ability to pay for this drug tends to decrease (as, for example, the heroin user is unable to work). As a result, individuals who are addicted to heroin may turn to stealing from others, drug dealing, or other activities that expose them to legal troubles. Individuals who are around those who abuse heroin may notice items of value go missing. The person abusing heroin may apologize or deny the theft or other illegal activities as a way of protecting the heroin use. Although theft is a legal matter, family member and friends who are victims of heroin-involved theft often will not contact authorities. During an intervention, a family member or friend could use the theft as an example of why rehab is necessary.
<h2>Heroin and Its Paraphernalia</h2>
At the outset, it is important to know <a href="http://www.drugfreeworld.org/drugfacts/heroin/what-does-heroin-look-like.html" target="_blank" rel="noopener">what heroin looks like</a>. Heroin, in pure form, is a fine white powder. When heroin gets to the level of street sales, it is usually black, rose gray, or brown (due to chemicals that have been added).There are different ways to use heroin, including by injection, smoking, or sniffing. The type of paraphernalia associated with heroin depends on the way it is used. Paraphernalia can include the containers used to carry the heroin as well as the implements involved in its use. Examples of heroin paraphernalia include baggies, balloons, glass or metal pipes, aluminum foil, and/or syringes.


<h2>The Path to Recovery</h2>

[quote]
The physical and behavioral signs of heroin addiction can motivate concerned individuals to stage an intervention or find another effective way to lead the addicted person to a rehab program.
[/quote]
In some cases, legal troubles can lead to rehab as an alternative to a prison sentence or as a condition of probation post-incarceration. <a href="/heroin-treatment/">Regardless of the path to rehab, there is an exceptional need for recovery services when heroin abuse is concerned.</a>

What Are the Signs of Heroin Addiction?

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<h4 class="text-elegant text-center no-margin-v">What Are The Dangers of Mixing Valium and Alcohol or Drugs?</h4>
<p class="text-sm">Although Valium is safe for most adult users when it is taken as prescribed by a doctor, mixing Valium with alcohol or other drugs can lead to:</p>

<div class="row">
<div class="small-6 large-6 columns">
<ul class="text-sm">
 	<li>Confusion</li>
 	<li>Disorientation</li>
 	<li>Accidents</li>
 	<li>Sedation</li>
 	<li>Stumbling</li>
 	<li>Dizziness</li>
</ul>
</div>
<div class="small-6 large-6 columns">
<ul class="text-sm">
 	<li>Nausea</li>
 	<li>Loss of consciousness</li>
 	<li>Addiction</li>
 	<li>Brain damage</li>
 	<li>Coma</li>
 	<li>Death</li>
</ul>
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<p class="text-dkblue text-smd lowercase">While some users mix Valium with alcohol or other drugs to intensify their calming effects, others take Valium with other substances without being aware that they are endangering their health and safety.</p>
Although Valium is safe for most adult users when taken as prescribed under a doctor's supervision, abusing this medication by mixing it with other medications, illicit drugs, or alcohol poses serious risks. To prevent excessive sedation, an injury, or an overdose, it is critically important to be aware of the possible interactions of Valium with other chemicals.

<img class="alignright size-full wp-image-33404" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/what-are-valium-side-effects.jpg" alt="Mixing Valium &amp; Drugs" width="350" height="300" />Valium, or diazepam, belongs to a category of drugs called benzodiazepines. Diazepam is currently prescribed as a sedative/anxiolytic and anti-seizure medication. It is also used to treat muscle spasms, <a href="/sleep-wake-disorders/restless-legs-syndrome/">restless leg syndrome</a>, and the symptoms of alcohol withdrawal. The benzodiazepine family includes other popular tranquilizers, such as alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin). Benzodiazepines are scheduled substances because these sedatives have a potential for abuse and addiction. Taking Valium with other drugs or alcohol not only sets the stage for dangerous side effects; it also <a href="/valium-treatment/long-term/">increases the likelihood of developing chemical dependency and addiction.</a>

<a name="Effects on the Brain and Body"></a>
<h2>Effects on the Brain and Body</h2>
<img class="alignleft size-medium wp-image-36256" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/Depressed-blond-woman-sitting-120986927-300x200.jpg" alt="mixing valium and effects " width="300" height="200" />Valium acts on the central nervous system to slow down excessive electrical impulses in the brain. This tranquilizing effect can help to prevent seizures, abnormal body movements, and muscle spasms. It can also have a quieting effect on the user's moods and emotions or make the user feel drowsy. Valium is often prescribed to help people with anxiety or insomnia to help them relax and fall asleep. Individuals who abuse Valium take the drug for its calming, soothing effects.

When taken by itself according to the directions of a doctor or therapist, Valium is a relatively safe drug, with a low risk of harmful side effects. But the dangers of Valium increase significantly when this medication is taken at the same time as other drugs. In particular, the following substances combined with Valium pose a high risk of overdose, loss of consciousness, coma, and death:
<ul>
 	<li>Alcoholic beverages</li>
 	<li>Opioid pain medications, such as prescription drugs that contain hydrocodone (Vicodin, Norco), oxycodone (<a href="https://americanaddictioncenters.org/percocet-treatment/dangers-of-mixing-with-alcohol/">Percocet</a>, OxyContin), hydromorphone (Dilaudid), and other narcotics</li>
 	<li>Illicit opiate drugs, like heroin</li>
 	<li>Other tranquilizers or sedatives, such as alprazolam (Xanax) or lorazepam (Ativan)</li>
 	<li>Sleep medications such as zolpidem (Ambien)</li>
 	<li>Barbiturates like secobarbital (Seconal) or <a href="https://americanaddictioncenters.org/phenobarbital-abuse/">phenobarbital</a> (Nembutal)</li>
 	<li>Cocaine</li>
 	<li>Methamphetamine</li>
</ul>
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<div class="small-6 large-6 columns">Many of these substances have depressant actions, suppressing activity in the brain and slowing various physiological processes. Mixing these drugs with Valium can intensify the effects of this tranquilizer, making the user even more vulnerable to the dangers of central nervous system depression. The use of Valium with stimulants like cocaine or methamphetamine can also endanger the user's health and safety. Abusing multiple drugs increases the risk of dangerous drug interactions, overdose, addiction, accidents, and fatalities.</div>
<div class="small-6 large-6 columns">The use of Valium with alcohol, opiate drugs, or other prescription medications is not always deliberate. Some people with legitimate prescriptions for Valium may consume alcohol or take other medications that interact with this drug without being aware of the potential dangers. The <a href="http://pubs.niaaa.nih.gov/publications/Medicine/Harmful_Interactions.pdf" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a> cautions that tranquilizers can increase the sedative effects of alcohol, making the user even more sleepy, confused, disoriented, and vulnerable to accidents or injuries. Valium users should read medication labels carefully and avoid alcohol while taking this drug.</div>
</div>
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<hr />

[callout]
<h4>Dangers of Mixing Drugs</h4>
<ul>
<li><a href="/prescription-drugs/dangers-of-mixing">Mixing Opiates and Benzos</a></li>
<li><a href="/steroid-abuse/mixing-with-cocaine">Taking Steroids and Cocaine</a></li>
<li><a href="/suboxone/combined-with-adderall">Consuming Suboxone and Adderall</a></li>
<li><a href="/benzodiazepine/mixing">Combining Suboxone and Benzos</a></li>
<li><a href="/xanax-treatment/dangers-of-mixing-with-klonopin">Consuming Klonopin and Xanax</a></li>
<li><a href="/methadone-addiction/and-mixing-heroin">Mixing Methadone and Heroin</a></li>
<li><a href="/polysubstance-abuse">Issues of Polysubstance Abuse</a></li>
</ul>
[/callout]

<a name="Risk of Overdose"></a>
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<h2>Risk of Overdose</h2>
According to <em><a href="http://www.cdc.gov/mmwr/pdf/wk/mm6340.pdf" target="_blank" rel="noopener">Morbidity &amp; Mortality Weekly Report</a></em> (<em>MMWR</em>), benzodiazepines like Valium were involved in over 408,000 emergency room visits in 2010. In patients who have overdosed on Valium, alcohol is often mixed with this prescription medication, augmenting its sedative effects. In fact, <em>MMWR </em>reports that over 27 percent of emergency department visits involving benzodiazepines also involved alcohol, and that over 26 percent of the individuals who died as a result of benzodiazepine use were also consuming alcohol.

Opioid medications like <a href="https://americanaddictioncenters.org/percocet-treatment/dangers-of-use-and-overdose/">Percocet</a>, OxyContin, Dilaudid, and <a href="/vicodin/">Vicodin are widely prescribed</a> in the US to control pain. The <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307731/" target="_blank" rel="noopener">Western Journal of Emergency Medicine</a></em> notes that in 2012, there were nearly 182 million prescriptions written for opioid drugs, and that the growing availability of these medications is partially responsible for the increase in ER visits involving opioids, alcohol, and benzodiazepines. The <em>Journal</em> adds that a significant number of patients who are treated for an opioid overdose in an emergency department setting also test positive for benzodiazepine use in urinalysis.

