Opioid Use Disorder Education and Resources

What is an accidental opioid overdose?

An overdose is when a person takes more medicine or drugs than their body can handle. Overdoses can cause harm to your body and even death. An accidental overdose is when a person did not mean to take too much of a medicine or drug. Examples of an accidental opioid overdose are:

  • Taking medicines or drugs by mistake
  • Taking more than the doctor prescribed
  • Taking the wrong drug or medicine

Who is at risk of an opioid overdose?

Some people are more likely to overdose on opioids than other people. Here are some things that might put you or your loved one at a higher risk of overdosing:

  • Taking high dosages of opioids every day
  • Changing your dosage without talking to your doctor first
  • Drinking alcohol while taking opioids
  • Taking sedating medicines like benzodiazepines (for example, Valium, Klonipin or Xanax), muscle relaxants or sleeping pills while on opioids
  • Taking opioids not prescribed to you
  • Taking illegal opioids like heroin or fentanyl
  • Being older than 65
  • Having conditions such as: kidney disease, asthma, sleep apnea, or emphysema

What are the signs and symptoms of an opioid overdose?

If you think a person you are with has overdosed, call 9-1-1 right away. Some signs that they may have overdosed are:

  • Slow shallow breathing or stopped breathing
  • Can’t respond or communicate
  • Small pupils
  • Extremely cold skin that has turned blue in color
  • Confusion
  • Nausea/ queasiness or vomiting

What should I do if I see someone experiencing an opioid overdose?

  • Call 9-1-1 right away.
  • Give them naloxone (NARCAN®) if you have it.
  • Turn the person to their side to help keep them from choking.
  • Stay with them until medical help arrives.

What is naloxone (NARCAN®)?

Naloxone is a medicine that you can give to someone you think is overdosing on opioids and who is not breathing or responding. It is a safe medicine that can reverse symptoms of opioid overdoses and save lives. Please be aware that naloxone does not help someone who has overdosed on a drug that is not an opioid. This video shows how to inject naloxone (NARCAN®).

 

Opioid FAQs and More

Opioid Use Disorder Treatment Options

What are treatment options for OUD?

Treatment options for OUD may include some combination of the following:

  • Detoxification (stopping opioid use, often with medicines to lessen withdrawal symptoms) and group or individual counseling
  • 12-Step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA)
  • Medicine to lessen cravings and withdrawal symptoms

What is Integrated Medication-Assisted Treatment (IMAT)?

IMAT combines talk therapy (either individual or group counseling) with medicines that can control cravings and lessen withdrawal symptoms. The medicines help a person feel normal again so they can focus on therapy and rebuilding their life. This therapy can continue as long as medically needed. The medicines that are often used are:

  • Buprenorphine (pronounced byoo-pre-nor-feen and also called Suboxone®)
  • Methadone (available only at a methadone clinic)
  • Naltrexone (pronounced nal-trek-sohn and also called NARCAN®)

The MaineHealth IMAT program ensures that patients in the communities we serve get the care they need, close to home. Patients who need intensive services will get care by providers with special training until they are more stable. More stable and healthy patients can get their IMAT treatment at primary care offices by doctors and behavioral health clinicians. If a condition worsens, they can switch back to intensive care for more help until they become more stable and ready to return to receiving care at a primary care office. While a small number of people can treat their opioid use disorder with behavioral therapies and/or 12-step programs, many people benefit from IMAT support to be successful and achieve long-term recovery. Your care team will help decide what the best treatment option is for you.

Can I take other medicines while in an IMAT program?

It can be dangerous to your health to take other prescription medicines while you are in an IMAT program. Talk to your doctor before combining the following medicines with IMAT treatment:

  • Benzodiazepines (ben-zoh-dahy-az-uh-peen) can cause overdose when taken with buprenorphine or methadone. These might be medicines like Klonopin, Ativan or Valium.
  • Talk with a psychiatrist to decide if you should take stimulant medicines for ADHD while in IMAT. These medicines may be Adderall or Ritalin.

Where can I find information on Integrated Medication-Assisted Therapy programs in Maine?

Call the MaineHealth IMAT treatment location closest to you.

