FAQs

Addiction is a relapsing disease of the brain that is chronic. This means simply that when taking drugs or drinking alcohol, those with the disease have a difficult time stopping the cycle, even if they desire to. Instead, the urge to continue taking their substance of choice overwhelms them, even if the substance is causing them harm.

You can characterize addiction by not only the inability to abstain from use for any significant length of time, but also an inability to manage the amount taken when using. There are additional symptoms that can include the loss of behavioral control, cravings, physical withdrawal, inability to recognize the problems caused by use and inability to manage functioning in areas of life.

Opiates are a collection of drugs that are utilized for pain treatment. They are derived from opium which naturally occurs in the poppy plant, and are also synthetically created to replicate the effects of naturally occurring opiates. You might hear these called a variety of names such as opiates, opioids, or narcotics.

When using the term “opiates”, that typically refers to close relatives of opium such as codeine, morphine, and heroin, while the term “opioids” is used for the entire class of drugs including synthetic versions such as OxyContin®. While the terms are interchanged often, the most common name is “opiate”.

Opioid addiction is often mistaken as a result from a lack of control, when in reality, it is actually a complex disease. Medical treatment is required often because opioid addiction causes both physical and psychological changes to the brain. The first time a person uses an opiate, the drug impacts certain brain receptors and the cycle of addiction begins. When the cycle is ongoing, the brain begins to rely on opioids instead of its natural chemicals it produces. When the addiction develops, the person requires opiates to level off physical withdrawal symptoms, causing the individual to become more and more addicted. There are also psychological needs that are met by the use of opioids, making it a multi-faceted and complex disease.

Below are some commonly used opioids and opiates, showing both their brand and generic names. They are listed in order of increasing strength:

• Codeine®
• Vicodin®, Hycodan® (generic: hydrocodone)
• MS Contin®, Kadian® (generic: morphine)
• OxyContin®, Percocet® (generic: oxycodone)
• Dilaudid® (generic: hydromorphone)
• Duragesic® (generic: fentanyl)
• Zohydro®
• Heroin (illegal street drug)

At Middlesex Recovery, we provide medication-assisted treatment (MAT) programs that prescribe FDA-approved buprenorphine medications. Buprenorphine, and buprenorphine compounds like Suboxone®, target the brain’s opioid receptors to aid in withdrawal symptom relief.

There is no guaranteed cure for addiction, however, buprenorphine and buprenorphine compounds with naloxone, such as Suboxone®, can help patients overcome their opioid addiction so they can live satisfying and productive lives. The medications limit withdrawal symptoms and manage cravings so that patients can focus on counseling to address the reasons for addiction while learning positive tools to help them manage their everyday lives. 

Buprenorphine is typed as a partial agonist, which means it will not activate brain receptors to the same level as methadone. It achieves what is known as a “ceiling effect”, meaning they will not reach an excessively high level, no matter the dosage amount. This makes it more difficult to misuse and become addicted to. Suboxone® contains naloxone, which is typed as an agonist that blocks other opioids from attaching to the brain receptors. Suboxone®, like other buprenorphine compounds, suppresses withdrawal symptoms while blocking other opioids, making it an effective treatment for opioid dependency.

Buprenorphine (the active ingredient in Suboxone®), and methadone are both types of opioids that activate brain opioid receptors. Both are FDA-approved and longstanding medications, which makes them useful for the purposes of substance use disorder treatments. However, there are key differences that separate these two medications from each other.

Buprenorphine is typed as a “partial agonist”, which is defined by it not activating brain receptors to the same level as methadone. The feelings experienced do not reach what is called a “ceiling effect”, or an excessively high level, no matter how much the dose is increased resulting in it not being as difficult to misuse. Suboxone®, a common buprenorphine compound, contains naloxone which acts as an “antagonist” that blocks other opioids from attaching to the brain’s receptors. 

Methadone is typed as a “full opioid agonist” with no ceiling effect. This is similar to how heroin impacts the brain, being a full agonist as well. Methadone can be more easily misused, and it is possible to overdose on it. However, once the right dosage is prescribed, it too can also be successful in the treatment of opioid addiction.

No. Since MAT prescribed medications such as buprenorphine target the brain opioid receptors, some believe the myth that MAT replaces one opioid addiction with another. They believe that taking MAT prescribed medicine instead of other opioids counts as an addiction. MAT actually reduces withdrawal symptoms to promote healthy behaviors and when taken as prescribed, at a therapeutic dose, does not cause euphoric feelings. Buprenorphine medications help patients control their drug-seeking urges so they can develop long lasting recovery skills. MAT providers such as Middlesex Recovery give patients the support needed to live a life free of substance use disorder.