Like Valium, opioid pain medications can depress certain central nervous system activity; however, opioids have a more powerful effect on respiration and heart rate than Valium. When taken alone, Valium is unlikely to cause severe respiratory depression or an excessively slow heart rate. But when taken with opioids, the opioid drugs can enhance the central nervous system depression of Valium, making it more likely that the user will experience one or more of the following reactions:
<div class="row">
<div class="large-6 columns">
<ul>
 	<li>Slow breathing</li>
 	<li>Slow heart rate</li>
 	<li>Low blood pressure</li>
 	<li>Cool, clammy skin</li>
 	<li>Drowsiness</li>
 	<li>Confusion</li>
</ul>
</div>
<div class="large-6 columns">
<ul>
 	<li>Stumbling</li>
 	<li>Loss of balance</li>
 	<li>Dizziness</li>
 	<li>Upset stomach</li>
 	<li>Fatigue</li>
 	<li>Unconsciousness</li>
 	<li>Coma</li>
</ul>
</div>
</div>
When an individual's heart rate becomes so slow that blood and oxygen are no longer delivered to the brain, and <a href="/health-complications-addiction/respiratory-system/">respiration become so shallow that the body is no longer receiving oxygen</a>, the user is at risk of death. While some fatal overdoses are accidental, others are intentional and planned carefully. The Centers for Disease Control and Prevention states that benzodiazepines like Valium were among the leading types of drugs used in suicide deaths between 2005 and 2007, and that 31 percent of suicides involved prescription drugs and alcohol.

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<a name="Addiction"></a>
<h2>Addiction</h2>
<img class="alignright" src="/wp-content/uploads/2015/09/bigstock-Woman-In-Depressed-Mood-Sits-O-89032895-250x167.jpg" alt="Woman In Depressed Mood Sits On The Window" width="250" height="167" />The use of Valium with alcohol or other drugs puts the user at a higher risk of chemical dependency and addiction. Valium and other substances can have a symbiotic effect, heightening the user's response to the drugs (a phenomenon known as "boosting"). Users who have experienced the combined effects of multiple substances may not be satisfied with using a single drug, especially when multiple drugs are readily available.
<div>
<p class="text-elegant">Statistics on substance abuse treatment in the US confirm that poly-drug abuse involving Valium is a common concern.</p>

</div>
The <a href="http://www.ncbi.nlm.nih.gov/books/NBK64146/" target="_blank" rel="noopener">Substance Abuse and Mental Health Services Administration</a> points out that individuals who already have substance abuse disorder, such as opiate addiction or alcoholism, are more likely to abuse benzodiazepines like Valium than the general population, and that a large percentage of patients in substance abuse treatment programs abuse benzodiazepines along with other drugs.

Individuals suffering from alcohol addiction sometimes self-administer Valium to avoid the symptoms of alcohol withdrawal. Valium is prescribed in some medical detox programs to help prevent some of the more serious effects of alcohol withdrawal syndrome, such as seizures and agitation; however, it is dangerous and illegal to take diazepam without a doctor's prescription. The only safe, effective way to withdraw from alcohol, benzodiazepines, opiates, and other drugs is through a professional detox program that provides intensive clinical monitoring.

<hr />

[quote]
Users who take Valium to self-medicate for anxiety may need mental health treatment through a rehab program that treats co-occurring issues, as well as recovery services for substance abuse.

[/quote]

<hr />

Valium abuse and addiction are becoming more widespread in the US. Many users assume that because Valium is a prescription medication, it is not as dangerous as illicit drugs and can easily be combined with other substances. However, the fact is that Valium is never more dangerous than when it is mixed with other central nervous system depressants.
<p class="text-dkblue sm-pad-none"><a href="/valium-treatment/">A comprehensive rehab program can help Valium users recover their health </a>and avoid the hazardous side effects of abusing multiple substances.</p>

Dangers of Mixing Valium and Alcohol or Drugs

[callout title="What Are Some Signs of Cocaine Abuse?"]
Signs of cocaine abuse include:
[columns count="2"]
<ul>
 	<li>Excitability</li>
 	<li>Dilated pupils</li>
 	<li>Runny nose</li>
 	<li>Weight loss</li>
 	<li>Mood swings</li>
 	<li>Social isolation</li>
 	<li>Risky behaviors</li>
 	<li>Nosebleeds</li>
 	<li>Boost in confidence</li>
 	<li>Talkative habits</li>
 	<li>Changes in sleeping and eating patterns</li>
 	<li>White powder residue around the nose and mouth</li>
 	<li>Burn marks on the hands and lips</li>
 	<li>Deterioration in hygiene habits</li>
 	<li>Financial difficulties</li>
 	<li>Loss of interest in things that once brought joy</li>
 	<li>Increased need for privacy</li>
 	<li>Spoons, razor blades, plastic baggies and other drug paraphernalia in the person's room or clothing pockets</li>
</ul>
[/columns]
[/callout]

Over 14 percent of all Americans age 12 and older have used cocaine in their lifetimes, the <a href="http://www.drugabuse.gov/drugs-abuse/cocaine" target="_blank" rel="noopener">National Institute on Drug Abuse</a> (NIDA) reports. Cocaine is a central nervous system stimulant that increases energy levels and keeps people awake while raising heart rate and blood pressure. Cocaine also makes people feel good by flooding the brain with dopamine, one of the chemical messengers that increase feelings of pleasure.

<img class="alignright size-full wp-image-33502" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/signs-of-cocaine-use.jpg" alt="signs of cocaine use" width="375" height="300" />

There are two main types of cocaine: a powder that is snorted, injected, or smoked, and a rock form called crack cocaine that is generally smoked, although sometimes it is placed into body orifices. Cocaine abuse accounts for most of the emergency department visits related to illicit drug abuse or misuse at 40.3 percent, according to the <a href="http://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf" target="_blank" rel="noopener">Drug Abuse Warning Network</a> (DAWN) report in 2011. There has also been a 29 percent rise in cocaine overdose deaths between 2001 and 2013, and close to 5,000 people died from an overdose on cocaine in 2013, <a href="http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates" target="_blank" rel="noopener">NIDA</a> publishes.

[quote]Cocaine is a highly addictive drug that can change the chemical makeup of a person's brain with regular use, making it challenging to quit using the drug without help.[/quote]

In order to prevent a potentially tragic outcome, it is beneficial to recognize the warning signs that a loved one or family member may be abusing cocaine.

[callout title="What to Watch For"]
Cocaine takes effect quickly, but has a short half-life, meaning that the high is generally short-lived—lasting from 5-30 minutes, depending on how the drug is used and how quickly the drug is absorbed into the bloodstream, <a href="https://www.psychologytoday.com/conditions/cocaine" target="_blank" rel="noopener"><em>Psychology Today</em></a> publishes. The <a href="http://learn.genetics.utah.edu/content/addiction/delivery/" target="_blank" rel="noopener">Genetic Science Learning Center</a> at the University of Utah reports that the fastest way to send drugs into the brain is by smoking, and injection is the second fastest method. Smoking cocaine is the most popular method of ingestion, as <a href="http://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers" target="_blank" rel="noopener">NIDA</a> reports that 72 percent of all admissions to substance abuse treatment centers for cocaine abuse involve crack cocaine abuse.

Cocaine creates its "high" by blocking dopamine from being recycled, therefore artificially increasing the activity of this “feel good” neurotransmitter. Users may be overly talkative, excitable, have fewer inhibitions and high confidence levels, and have lowered appetites or need for sleep when under the influence of cocaine. After coming down from the cocaine high, there is often a crash period, and users may eat and sleep more than usual during this time. Some other signs that someone may be abusing cocaine include:
[columns count="2"]
<ul>
 	<li>White powder residue around the nose and mouth</li>
 	<li>Needle marks from injecting the drug</li>
 	<li>Burn marks on hands and lips</li>
 	<li>Drug paraphernalia in their personal effects (e.g., syringes, pipes, spoons, razor blades, small plastic baggies, etc.)</li>
 	<li>Change in sleeping and eating patterns</li>
 	<li>Weight loss</li>
 	<li>Mood swings</li>
 	<li>Increased risk-taking behaviors</li>
 	<li>More frequent sexual encounters</li>
 	<li>Dilated pupils that may be sensitive to light</li>
 	<li>Runny nose and/or frequent nosebleeds</li>
 	<li>Lack of concern for personal appearance and personal hygiene</li>
 	<li>Financial troubles</li>
 	<li>Social isolation</li>
</ul>
[/columns]

[quote]Since cocaine leaves the body quickly, some people may abuse cocaine in a binge pattern, taking several doses back to back, which may lead more quickly to physical and psychological dependence than other methods of taking the drug.[/quote]

Other times cocaine abusers may take higher doses at once, which can lead to hostility, anger, irritability, and even violent outbursts. Long-term users of cocaine may start to experience negative side effects when taking the drug as well. Paranoia, anxiety, anger, and hallucinations may be signs of cocaine abuse in someone who has been using for a long period of time.
[/callout]
<h2>Cocaine and Other Drugs</h2>
Cocaine is often abused with other drugs or alcohol.

For instance, the <a href="http://www.samhsa.gov/data/sites/default/files/TEDS2012N_Web.pdf" target="_blank" rel="noopener">Treatment Data Episode Set</a> (TEDS) from 2002-2012, which details admissions to substance abuse treatment services in the United States, reported that 7 percent of all admissions for illicit drug use were for people primarily abusing cocaine, while double that number cited cocaine as a secondary or tertiary drug of abuse.