Other resources:

Prescription Opioids Overview

Why are opioids prescribed?

  • To treat medium-to-severe pain, such as pain after a surgery or an injury
  • Opioids lessen the feeling of pain, but do not treat the cause of it
  • Opioid therapy works to decrease pain, but does not completely take it away

What are the names of some common prescription opioids?

  • Morphine
  • Fentanyl
  • Codeine
  • Hydrocodone (Vicodin)
  • Oxycodone (OxyContin and Percocet)
  • Hydromorphone (Dilaudid)

What side effects can opioids cause?

  • Constipation
  • Nausea, vomiting, and dry mouth
  • Sleepiness and dizziness
  • Confusion
  • Depression
  • Itching
  • Sweating
  • Lower sex drive or function

What are the risks of opioid use?

  • Tolerance: when the same amount of medicine stops working and you need a higher dose to feel the same amount of pain relief
  • Physical dependence: when a person experiences physical withdrawal symptoms after lowering their dosage or suddenly stopping the opioid medicine
  • Addiction: a chronic brain disease that results in uncontrolled substance use, craving, and life problems. Without treatment, addiction gets worse and can result in disability or early death. Addiction to opioids is also called Opioid Use Disorder (OUD).
  • Overdose: when taking too much medicine or taking it in a different way than prescribed hurts your body or causes death

How do I decide whether or not to take opioids?

  1. Talk to your doctor about other treatment options such as:
    • Pain relievers like acetaminophen, ibuprofen, and naproxen
    • Some medicines that are also used to treat depression or seizures
    • Non-drug or complimentary treatments such as physical therapy or acupuncture
  2. Talk to your doctor about the risks. We are all at risk for side effects or developing an OUD, but you might be at higher risk if you:
    • Have a history of drug misuse, substance use disorder, or overdose
    • Have mental health conditions like depression or anxiety
    • Are age 65 or older
  3. What type of pain are you experiencing?
    • Opioids may be better at treating severe pain due to cancer and acute pain following a severe injury or major surgery
    • Opioids do not work as well for chronic pain that is not caused by cancer

What should I do if I decide to take prescription opioids?

  1. Talk to your doctor about the possible side effects and risks.
  2. Watch for side effects and signs of developing OUD, such as:
    • Unusual moodiness or bursts of temper
    • Cravings for more opioids
    • Taking more medicine than prescribed
  3. If you experience side effects or signs of OUD, talk to your doctor about this.

How do I take opioids safely?

  1. Do not take opioids at the same time as:
    • Alcohol
    • Benzodiazepines like Xanax or Valium
    • Muscle relaxants like Soma or Flexeril
    • Sedatives like Ambien or Lunesta
    • Other prescription opioids
  2. Follow your doctor’s advice. Ask your doctor or pharmacist if you have any questions.
  3. Do not share medicines with family or friends. Opioids do not work the same for everyone.
  4. Do not stop taking these medicines all at once if they were prescribed for longer than a few weeks, because you may have withdrawal symptoms.
  5. Store them safely where children, adolescents and teens can’t get to them.
  6. Throw them out safely, by returning to your local disposal program.

Safe Storage and Disposal

How should I store opioid medicines?

  • Keep track of your medicines.
  • Check expiration dates and get rid of expired medicines.
  • Lock your medicines in a safe place.
  • Take your medicines as prescribed by your doctor.
  • Never share your medicines with others.
  • Keep your medicines in the original containers, even when traveling.

Unused medicines can harm those in your home and community.

Keeping unused medicines in your home does more than just take up space in your medicine cabinet. Unused medicine can be a danger to children, seniors and pets. Every minute of every day, a poison control center answers a call about a young child that has swallowed a medicine by mistake. Having unused prescription opioids in your home may also contribute to the opioid epidemic. More than 70% of people misusing opioids are getting them from family and friends.

Flushing or throwing medicines in the trash is not safe.

Many people think that flushing used medicines down the toilet or simply throwing the bottle in the trash are safe ways to get rid of medicines. While this may remove the medicines from your home, it does not remove them from the environment.

Use local medicine disposal programs.