If cocaine is abused in conjunction with other drugs or alcohol, this is called poly-drug abuse and there may be additional noticeable physical and psychological side effects. For example, injection drug users may mix cocaine with heroin, which is called a "speedball." Since cocaine is a stimulant and heroin is a central nervous system depressant, there may be a conflicting effect. Anxiety and stress are dampened by heroin, which may accompany the high energy and excitability indicative of cocaine abuse. Someone taking both of these drugs may have impaired motor functions and blurred vision in conjunction with suppressed appetite and lack of sleep.

All of the potential side effects from each drug may be multiplied by mixing them, and mental health issues may also be compounded.

When a large amount of cocaine is taken at once or in conjunction with other drugs or alcohol, t<a href="/cocaine-treatment/risks/">he risk for an overdose or other negative health consequences increases also.</a> An overdose occurs when too much of the drug is ingested at one time for the body to handle, and drug amounts reach toxic levels in the bloodstream. The signs of an overdose from cocaine include nausea, vomiting, tremors, seizures, elevated heart rate, chest pain, and a rise in blood pressure and body temperature. A cocaine overdose can result in a stroke or heart attack, and it is a medical emergency. If an overdose is suspected, call for professional help immediately.

[callout title="Signs &amp; Symptoms of Drug Abuse"]
<ul>
 	<li><a href="/alcoholism-treatment/symptoms-and-signs">Alcohol</a></li>
 	<li><a href="/benzodiazepine/symptoms-and-signs">Benzodiazepines</a></li>
 	<li><a href="/ecstasy-abuse/withdrawal-symptoms">Ecstasy</a></li>
 	<li><a href="/heroin-treatment/signs">Heroin</a></li>
 	<li><a href="/ketamine-abuse/physical-symptoms">Ketamine</a></li>
 	<li><a href="/marijuana-rehab/signs-of-abuse">Marijuana</a></li>
 	<li><a href="/meth-treatment/signs-symptoms">Meth</a></li>
 	<li><a href="/adult-addiction-treatment-programs/signs">Addiction Symptoms</a></li>
</ul>
[/callout]
<h2>When Abuse Turns into Addiction</h2>
Cocaine is considered a Schedule II drug in the United States by the <a href="https://www.dea.gov/drug-scheduling" target="_blank" rel="noopener">Drug Enforcement Agency</a> (DEA) in part due to its high potential for addiction. Cocaine makes people feel good by changing the way the brain feels pleasure, making it more difficult to feel as good without the drug.

[button-color link='insurance-coverage']Learn more about insurance coverage and verify your insurance with AAC[/button-color]

Regular use of cocaine can cause someone to become tolerant to the drug, and higher doses must be taken in order to continue to feel the effects that are desired. More and more time may be spent trying to obtain the drug, using it, and then recovering from using cocaine as control over drug use becomes harder. Other duties such as schoolwork, familial obligations, or workplace responsibilities may be overlooked or neglected completely. It may be difficult to rely on people who are addicted to cocaine, and they may withdraw from loved ones and peers, and stop participating in activities or events that they used to enjoy.

Addiction is a disease affecting the motivation and reward circuitry in the brain. When people are addicted to cocaine, they may feel that they need the drug in order to feel any sort of balance. Someone addicted to cocaine may seek out the drug in order to feel some relief from physical and emotional withdrawal side effects that may occur as soon as the drug leaves the bloodstream. Withdrawal symptoms may include drowsiness and fatigue, increased appetite, depression, irritability, mood swings, nightmares, and drug cravings. Cocaine may not have the same physical withdrawal symptoms as other drugs; <a href="/cocaine-treatment/how-to-help/">however, the emotional toll can be just as difficult to manage without help.</a>

In 2013, the <a href="http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf" target="_blank" rel="noopener">National Survey for Drug Use and Health</a> (NSDUH) reported that 1.5 million Americans were considered current users of cocaine, and the <a href="http://www.samhsa.gov/disorders/substance-use" target="_blank" rel="noopener">Substance Abuse and Mental Health Services Administration</a> (SAMHSA) published that 855,000 were classified with a substance use disorder due to cocaine abuse that same year. The physical and emotional side effects of cocaine abuse and addiction can generally be reversed with proper care and support.

[quote]Early intervention and recognition of the signs of use or abuse of cocaine can be essential to <a href="/cocaine-treatment/">getting someone on the right path toward recovery.</a>[/quote]

Signs of Cocaine Abuse

[callout title="What Are Oxycodone Withdrawal Symptoms?"]

Oxycodone withdrawal symptoms can last about a week and may include:
[columns count="4"]
<ul>
 	<li>Irritability</li>
 	<li>Agitation</li>
 	<li>Depression</li>
 	<li>Insomnia</li>
 	<li>Thoughts of suicide</li>
 	<li>Anxiety</li>
 	<li>Inability to concentrate</li>
 	<li>Diarrhea</li>
 	<li>Sweating</li>
 	<li>Body aches</li>
 	<li>Runny nose</li>
 	<li>Headaches</li>
 	<li>High blood pressure</li>
 	<li>Irregular heartbeat</li>
</ul>
[/columns]

Medical detox can help, as providers can use medications and therapy to soothe severe symptoms.
[/callout]

Around 20 percent of the American adult population (those 12 and older) has abused a prescription medication at least once, the <a href="http://www.drugabuse.gov/publications/research-reports/prescription-drugs/director" target="_blank" rel="noopener">National Institute on Drug Abuse</a> (NIDA) estimates.

<a href="/prescription-drugs/">Prescription opiates are among the most commonly abused.</a> About 75 percent of those who abuse opioids do so with either oxycodone or hydrocodone, and almost 45 percent of that group prefers oxycodone, publishes the <a href="https://www.ncadd.org/blogs/in-the-news/people-who-abuse-prescription-opioids-prefer-oxycodone-over-hydrocodone" target="_blank" rel="noopener">National Council on Alcoholism and Drug Dependence, Inc.</a> (NCADD).

Oxycodone is the active ingredient in OxyContin. It is a prescription painkiller that, by activating opioid receptors, modifies pain perception and also produces euphoric feelings by altering the levels of dopamine in the brain. Dopamine is a neurotransmitter and chemical messenger instrumental in brain processes that mediate pleasure and reward. The effects of opioid use aren’t all positive—for example, respiration and heart rate slow, and blood pressure and body temperature lower as opioid receptors are activated.

The brain grows accustomed to the constant presence of oxycodone. After a consistent period of opioid receptor stimulation and altered chemical messaging, the brain might not function so well without it.

When someone quits oxycodone, the brain will attempt to rebalance itself, and withdrawal symptoms may occur.

Stopping oxycodone suddenly can send the central nervous system into a sort of tailspin, disrupting vital signs. <a href="https://americanaddictioncenters.org/oxycodone/side-effects/" target="_blank" rel="noopener">Multiple side effects, both physical and psychological</a>, accompany oxycodone withdrawal. It is not recommended to stop taking oxy "cold turkey," without the help of a qualified professional.

[callout title="More on Withdrawal &amp; Timelines"]
<ul>
 	<li><a href="/dilaudid-abuse/how-long-is-withdrawal">Dilaudid</a></li>
 	<li><a href="/heroin-treatment/withdrawal-symptoms">Heroin</a></li>
 	<li><a href="/methadone-addiction/as-short-term-detox">Methadone</a></li>
 	<li><a href="/morphine-treatment/timelines-symptoms">Morphine</a></li>
 	<li><a href="/opana-treatment/detox-timeline">Opana</a></li>
 	<li><a href="/suboxone/withdrawal">Suboxone</a></li>
</ul>
[/callout]

[callout]
<h2>Potential Symptoms of Oxycodone Withdrawal</h2>
<img src="/wp-content/uploads/2015/09/bigstock-close-up-of-patient-and-doctor-69241132-250x168.jpg" alt="getting help" width="250" height="168" class="alignleft" />

 Physically, withdrawal from opioid drugs usually is similar to the experience of having the flu. An individual may experience body aches, chills, sweats, goose bumps, nausea, stomach cramps, fever, vomiting, diarrhea, tremors, a runny nose, and headaches. During oxycodone withdrawal someone may also yawn a lot more than normal and tear up easily. High blood pressure, irregular heart rate, and trouble breathing are more serious side effects that may also occur when someone is more physically dependent on oxycodone and stops taking it. Side effects of withdrawal are not usually fatal; however, hazardous complications can arise, so opioid withdrawal should be supervised closely.

Psychological side effects of oxycodone withdrawal may also be very uncomfortable as the chemicals in the brain responsible for positive emotions and motivation may take some time to recover to previous levels.

Emotional symptoms of oxycodone withdrawal may include:

[columns count="2"]
<ul>
 	<li>Irritability</li>
 	<li>Agitation</li>
 	<li>Insomnia</li>
 	<li>Depression</li>
 	<li>Suicidal thoughts</li>
 	<li>Anxiety</li>
 	<li>Trouble concentrating</li>
 	<li>Mental "fog"</li>
 	<li>General malaise</li>
</ul>
[/columns]

[quote]An individual in oxycodone withdrawal may also experience powerful drug cravings and the desire to return to using the drug as a way to relieve the side effects of withdrawal.[/quote]

[/callout]

<h2>Oxycodone Withdrawal Timeline</h2>

Withdrawal is a collection of side effects that occur when someone who is dependent on a drug stops using it; while detox refers to the process of clearing the drug from the system.

Withdrawal from oxycodone usually starts within 8-12 hours of taking the drug, and it peaks in the first 72 hours. Symptoms generally subside in about a week, although some of the psychological effects and drug cravings may persist for longer.

The time within which withdrawal symptoms start depend on the formulation of oxycodone taken and the method it was taken. Immediate-release formats have a half-life of 3-4 hours, for example, while extended-release oxycodone has a longer half-life of around 12 hours, the journal <a href="http://www.ncbi.nlm.nih.gov/pubmed/17525040" target="_blank" rel="noopener"><em>Clinical and Translational Oncology</em></a> reports. Injecting, snorting, or smoking oxycodone also may send the drug more rapidly into the bloodstream, meaning that it may take an almost instant effect and will likely be active for a shorter period of time, as opposed to when the drug is swallowed in pill or tablet form and digested.

In some cases, a detox program may begin even before withdrawal symptoms start—while the drug is still active in the body. This way the drug can be safely removed. During medical detox, individuals are monitored around the clock for 5-7 days, vital signs are continually checked, and medications may be used to control more difficult withdrawal symptoms. Detox may last somewhat longer, on the order of 10 days, if physiologic dependence is severe or if a person has a history previous difficult detox experiences. Medical detox ensures that an individual is stable before moving on with a comprehensive substance abuse treatment program.

<h2>Oxycodone Relapse Dangers</h2>
Medical detox is oftentimes the initial stage of a more comprehensive substance abuse treatment program that can provide a strong foundation for recovery. There are several medications commonly used in opiate medical detox programs that not only help reduce the range and severity of withdrawal side effects, but also serve to help prevent a return to drug abuse, or relapse.

Relapse after detox can increase the risk for a potentially life-threatening overdose since the brain and body may not be used to the same amount of drugs that was used before. The <a href="http://www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a> (CDC) estimates that almost 15,000 Americans die each year as the result of a prescription pain reliever overdose. The <a href="http://www.drugabuse.gov/publications/drugfacts/drug-related-hospital-emergency-room-visits" target="_blank" rel="noopener">Drug Abuse Warning Network</a> (DAWN) also reports that over 175,000 sought emergency department treatment for a reaction to the abuse of oxycodone in 2009.

By decreasing drug cravings and other negative withdrawal symptoms, an individual may be less prone to seek out oxycodone again after detox.
[quote]Medical detox can help sustain abstinence and potentially prevent a tragic, relapse-related consequence.[/quote]

<h2>Finding a Detox Center and Preventing Relapse</h2>
<a href="http://www.drugabuse.gov/publications/research-reports/prescription-drugs/treating-prescription-drug-addiction/treating-addiction-to-prescription-opio" target="_blank" rel="noopener">NIDA</a> currently supports three main medications for the treatment of opioid abuse and dependency and the prevention of relapse: methadone, buprenorphine, and naltrexone. As it is not a good idea to stop oxycodone suddenly, <a href="/withdrawal-timelines-treatments/">a oxycodone detox center may instead use a tapering method, wherein drug amounts are slowly lowered over a set length of time until the drug is removed fully from the body.</a>

Opioid replacement therapy is another method of ensuring that the opioid receptors remain at least partially activated, which reduces both withdrawal symptoms and drug cravings. Longer-acting opioid drugs, such as methadone, can be used to manage withdrawal with less-frequent dosing. Methadone is sometimes abused, however, so it may not be the first choice at a detox center for oxycodone.

Buprenorphine is a partial opioid agonist that remains active in the bloodstream for longer and does not produce quite the same euphoric effects as full agonists like oxycodone. The "high" of a partial agonist is of relatively low intensity if abused. Buprenorphine even has a ceiling to its effects so that after a certain amount is taken, the opioid effects will plateau, even with additional drug used.

Naloxone is added to buprenorphine products like Zubsolv and Suboxone, which is a opioid antagonist. Naloxone blocks opioid receptors from receiving any more opioid drugs, so if an individual taking one of these medications attempts to abuse oxycodone again, it will have no effect. The naloxone is also an abuse-deterrent because if these combination buprenorphine products are altered and then injected, the naloxone will precipitate withdrawal, which is very uncomfortable and can keep someone from wanting to try to abuse these medications. Naltrexone is another opioid antagonist that comes in pill form (Depade and ReVia) or even as a longer-acting injectable format (Vivitrol). These drugs are often considered effective at reducing potential episodes of relapse by acting as opioid-deterrents.

Most oxycodone detox providers agree that medications alone are not the complete answer for preventing relapse and sustaining long-term abstinence. Addiction is a brain disease that affects many aspects of a person's psyche and personal life, including the regulation of emotions, feelings of self-worth, relationships with friends and family, motivation, and more.

Behavioral therapies, counseling sessions, and long-term support groups are also included in opioid abuse and dependency treatment centers. As a result, comprehensive care is designed to care for the person as a whole, from detox into recovery and beyond.

[callout title="About Drug and Alcohol Detox"]
<ul>
 	<li><a href="/drug-detox/same-day-admittance">Same Day Admittance</a></li>
 	<li><a href="/drug-detox/cost">What Is the Cost?</a></li>
</ul>
[/callout]

Oxycodone Withdrawal Timeline, Symptoms, and Treatment Options

[content-overview]
Hydrocodone is the primary active component of several common prescription painkillers, including the widely available Vicodin.
[/content-overview]

Hydrocodone products are the most commonly prescribed drugs in America, according to <a href="http://www.consumerreports.org/cro/2014/01/5-surprising-things-you-need-to-know-about-prescription-painkillers/index.htm"><em>Consumer Reports</em></a>. Because of the high potential for diversion and abuse, not to mention addiction liability, hydrocodone products were moved to the more tightly controlled Schedule II <a href="http://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0822.htm">Drug Enforcement Administration</a> (DEA) classification after the <a href="http://blogs.fda.gov/fdavoice/index.php/2014/10/re-scheduling-prescription-hydrocodone-combination-drug-products-an-important-step-toward-controlling-misuse-and-abuse/">Food and Drug Administration</a> (FDA) completed a scientific review and requested the change in 2013.

[callout]
Like most prescription narcotics, abrupt hydrocodone cessation may herald the onset of withdrawal symptoms, which may include:
[columns count="3"]
<ul>
 	<li>Muscle aches</li>
 	<li>Runny nose</li>
 	<li>Sweating</li>
 	<li>Chills</li>
 	<li>Goosebumps</li>
 	<li>Vomiting</li>
 	<li>Diarrhea</li>
 	<li>Anxiety</li>
 	<li>Headaches</li>
 	<li>Mood swings</li>
 	<li>Depression</li>
 	<li>Fatigue</li>
 	<li>Drug cravings</li>
</ul>
[/columns]
Symptoms last 5-7 days, in most cases. Medications and therapy can soothe distress and reduce the risk of drug relapse.
[/callout]

<img class="aligncenter size-full wp-image-30978" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/hydrocodone-withdrawal-timeline.png" alt="hydrocodone withdrawal timeline" width="700" height="400" />

&nbsp;

[button-color link='insurance-coverage']Learn more about insurance coverage and verify your insurance with AAC[/button-color]

Prescription opioids are frequently reserved for the management of chronic and/or significantly severe pain; in a dose-dependent manner, their use is also associated with rewarding, euphoric sensations. The <a href="http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse">National Institute on Drug Abuse</a> (NIDA) reports that opioid painkiller prescriptions reached 207 million in the United States in 2013, and America consumes practically 100 percent of the world's hydrocodone.

Hydrocodone is an opioid drug that affects levels of dopamine in the brain. When an individual takes hydrocodone regularly for a length of time, they may develop tolerance to the drug, and in order to continue to feel its desired effects, more will need to be taken. Taking increasingly large amounts of hydrocodone may lead to the swift development of physical dependence, however, and ultimately, addiction.

An estimated 2 million Americans struggle with a substance use disorder involving prescription opioids, the <a href="http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf">American Society of Addiction Medicine</a> (ASAM) reports. One of the effects of significant physiological dependence is the onset of withdrawal symptoms when the drug leaves the system.

[callout title="Timeline for Withdrawal"]

<img class="alignleft" src="/wp-content/uploads/2015/09/bigstock-close-up-of-patient-and-doctor-69241132-250x168.jpg" alt="getting help" width="250" height="168" />

Most hydrocodone products, including Norco and Vicodin, are immediate release formulations, with a duration of effects lasting roughly 4-6 hours, the <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555555/"><em>Journal of Pain Research</em> </a> publishes, although there are a few extended-release varieties that last up to 12 hours per dose, which could slightly delay the onset of withdrawal.

Generally speaking, hydrocodone withdrawal will start between 6 and 12 hours after the last dose, depending on which specific drug the dependent individual last took. Opioid withdrawal usually peaks within 72 hours and can last anywhere from a week to a month. Drug cravings and some of the emotional side effects may last longer than a month.