Here are some ways to safely get rid of opioid medicines:

  • Bring them to your local police station.
  • Search for any community collection events or programs such as “drug take-back days” in your area.
  • Visit DisposeMyMeds.org for a list of pharmacies in your community that will safely get rid of your unused medicines.
  • Contact your local waste management authorities to learn about community solid waste programs.
  • If you are unsure of how to dispose of your medicine, contact your pharmacist.

If you can’t use a safe disposal program, follow these steps.

To safely throw away medicine with your household garbage, follow these steps:

  1. Put medicine in a plastic container.
  2. Mix medicine with coffee grounds, kitty litter or add water and liquid soap.
  3. Mix and then throw the plastic container in your garbage.
  4. Scratch out all personal information on the prescription label of your empty pill bottle to make it unreadable, then dispose of the container.

More Resources:

 

Treating Pain Without Opioids

Treating your pain

The goal for pain management is to reduce your pain so that you can live your life as normally as possible. Opioids are one option for treating your pain out of many other options. When choosing how best to treat your pain, your healthcare team will talk about the potential benefits and risks of both opioid and non-opioid treatment options. Your healthcare team may recommend that you try treating your pain with medicines other than opioids, or with a mix of different treatments.

Treatment may be different from person to person.

People can respond differently to treatment and pain medicines. Sometimes pain can be hard to treat, especially if you have had it for a long time (chronic pain). You may need a few types of medicines and/or other therapies to reduce your pain. Combining different therapies with opioid medicines may work better for your pain. This might help you use a lower dose of opioids for your pain or can shorten the amount of time you need to be on opioids.

Examples of non-opioid treatment choices

Below is a chart showing some of the common non-opioid pain medicines your doctor might recommend. Be sure to tell your doctor if you are taking any medicines that don’t require a prescription. In this chart, you will find what type of pain they treat best and other things you should know about these medicines. It is important to remember to read the instructions and ingredients in each of these medicines carefully because taking too much can hurt your body. Also below are some treatment options your doctor might recommend in addition to or instead of pain medications. These treatments have been shown to help many people reduce their chronic pain.

Talk with your doctor.

It is important for you and your healthcare team to work together to make sure your pain is managed in the best way. Your care team can help you keep track of your pain levels, see how your pain responds to treatment, and follow up with you to make sure you are taking your medicine correctly.

Examples of Non-Opioid Treatment Choices:

Medicine Used to Treat What You Need to Know
Acetaminophen (Tylenol) Weak to average pain, cuts, muscle or bone injuries, osteoarthritis, low back pain, migraine
  • Does not require a prescription
  • May not treat pain as well as NSAIDS (does not treat inflammation)
  • Fewer side effects than NSAIDs
  • Use with caution if you have liver disease or drink alcohol heavily
  • Taking more than the recommended dose can damage your liver
Aspirin (Bayer, Bufferin) Weak to average pain, fever
  • Does not require a prescription
  • Can increase risk of stomach bleeding
  • Lowers risk of stroke and heart attack when taken regularly at low doses
  • Less effective for pain relief than NSAIDS
  • Will lower fever
  • Use with caution if you have a blood clotting disorder, take blood thinners, or are allergic to aspirin
NSAIDs (non-steroidal antiinflammatory drugs) (Ibuprofen, Advil, Aleve Osteoarthritis, low back pain without sciatica,  pain after surgery
  • May not need a prescription
  • Treats inflammation
  • Use with caution if you have kidney disease, a history of stomach ulcers, gout or bleeding disorders
  • Can cause stomach upset, bleeding or kidney damage if taken without food, in large amounts, or for a long time
Cox-2 Inhibitors (Celebrex) Osteoarthritis, low back pain without sciatica
  • You need a prescription
  • Less likely than NSAIDS to cause ulcers or bleeding in the digestive tract
  • Side effects include headache and dizziness, kidney problems, fluid retention and high blood pressure
  • Talk with your healthcare team if you have heart disease or risk factors for heart disease
Other medicines (pregabalin, duloxetine, gabapentin, tricyclic antidepressants ) Nerve pain, pain complicated by depression
  • You need a prescription
  • Side effects include sleepiness, dizziness and constipation
Topical creams or ointments (lidocaine or capsacin) Nerve pain, osteoarthritis, musculoskeletal pain
  • You need a prescription
  • You might have skin irritation