The amount of time an individual took hydrocodone, as well as the average dose and exact formulation of the drug may make a difference in the precise withdrawal timeline and severity. The longer a drug is taken, the more likely that significant physiological dependence has developed. Some underlying medical or mental health issues may also change how long withdrawal will last, as the brain works to restore itself to where it was before hydrocodone was introduced.
[/callout]

[callout]
<h4>More on Withdrawal &amp; Timelines</h4>
<ul>
 	<li><a href="/heroin-treatment/withdrawal-symptoms">Heroin</a></li>
 	<li><a href="/methadone-addiction/as-short-term-detox">Methadone</a></li>
 	<li><a href="/morphine-treatment/timelines-symptoms">Morphine</a></li>
 	<li><a href="/opana-treatment/detox-timeline">Opana</a></li>
 	<li><a href="/withdrawal-timelines-treatments/opiate">Opiates</a></li>
 	<li><a href="/suboxone/withdrawal">Suboxone</a></li>
</ul>
[/callout]
<h2>Hydrocodone Withdrawal Symptoms</h2>
<img class="alignright size-medium wp-image-36046" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/06/risk_factors-300x300.jpg" alt="withdrawal symptoms" width="300" height="300" />

Side effects of hydrocodone withdrawal range from mild to moderate to severe and may differ from person to person. Just as the withdrawal timeline can be influenced by the level of dependency the brain exhibits to hydrocodone, so can the intensity and variety of withdrawal symptoms.

Opiate drugs bind to the multiple opioid receptors throughout the brain and central nervous system, and they act to depress certain physiological processes—resulting in a reduction in breathing rate, heart rate, blood pressure, and body temperature. When someone is dependent on an opioid drug like hydrocodone, the sudden removal of it can have distressing consequences as the brain and body work in overdrive to recover. Blood pressure, respiration, body temperature, and heart rate may all spike if hydrocodone use or abuse is stopped suddenly. It is therefore not recommended to stop taking a hydrocodone product "cold turkey" or without medical supervision and input.

Specific withdrawal symptoms when stopping hydrocodone may include:
[columns count="3"]
<ul>
 	<li>Muscle aches</li>
 	<li>Runny nose</li>
 	<li>Excessive tearing</li>
 	<li>Nausea and abdominal cramps</li>
 	<li>Sweating</li>
 	<li>Chills</li>
 	<li>Goosebumps</li>
 	<li>Trouble sleeping</li>
 	<li>Yawning</li>
 	<li>Vomiting</li>
 	<li>Diarrhea</li>
 	<li>Irregular heart rate</li>
 	<li>Difficulties focusing or concentrating</li>
 	<li>Anxiety</li>
 	<li>Irritability</li>
 	<li>Headache</li>
 	<li>Restlessness</li>
 	<li>Mood swings</li>
 	<li>Trouble feeling pleasure</li>
 	<li>Depression</li>
 	<li>Agitation</li>
 	<li>Night sweats</li>
 	<li>Fatigue</li>
 	<li>High blood pressure</li>
 	<li>Drug cravings</li>
 	<li>Thoughts of suicide</li>
</ul>
[/columns]
[callout title="Finding and Evaluating Hydrocodone Detox Centers"]
In many cases of hydrocodone addiction, medical detox helps keep the individual comfortable as the drug clears from the body. Detox can be performed in either an outpatient or inpatient capacity, with a medical professional monitoring withdrawal progress.

Medical detox is the optimal choice for helping to minimize hydrocodone withdrawal and ensure an individual's safety and comfort. Hydrocodone detox programs monitor vital signs and use medications to keep patients comfortable and stable for a period of 5-7 days in most cases. There are several pharmaceutical options used during medical detox from hydrocodone that reduce withdrawal symptoms and help to prevent relapse in part by lowering the amount and intensity of drug cravings.
[/callout]
<h2>Medications for Hydrocodone Dependence Treatment</h2>
<img class="alignleft" src="/wp-content/uploads/2015/07/opioid-painkillers-300x200.jpg" alt="medication" width="300" height="200" />

Abruptly quitting an opioid like hydrocodone may result in the onset of very unpleasant withdrawal symptoms.

If a person develops dependence as a result of chronic prescription use, their doctor may first attempt to slowly taper the doses to minimize the severity of the associated withdrawal syndrome. There are also several medications approved to manage opioid dependence, which include:

[callout]
<ul>
 	<li><em>Buprenorphine products like Subutex</em>: Buprenorphine is a partial opioid agonist, and by activating opioid receptors, is able to  stop withdrawal symptoms from being as intense. As a longer-acting partial agonist drug, buprenorphine has less abuse potential than many of the abused opioids that it is used to treat dependence on. Buprenorphine has a "ceiling" to its effects, so even if someone does try to take more or abuse the drug, it is not as likely to elicit the powerful high they are seeking.</li>
 	<li><em>Buprenorphine and naloxone combination products, such as Suboxone and Zubsolv:</em> In addition to the opioid agonist buprenorphine, these drugs also contain naloxone, which is an opioid antagonist. Opioid antagonists block other opioids from binding to and activating opioid receptors in the brain, rendering them ineffective. The naloxone component can also precipitate, or bring about, rapid withdrawal symptoms when triggered and works as a deterrent for abuse. Naloxone generally remains inactive in these combination buprenorphine products unless the drugs are tampered with and injected.</li>
 	<li><em>Methadone</em>: A long-acting opioid drug, methadone can be substituted for hydrocodone during detox. Dispensed in federally regulated clinics usually once per day, <a href="/methadone-addiction/how-long-in-system/">methadone can stay in a person's system for up to 30 hours</a>, and it can keep withdrawal symptoms and drug cravings to a minimum. It does have the potential for abuse itself, and its use should be closely monitored.</li>
 	<li><em>Naltrexone products such as Vivitrol</em>: Like naloxone, naltrexone is an opioid antagonist that blocks opioid receptor sites. These drugs are generally used after the initial stages of detox are finished. They help to prevent relapse and deter future opioid abuse.</li>
</ul>
[/callout]

A hydrocodone detox program first works to stabilize an individual physically, and generally lasts about a week. A comprehensive hydrocodone detox center will likely include both pharmaceuticals and holistic methods to accomplish this. For instance, a healthy diet plan, exercise program, and structured sleep schedule may all be included at a medical detox center to help the body heal faster, as may meditation, yoga, spa treatments, and/or massage therapy. Detox is likely to be smoother and go faster if all physical elements are attended to so that the psychological side effects of withdrawal and addiction can be managed as well.

The detox center should be only one part of <a href="https://americanaddictioncenters.org/hydrocodone-treatment/">a more comprehensive substance abuse treatment plan</a> that will also include therapy, counseling, and relapse prevention techniques.

[callout]
<h4>About Drug and Alcohol Detox</h4>
<ul>
 	<li><a href="/drug-detox/find-center">Find Detox Help</a></li>
 	<li><a href="/outpatient-treatment/detox">Outpatient Options</a></li>
</ul>
[/callout]

Hydrocodone Withdrawal Timeline, Detox Centers and Treatment

[content-overview] Marijuana can be problematic for some users. Despite relatively widespread perceptions that would suggest otherwise, frequent marijuana use is associated with the development of physiological dependence, a distinct withdrawal syndrome, and addiction.

Signs of addiction include using more than intended, neglecting responsibilities in favor of marijuana use, tolerance, and <a href="https://americanaddictioncenters.org/marijuana-rehab/withdrawal">withdrawal symptoms</a>.

About 4 million people struggled with marijuana addiction in 2017, and over 200,000 sought treatment for it in 2015.<sup>4,11 </sup>[/content-overview]
<h2>Can You Get Addicted to Marijuana?</h2>
[quote position="left"] The hallmark sign of an addiction is compulsive use despite adverse effects.[/quote]

Both the National Institute on Drug Abuse (NIDA) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) identify marijuana as an addictive drug.

According to NIDA, marijuana users can develop problematic use, or what’s known as a marijuana use disorder (or marijuana addiction) in severe cases.<sup>1</sup>

Cannabis use disorder is listed as a diagnosable condition in the DSM-5. The DSM states that people who regularly use the drug may begin to exhibit the same symptoms and problematic behaviors observed with other forms of substance use disorder. Many people with cannabis use disorder do not develop additional substance use disorders. However, some people may also struggle with abuse of alcohol, cocaine, and opioids, among other drugs.<sup>2</sup>

People with marijuana use disorders often develop significant physical dependence to the drug, meaning that the person’s system comes to rely on the presence of the drug to function normally. When the person stops taking marijuana or reduces the dose, they may experience withdrawal symptoms such as irritability, trouble sleeping, cravings, loss of appetite, and restlessness.<sup>1  </sup>Dependence often develops in conjunction with tolerance, in which the user must use increasing amounts of marijuana to achieve the desired effect or experiences less of an effect if they continue to use the same amount of the drug.<sup>2</sup>

The presence of tolerance or dependence/withdrawal is not enough to make a diagnosis of marijuana addiction (for instance, not everyone who develops some amount of dependence to marijuana will necessarily begin to compulsively use it). But they are strong indicators that problematic use is already underway—the type of use that could ultimately lead to the development of a substance use disorder.

The hallmark sign of an addiction is compulsive use despite adverse effects. The person finds it difficult to control their use of the drug even though it is causing problems in their life, such as trouble with relationships, work, school, or the law.<sup>1</sup>

&nbsp;

<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/5-Myths-of-Drug-Use-vFinal.png"><img class="aligncenter size-full wp-image-56496" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/5-Myths-of-Drug-Use-vFinal.png" alt="myths of drug use and addiction rehab" width="700" height="2973" /></a>
<h2>What Are the Signs of Abuse and Addiction?</h2>
In the earliest stages of marijuana use disorder, neither the drug user nor loved ones may recognize that there is a problem. But over time, the person who abuses marijuana may begin to show <a href="https://americanaddictioncenters.org/marijuana-rehab/signs-of-abuse">signs of physical dependence and addiction</a>.

[callout] Some signs and symptoms used to make a diagnosis of a marijuana use disorder, or addiction, include:<sup>2</sup>
<ul>
 	<li>Using marijuana in greater amounts or over a longer period of time than intended.</li>
 	<li>An inability to control or reduce marijuana use.</li>
 	<li>Spending a large amount of time acquiring marijuana, using it, and recovering from its effects.</li>
 	<li>Cravings to use marijuana.</li>
 	<li>Difficulties meeting responsibilities at work, school, or home due to marijuana use.</li>
 	<li>Continuing to use marijuana even though it is causing social or interpersonal problems.</li>
 	<li>Neglecting social, occupational, or recreational activities in favor of marijuana use.</li>
 	<li>Using marijuana in situations where it is dangerous to do so, such as while driving a car or operating machinery.</li>
 	<li>Continuing to use marijuana even though it is causing physical or psychological problems.</li>
 	<li>Developing tolerance.</li>
 	<li>Developing withdrawal symptoms when use slows or stops.</li>
</ul>
To meet the criteria for a cannabis use disorder in the DSM, a person must exhibit at least 2 of the above symptoms in a 12-month period.<sup>2</sup>

[/callout]

Individuals who do become addicted to a drug will give it a high priority in their lives, even though doing so may lead to personal conflicts and an inability to fulfill important obligations. People who have reached this point may find it <a href="https://americanaddictioncenters.org/marijuana-rehab/how-to-quit-smoking-weed/">difficult to quit without seeking professional treatment</a>.
<h2>How Many People Are Addicted to Marijuana?</h2>
The <a href="https://www.samhsa.gov/data/sites/default/files/nsduh-ppt-09-2018.pdf" target="blank">National Survey on Drug Use and Health</a> (NSDUH) is one of the most comprehensive and reliable sources of information on patterns of drug use in America. According to the 2017 NSDUH, marijuana is the most commonly used illicit drug in the nation.<sup>3</sup>

The survey also found that:<sup>3</sup>
<ul>
 	<li>In the 12+ age group, an estimated 40.9 million Americans had used marijuana in the year prior to the survey (this represents 15% of that population).</li>
 	<li>An estimated 22.1% of young Americans in the 18-25 age group had used marijuana in the past month.</li>
 	<li>Roughly 2.6 million, or 7.6% of young adults in the U.S., reported daily or near-daily use of marijuana.</li>
</ul>
According to the <a href="http://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive" target="blank">National Institute on Drug Abuse</a>, an estimated 30% of marijuana users have some form of marijuana use disorder. The age of initiation into marijuana use can influence the potential for addiction: People who begin using in their teens are 4 to 7 times more likely to develop a marijuana use disorder than people who begin using as adults.<sup>1</sup>

In 2017, about 4 million people age 12 and older had a marijuana use disorder in the past year, which is about 1.5% of that population. That percentage was lower than most years between 2002 and 2010, but it was similar to the percentages from 2011 to 2016.<sup>4</sup>
<h2>Legalization and Addiction</h2>
[quote position="right"] Some Americans may perceive the legality of marijuana to mean that this drug is not harmful or addictive.[/quote]

The Drug Enforcement Administration (DEA) places drugs into schedules based on their medical use and potential for abuse. Marijuana is currently <a href="https://americanaddictioncenters.org/prescription-drugs/classifications">classified as a Schedule I drug</a>, which means that it has no recognized medical value and carries a high risk for abuse and severe dependence.<sup>5</sup>

The idea that marijuana does not have any legitimate therapeutic value may be surprising to many because several states have legalized marijuana for medical purposes. Additionally, there is some evidence of marijuana’s ability to help people with certain medical issues (e.g., neuropathic pain, chemotherapy-induced nausea/vomiting, improving appetite in patients with HIV).<sup>6</sup>

Marijuana laws vary widely among states.<sup>6 </sup>As of June 2019, 33 states had legalized marijuana for medical use, 23 states and the District of Columbia had decriminalized small amounts of marijuana, and 11 states and the District of Columbia had legalized it for recreational use. Some states, such as Texas, have not passed any marijuana laws.<sup>7,8</sup>

Nevertheless, under federal law, marijuana is illegal to prescribe, possess, or sell. State marijuana laws continue to evolve, and the trend points toward more states legalizing the drug for recreational use. Legalization bills are currently advancing in New Mexico, New Hampshire, and Hawaii.<sup>9</sup> Whether the drug’s status will change on the federal level remains to be seen.

The variation in laws is a potential source of confusion for the American public. Some Americans may perceive the legality of marijuana, at least in some jurisdictions, to mean that this drug is not harmful or addictive. However, as stated earlier, marijuana can lead to addiction in some users. Marijuana can also lead to short-term and <a href="https://americanaddictioncenters.org/marijuana-rehab/long-term-effects">long-term mental and physical health problems for users</a>, including impaired memory and attention, anxiety, impaired coordination, learning problems, sleep problems, risk of bronchitis, and risk of other drug and alcohol disorders.<sup>10</sup>

The fact that states have legalized marijuana does not mean it is a completely safe drug. Users should be aware of the risks.
<h2>Help for Addiction</h2>
In 2015, 213,000 people age 12 and older cited marijuana as their primary drug of abuse when they were admitted to drug treatment programs. That makes marijuana one of the most common drugs for which people seek substance abuse treatment.<sup>11</sup>

If you think you or someone you care about may have a problem with marijuana, contact one of our admissions navigators today for more information about our treatment programs. We treat marijuana addiction as well as other substance use disorders and co-occurring mental health conditions. Many people struggle with marijuana addiction, and there is no shame in reaching out for help.
<h2>Sources</h2>
[1]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive" target="blank"><em>Is marijuana addictive?</em></a>

[2]. American Psychiatric Association. (2013). <em>Diagnostic and statistical manual of mental disorders </em>(5th ed.). Arlington, VA: American Psychiatric Publishing.

[3]. Substance Abuse and Mental Health Services Administration. (2018). <a href="https://www.samhsa.gov/data/sites/default/files/nsduh-ppt-09-2018.pdf" target="blank"><em>The National Survey on Drug Use and Health: 2017</em></a>.

[4]. Substance Abuse and Mental Health Services Administration. (2018). <a href="https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report" target="blank"><em>Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health</em></a>.

[5]. Drug Enforcement Administration. <a href="https://www.dea.gov/drug-scheduling" target="blank"><em>Drug Scheduling</em></a>.

[6]. American Cancer Society. <a href="https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/marijuana-and-cancer.html" target="blank"><em>Marijuana and Cancer</em></a>.

[7]. Berke, J. and Gould, S. (2019). <a href="https://www.businessinsider.com/legal-marijuana-states-2018-1" target="blank">Illinois is poised to become the first state to legalize marijuana sales through the legislature—here are all the states where marijuana is legal</a>. <em>Business Insider</em>.

[8]. National Conference of State Legislatures. (2019). <a href="http://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx" target="blank"><em>Marijuana Overview</em></a>.

[9]. Angell, T. (2019). <a href="https://www.forbes.com/sites/tomangell/2019/02/27/marijuana-legalization-bills-are-advancing-in-several-states/#79e725867a35" target="blank"><em>Marijuana Legalization Bills Are Advancing in Several States</em></a>. <em>Forbes</em>.

[10]. National Institute on Drug Abuse. (2018). <a href="https://www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders" target="blank"><em>Is there a link between marijuana use and psychiatric disorders?</em></a>

[11]. Substance Abuse and Mental Health Services Administration. (2017). <a href="https://wwwdasis.samhsa.gov/dasis2/teds_pubs/2015_teds_rpt_st.pdf" target="blank"><em>Treatment Episode Data Set (TEDS): 2005-2015</em></a>.

&nbsp;

Marijuana Addiction Facts: Is Marijuana Physically Addictive?

[callout title="What Relief Options are Available For Opiate Withdrawal?"]
	Opiate withdrawal can be uncomfortable, and in some cases, it can lead to serious health complications. As a result, medical detox is needed. Therapies that can help include:

<ul>
 	<li>Nutritional support, through diet and/or vitamin supplements</li>
 	<li>Hydration</li>
 	<li>Hydrotherapy, including baths and whirlpools</li>
 	<li>Nonsteroidal anti-inflammatory drugs</li>
 	<li>Anti-nausea medications</li>
 	<li>Topical analgesics</li>
 	<li>Natural sleep supplements</li>
 	<li>Antidiarrheal medications</li>
 	<li>Replacement medications, including methadone and buprenorphine</li>
</ul>
[/callout]

[quote]The symptoms of opiate withdrawal whether the opiates in question are prescription drugs or heroin can be extremely uncomfortable.[/quote]

Although these symptoms are eased through monitored medical detox programs, they can still make detox frustrating to undertake. According to an article in <a href="http://www.acphospitalist.org/archives/2009/10/residents.htm" target="_blank" rel="noopener">ACP Hospitalist</a>, the symptoms may include:

[columns count="2"]
<ul>
 	<li>Muscle aches</li>
 	<li>Restless leg syndrome</li>
 	<li>Runny nose</li>
 	<li>Sweating</li>
 	<li>Yawning</li>
 	<li>Digestive discomfort</li>
 	<li>Dilated pupils and tearing</li>
 	<li>Goose bumps</li>
 	<li>Nausea and vomiting</li>
 	<li>Agitation and anxiety</li>
 	<li>Insomnia</li>
</ul>
[/columns]

For many of the symptoms of opiate withdrawal, there are a number of tips and tricks that can be used to bring relief from the discomfort and make the detox process easier. In addition, there are some methods of care that can be considered based on how they specifically counter the action of opiates in the brain.