 Other Treatment Options

Treatment What You Need to Know
Joint injections (steroid shot) or removal of fluid from a painful joint (arthrocentesis)
  • Steroids can help lower inflammation and take away pain around nerves, spine or joints like your shoulder, knee, hip or fingers. These therapies are used to treat arthritis, rheumatoid arthritis, rotator cuff disease, and nerve-related pain (radiculopathy)
  • They can improve short-term pain and function, but these benefits may not last, so you may need many injections.
  • The risks are more joint damage or swelling, loss of cartilage (thin covering of the joint), or loosening of the ligaments around the joint.
  • Rarely, serious events can happen, including loss of vision, stroke, paralysis, and death.
Exercise therapy
  • Used to treat muscle or bone pain, low back pain, fibromyalgia symptoms, hip and knee osteoarthritis pain, and to help prevent migraines
Physical therapy (PT) and occupational therapy (OT)
  • Helps improve your ability to do activities of daily living like walking, standing, driving, dressing, bathing, and eating
  • You may need multiple visits and to do exercises at home
Cognitive Behavioral Therapy (CBT)
  • Can help you learn how to identify and cope with other emotions and behaviors related to pain, like fear, avoidance, distress, and anxiety
Mind-body techniques like meditation, yoga, breathing exercises and tai chi
  • There are many public classes and videos that can help teach you these techniques
Massage
  • Can help loosen tight muscles and relieve pain
Acupuncture
  • May be covered for chronic pain, migraines, or nausea and vomiting after surgery
Chiropractic care (correcting when a person’s spine may be crooked)
  • This helps low back and neck pain, headaches and fibromyalgia
Psychotherapy (talk therapy)
  • Can give emotional support, teach strategies to live better with chronic pain, and stress-reduction techniques

Next Steps:

These treatment options may or may not be covered by your insurance. If you are interested:

  • Ask your doctor for a recommendation and a referral
  • Call your insurance company to see if they will help pay for it

Next Steps for Someone Seeking Treatment

If you or someone you know is struggling with OUD, the first step is to begin Integrated Medication-Assisted Treatment (IMAT) at one of our intensive treatment locations. IMAT Locations

Next Steps for Providers

If you would like to refer a patient for OUD treatment, please call 1-844-292-0111.

Visit our provider page to view training and resources.

For Providers

What is Opioid Use Disorder (OUD)?

OUD is a chronic (or constant) brain disease that some people can get from taking opioids often. This type of disease leads to craving opioids, not being able to stop using opioids, and can cause major life problems.

What are signs of OUD?

Signs of OUD include:

  • Craving- When you have a strong desire or urge to use opioids
  • Tolerance- When your body does not respond to the same amount of medicine and you need a higher dose to have
    the same relief
  • Withdrawal- When a person feels physical withdrawal symptoms after a fast change in dose or stopping the opioid
  • Loss of Control
  • Continuing to use opioids even though you know it may be harmful
  • Taking larger amounts or for a longer period of time than the doctor recommends
  • Difficulty cutting back or stopping opioids
  • Not being able to follow through with major life responsibilities

What financial aid is available for opioid treatment?

MaineHealth is committed to providing treatment to all patients, regardless of their ability to pay. We accept most commercial insurance, Medicare and MaineCare, and we provide treatment to patients who lack insurance as well. You do not need insurance to receive services. We are here to help. Visit our Financial Assistance page for more information.

How long does treatment last?

The length of treatment is different based on each person’s needs. Some clients will need longer periods of intensive care than others before moving on to the next level of care.

What happens after the period of intensive care?

After intensive care, clients will move to primary care practices in their local communities where primary care clinicians provide medication and social workers provide therapy. MaineHealth makes every effort to make sure that clients experience a smooth transition through each level of treatment. 

Where can I find intensive IMAT treatment for OUD?

Call the MaineHealth opioid treatment location that is closest to you.