[quote]There are also some methods that, while they may promise relief, can cause complications in the recovery process. These should be undertaken under a doctor's care to provide optimum safety during detox.[/quote]

<img class="alignright" src="/wp-content/uploads/2014/07/Mythis-About-Substance-Abuse-and-Adults1-300x200.jpg" alt="Mythis-About-Substance-Abuse-and-Adults" width="300" height="200" />

Oftentimes, replacement medications are needed as well as medical intervention to ensure the safety and comfort of the individual detoxing. For all opiates, including prescription painkillers and heroin, medical detox is recommended. An inpatient treatment program that offers medical detox can provide the most effective care to ease the discomfort that comes from opiate withdrawal.
<h2>Tips and Tricks for Managing Symptoms</h2>
The following are some standard treatments for the symptoms of opiate withdrawal that resemble cold and flu symptoms.

Again, at-home detox for opiates is never recommended; seek medical detox at a professional treatment program to ensure a safe and healthy detox experience.
[callout]
<ul>
 	<li><strong><em>Healthy eating and vitamins</em></strong><em>: </em>During both addiction and withdrawal from opiates, the body can experience a number of nutritional deficiencies. According to a study in the <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411899/">Iranian Journal of Public Health</a>, people who have been addicted to opiates may have deficiencies of calcium and magnesium, which can contribute to muscle pain and spasms. Low potassium is also implicated in restless leg syndrome. Eating light, healthy meals can help improve nutritional balance. For example, eating bananas increases potassium intake.</li>
</ul>
[/callout]

Taking a multivitamin or supplementing in areas of deficiency can help with recovery and ease symptoms.
[callout]
<ul>
 	<li><strong><em>Hydration</em></strong><em>: </em>The excessive sweating and diarrhea that accompany opiate withdrawal can leave a person dehydrated. Drinking plenty of water and other fluids can help prevent the additional discomfort that can be caused by dehydration.</li>
</ul>
[/callout]

In many cases, using an enhanced hydration beverage, such as sports drinks, can help restore some of the electrolytes that are also lost when a person is dehydrated.

[callout]
<ul>
 	<li><strong><em>Hot baths</em></strong><em>: </em>Many individuals in recovery from opiate addiction report that taking a hot bath is a helpful trick that can improve the experience of some withdrawal symptoms. Muscle aches and pains, headaches, and back pain can be relaxed away by soaking in hot water, and the relaxation can help improve sleep. Epsom salt added to the water aids in soothing sore muscles.</li>
</ul>
[/callout]

Avoid hot baths during episodes of fever; in this case, a heating pad can be helpful to soothe achy muscles while keeping the rest of the body cool.
[callout]
<ul>
 	<li><strong><em>Entertainment</em></strong><em>: </em>The symptoms of opiate withdrawal can be overwhelming. Distraction can bring a welcome relief from the continued discomfort and frustration of the detox process. In addition, laughter can cause the body to release endorphins that help ease multiple withdrawal symptoms. Funny movies, books, games, and time spent with supportive friends can all provide needed distraction from withdrawal symptoms.</li>
</ul>
[/callout]

<h2>Other Methods of Symptom Relief</h2>
The following methods are perhaps not as intuitive as the ones listed above. However, they have value based on the action of opiates in the brain and the body's natural responses to the treatment methods.
[callout]
<ul>
 	<li><strong><em>Exercise</em></strong><em>: </em>Exercise can help relieve a number of symptoms of opiate withdrawal. Opiate drugs act on the brain through a specific pathway that is normally occupied by some of the body's natural chemicals " endorphins. These are the hormones that the body makes when we exercise, which help create a sense of elation, also known as the “runner's high.”This sense of elation is what makes opiate use so attractive and can lead to addiction.</li>
</ul>
[/callout]
Because of this connection, when an individual who is struggling with opiate addiction is going through withdrawal, exercise can be a great way to relieve some of the symptoms. For example, in one study from the journal <a href="http://www.ncbi.nlm.nih.gov/pubmed/21871908" target="_blank" rel="noopener">Physiology &amp; Behavior</a>, rats who ran on a wheel were less likely to demonstrate anxious behaviors both during addiction and during withdrawal than rats that remained sedentary.
Exercise may even contribute to a better outcome in opiate detox. As reported in the journal <a href="http://www.sciencedirect.com/science/article/pii/S1734114012708915" target="_blank" rel="noopener">Pharmacological Reports</a>, a study showed that addicted rats that exercised were less likely to dose themselves with heroin that they could access, demonstrating that exercise may help lower the desire or need for heroin.

In addition to these benefits, exercise can help reduce the occurrence of restless leg syndrome and insomnia. Because of these outcomes, exercise in concert with treatment of opiate withdrawal can be extremely beneficial in managing withdrawal symptoms.
[callout]
<ul>
 	<li><strong><em>Acupuncture</em></strong><em>: </em>Some studies seem to demonstrate that acupuncture can help individuals dealing with opiate withdrawal to manage their symptoms and even reduce cravings for the drug. For example, a study in Neuroscience Letters found that opiate-addicted rats that were given acupuncture were less likely to demonstrate morphine-seeking behaviors.</li>
</ul>
[/callout]

The hypothesis about how this works is that acupuncture affects dopamine release in the brain; this may counter some withdrawal effects and thereby diminish the urge to use opioids again.
While some analysis of the research behind acupuncture for opiate use questions the ability of this method to prevent cravings, such as one meta-analysis from <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296192/" target="_blank" rel="noopener">Evidence-Based Complementary and Alternative Medicine</a>, acupuncture is still considered by some to be useful in helping individuals ease the discomfort of individual withdrawal symptoms. It can help individuals relax and feel a diminished level of discomfort from these symptoms, making the detox process easier and more comfortable to manage.

[callout]
<h2>Opiate Withdrawal Remedies Over-The-Counter</h2>
<img class="alignright" src="/wp-content/uploads/2015/09/bigstock-close-up-of-patient-and-doctor-69241132-250x168.jpg" alt="getting help" width="250" height="168" />

There are many tips and tricks for opiate withdrawal found online that, if followed, could increase the risk of complications or promote the development of additional dependencies if not prescribed as part of a professional medical detox protocol. The use of over-the-counter medications is often recommended; however, medications should only be used as part of a controlled, reputable treatment program when advised by a doctor.

Some of the symptoms of opiate withdrawal are common and can be helped through medications that can be obtained over the counter.


For example, diarrhea that sometimes occurs with opiate withdrawal can be eased using a non-prescription diarrhea medication, such as loperamide (found in brand names like Imodium AD). Other nonprescription medications and supplements for opiate withdrawal symptoms that could be taken under the care of a professional treatment program include:

<ul>
 	<li><a href="https://americanaddictioncenters.org/meloxicam-abuse/compare-ibuprofen-motrin">Non-steroidal anti-inflammatory drugs</a> (NSAIDs), such as ibuprofen, naproxen, and aspirin</li>
 	<li>Anti-nausea formulations like Pepto Bismol</li>
 	<li>Topical analgesics such as Ben Gay or Tiger Balm</li>
 	<li>Natural sleep supplements such as melatonin or Valerian root</li>
</ul>
Because any over-the-counter medication has the potential to interact with other drugs, a doctor can help to make sure that the individual is avoiding anything that might interfere with other medicines that are prescribed to address the addiction.
[/callout]

<h2>Detox Program Support</h2>
The experienced doctors and therapists who provide professional treatment for opiate detox understand the discomfort of withdrawal symptoms and can advise further helpful tips and tricks to aid with opiate withdrawal.

[quote]Using these methods in concert with a managed, compassionate, and professional treatment program can help ensure that recovery from opiate addiction is less uncomfortable and ultimately more successful.[/quote]

Opiate Withdrawal Remedies, Medications, and Supplements

Drug Rehab Guides for Addiction & Mental Health

[callout title="What is the 12-Step Program?"]
<p>The 12-Step philosophy pioneered by <a href="https://americanaddictioncenters.org/rehab-guide/12-step/whats-the-success-rate-of-aa/">Alcoholics Anonymous</a> is used by about 74 percent of treatment centers. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. The 12-Step movement can be a force for good for many people, but some struggle with what they interpret as a strong religious element of the program. Many <a href="https://americanaddictioncenters.org/adult-addiction-treatment-programs">addiction treatment programs</a> offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.</p>
[/callout]

<strong>One of the most well-known and commonly used types of recovery support is the 12-Step model. Just about everyone has heard of these meetings or of the organization that originated the idea – Alcoholics Anonymous.</strong>Twelve-Step programs remain a commonly recommended and used treatment modality for various types of addiction. According to the Substance Abuse and Mental Health Services Administration (SAMSHA) in its <a href="http://www.samhsa.gov/data/sites/default/files/2013_N-SSATS_National_Survey_of_Substance_Abuse_Treatment_Services/2013_N-SSATS_National_Survey_of_Substance_Abuse_Treatment_Services.pdf" target="_blank" rel="noopener">National Survey of Substance Abuse Treatment Services</a> from 2013, 12-Step models are used, at least occasionally, by approximately 74 percent of treatment centers.
<h2>The History of the 12-Step Program</h2>
<img class="alignright size-full wp-image-36069" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/11/12-step-group-therapy.jpg" alt="Meeting Of Support Group" width="300" height="200" />Alcoholics Anonymous (AA) originated the idea for the 12-Step model in 1938, when founder Bill Wilson wrote out the ideas that had been developing through his experience with and vision of alcoholism. He wrote about the positive effects experienced when people struggling with alcoholism shared their stories with one another.

Wilson wrote his program in what has become known as the <em>Big Book</em>. As explained in <a href="http://www.aa.org/pages/en_US/aa-timeline" target="_blank" rel="noopener">historical information from the AA site</a> itself, the steps were developed through synthesizing concepts from a few other teachings he had encountered, including a six-step program espoused by an organization called the Oxford Group.

In their original form, the 12 Steps came from a spiritual, <a href="https://americanaddictioncenters.org/rehab-guide/christian">Christian inspiration that sought help from a greater power as well as from peers suffering from the same addiction struggles.</a>

The <em>Big Book</em> was originally written as a guide for people who couldn’t attend AA fellowship meetings, but it soon became a model for the program in general. It has since been adopted as a model for a wide range of addiction peer-support and self-help programs designed to help drive behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various offshoots now exist, such as <a href="https://www.na.org/" target="_blank" rel="noopener">Narcotics Anonymous</a> (NA), <a href="http://www.heroinanonymous.org/" target="_blank" rel="noopener">Heroin Anonymous</a> (HA), and <a href="http://www.gamblersanonymous.org/ga/" target="_blank" rel="noopener">Gamblers Anonymous</a> (GA).

[callout]
<h2>The 12-Step Practice</h2>
<img class="alignleft size-full wp-image-36081" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/11/addiction-treatment-therapy.jpg" alt="Addiction Treatment Therapy Options 12 steps" width="350" height="233" />

The basic premise of the 12-Step model is that people can help one another achieve and maintain abstinence from the substances or behaviors to which they are addicted. They can do this through meetings in which they share their experiences with one another and support each other in the ongoing effort of maintaining abstinence. In research, as seen in a recent article from the journal <a href="http://www.acceptandchange.com/wp-content/uploads/2015/08/mcgaffin-et-al-ciarrochi-2015-flourishing-languaging-and-moderate-mental-health-prevelance-and-change-in-mental-health-during-recovery.pdf" target="_blank" rel="noopener">Addiction Research and Theory</a>, abstinence practices (as supported by 12-Step programs) can account for high levels of what experts call <em>flourishing</em>, which is positive mental health and can contribute to longer-term recovery. In the study, those who maintained abstinence were more likely to flourish in the long-term, with 40.7 percent flourishing after three months (as compared to 9.3 percent languishing) and nearly 40 percent flourishing after 12 months (compared to 12.4 percent languishing).

Based on this study, those who abstain altogether from substances – as advised in the 12-Step model – have better mental health outcomes than those who don’t abstain. The 12-Step model gives people a framework from which to surrender their addiction, process their experience, and move forward into new patterns. As described in an article on Psych Central called <a href="http://psychcentral.com/lib/recovery-using-the-12-steps/" target="_blank" rel="noopener">Recovery Using the 12 Steps</a>, following the model assists an individual by helping build the following mental and emotional transformative practices and tools:
<ul>
 	<li>The ability to recognize and admit that one is experiencing an addiction problem</li>
 	<li>A surrender to the fact that the addiction exists and a decision to seek control through an outer guide</li>
 	<li>Self-observation and awareness of the behaviors that were part of and arose from the addiction, as well as those that
help promote self-restraint</li>
 	<li>A chance to practice that restraint and build self-esteem in one’s positive capabilities</li>
 	<li>Achievement of self-acceptance and the ability to change behaviors</li>
 	<li>Compassion, both for those who have been affected by the addiction and for others who similarly struggle with addiction</li>
 	<li>Tools that make the process a continual practice throughout the individual’s life</li>
</ul>
By providing these experiences and tools, the 12-Step model can be a method for change in many types of behavior. As a result, it can help individuals who wish to overcome addiction to find a path to recovery.
[/callout]

<h2>What are The 12 Steps?</h2>
The 12 Steps, as outlined in the original
<em>Big Book</em> and presented by <a href="http://www.aa.org/assets/en_US/smf-121_en.pdf" target="_blank" rel="noopener">AA</a> are:
<ol>
 	<li>Admitting powerlessness over the addiction</li>
 	<li>Believing that a higher power (in whatever form) can help</li>
 	<li>Deciding to turn control over to the higher power</li>
 	<li>Taking a personal inventory</li>
 	<li>Admitting to the higher power, oneself, and another person the wrongs done</li>
 	<li>Being ready to have the higher power correct any shortcomings in one’s character</li>
 	<li>Asking the higher power to remove those shortcomings</li>
 	<li>Making a list of wrongs done to others and being willing to make amends for those wrongs</li>
 	<li>Contacting those who have been hurt, unless doing so would harm the person</li>
 	<li>Continuing to take personal inventory and admitting when one is wrong</li>
 	<li>Seeking enlightenment and connection with the higher power via prayer and meditation</li>
 	<li>Carrying the message of the 12 Steps to others in need</li>
</ol>
<h2>Variations on the 12 Steps</h2>
Since its origin with AA, the 12-Step model has been adopted and altered by many groups to fit other programs – for addiction treatment and otherwise. Many groups, like Narcotics Anonymous, use the steps exactly as they were conceived by AA. Others have modified the steps to fit their own needs and cultures. For example, a Native American group has combined the 12 Steps with the Native American concept of the Medicine Wheel to create a program designed specifically to help indigenous Americans who struggle with alcoholism and addiction, the Medicine Wheel and 12 Steps program. Others have come up with similar ideas to integrate the basic ideas of the 12 Steps into a cultural framework that makes sense for members of that culture.

Another variation comes from the fact that some people are uncomfortable with the specific, religious aspects of the 12-Step program. As stated above, and as evident by the steps themselves, the 12-Step model originated from a Christian point of view. Those who are not Christian have modified the steps to refer to their specific religious or spiritual practice as a way to connect more with the structure of the 12-Step program. In addition, a number of non-religious 12-Step groups have modified the steps to fit a secular model that can help those <a href="/faith-based-addiction-recovery/agnostic-atheist/">who are agnostic or atheist practice the program</a> without feeling forced to adhere to a religion they don’t believe in.

[callout title="More About Recovery Support"]
<ul>
 	<li><a href="/therapy-treatment/aftercare-support-groups">Aftercare Support</a></li>
 	<li><a href="/therapy-treatment/12-step-alternatives">12-Step Alternatives</a></li>
 	<li><a href="/alcoholism-treatment/support">Helping an Alcoholic</a></li>
</ul>
[/callout]
<h2>The 12 Steps with Other Treatments</h2>
According to the National Institute on Drug Abuse’s <a href="https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs" target="_blank" rel="noopener">Principles of Drug Addiction Treatment: A Research-Based Guide</a>, short-term
<a href="https://americanaddictioncenters.org/rehab-guide/residential/whats-day-like-rehab/">residential</a> programs developed the idea of using a modified 12-Step approach to provide a shorter stay in treatment that included follow-up through a 12-Step fellowship. This is seen as a way to provide the important post-treatment structure that helps people maintain long-term recovery. Other programs have also incorporated the 12 Steps, both by encouraging clients to attend 12-Step fellowship meetings, and by incorporating 12-Step ideas into their practices.

While 12-Step facilitation programs don’t necessarily follow the steps, they promote the use of a 12-Step methodology, in the hope that clients will move to a 12-Step program after rehab to help maintain sobriety. In addition, certain treatment centers base their model for service around some of the ideas promoted through the 12-Step program. These centers can offer research-based services and promote a more scientific understanding of addiction treatment, but they incorporate some of the spiritual, psychological, and practical practices that the 12-Step program promotes. This results in an encompassing model of care designed to support clients through rehab and to give tools that they can use after treatment to maintain their recovery for the long-term.
<h2>Alternatives to the 12-Step Model</h2>
Some people don’t like or are not interested in the 12-Step model, even with the variations above or through organizations that facilitate the 12-Step model. Some people don’t like basing their recovery on the idea that they cannot control their addiction, when there is evidence that there are ways of practicing internal control over the recovery process.

Some of the programs based on this active control model include groups like <a href="http://www.smartrecovery.org/" target="_blank" rel="noopener">SMART Recovery</a> and <a href="http://www.moderation.org/meetings/" target="_blank" rel="noopener">Moderation Management</a>. These groups use a similar peer-sharing model, but they don’t rely on the idea of surrender. They instead promote the empowerment of the individual to exercise control over the treatment of and recovery from addiction
<h2>The Path to Recovery</h2>
<img class="alignleft size-full wp-image-36075" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/11/Happy-cheering.jpg" alt="Options for Treatment" width="300" height="200" />Most experts believe that a research-based, residential treatment program that is customized to an individual’s needs is the most effective method to achieve and maintain recovery. Whether this program includes 12-Step aspects, is based on the 12-Step concept, or is an alternative to this original model of addiction treatment, it’s important that care is customized to the individual. Working with an addiction treatment professional is a good way to find the treatment modality that is appropriate for each person, leading to the best path to recovery.

Scot Thomas, M.D.

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