Common side effects include:

• Nausea
• Vomiting
• Drug withdrawal syndrome
• Headache
• Sweating
• Constipation
• Loss of sleep (insomnia)
• Blurred vision
• Back pain
• Fainting
• Dizziness
• Sleepiness
• Intoxication (feeling lightheaded or drunk)
• Disruption in attention
• Irregular heart beat (palpitations)

Potential side effects of buprenorphine and its compounds include:

• Respiratory Issues – View warnings regarding taking buprenorphine-based medications with benzodiazepines or other medications with possible interactions.
• Sleepiness
• Dizziness
• Issues with coordination
• Dependency or abuse if not medically supervised
• Liver problems
• Allergic reaction
• Opioid withdrawal
• Decrease in blood pressure

Please speak to a Middlesex Recovery specialist or your physician for more information on possible side effects, interactions and other safety information.

It is a common concern for new patients interested in MAT that they worry the buprenorphine will appear on drug screenings. As a Middlesex patient, you will be protected from job discrimination based on your treatment. While some professional drug screenings do check for buprenorphine elements, standard tests do not, and your Middlesex team can help you inform the testing lab that you are prescribed it. Under federal law, an employer cannot deny you a job or fire you based on you being in MAT for substance use addiction.

Research states that buprenorphine may help pregnant patients reduce their risk of neonatal abstinence syndrome, a condition that happens when infants are exposed to opioids within the womb. At Middlesex Recovery, we also individualize treatment plans during a patient’s pregnancy to account for their unique needs and in collaboration with obstetrical care providers. 

Withdrawal from opioids and opiates can be extremely uncomfortable. Treatment with buprenorphine or its compounds is intended to lessen the discomfort caused by withdrawal, and from there eliminate the cravings that often do lead to relapse.

While the first days of treatment won’t make you feel 100% back to normal, you will continue improving as your dose is stabilized during treatment. Your withdrawals will continue to decline until you are no longer experiencing them at all.

Remember that opioid and opiate withdrawal is not dangerous if you are withdrawing only from opiates/opioids and not a combination of drugs. It is important to inform your doctor of any other drugs or medications you may be taking.

No medication-assisted treatment plan has a specified duration of time for patients. Each patient’s journey in treatment is unique, and the treatment length is affected by a multitude of factors including the duration and how much they used and whether or not they participate in substance use counseling. Experts report that success in medication-assisted treatment is much more likely for those patients who participate for a minimum of one year.

As a patient with Middlesex Recovery, you will receive appointment-based, outpatient care. As a result, you can carry on with typical daily obligations while participating in treatment.

Individual and group substance use counseling is available at select Middlesex Recovery locations and others work with trusted behavioral health partners to refer patients. Those who actively participate in substance use counseling while in a medication-assisted treatment program are much more likely to achieve success of long-lasting recovery.

Middlesex Recovery abides by HIPAA Privacy Practices, and is not eligible for releasing any of your private health information without your written consent or a court order signed by a judge. At Middlesex, prioritizing and protecting your privacy and confidentially is a matter of high importance to our teams.

Our Middlesex Recovery staff members at each clinic is selected very carefully with special attention on each members’ ability to express professional compassion and provide the highest quality of care. Addiction is a disease, and each patient deserves to be treated just as you would if being treated for any other life-threatening disease.

The treatment provided by Middlesex Recovery is exclusive to opioid and alcohol use disorders.

When starting a recovery program, the top priority begins with addressing the physical withdrawals and cravings you are experiencing. As the prescribed medication begins to take effect, you can then begin improving your overall health and well-being. Take that time to start focusing on the basics such as nutrition, exercise, and getting enough sleep. Nutritious foods and plenty of water are keys to the regenerating process the body is going through during recovery. Exercise is the prime way to boost natural production and release of hormones which help with improving mood and concentration. When one achieves plenty of sleep, the body gets a break and needs to put all of these new healthy habits to work to repair the damage caused by drug and alcohol use.

A support system is a group of similar individuals close to a patient who provide balance and community for encouragement during recovery. They hold you accountable and provide good company to eliminate feelings of loneliness through acceptance and hope. It’s helpful for patients to know that others’ experiences similar to yours and understand your struggle with addiction. This type of community support can be found in:

• group counseling sessions at a medication-assisted treatment program
• a 12-step meeting
• other recovery groups such as sober living houses or IOP

It is common for patients who struggled with addiction before entering treatment to feel very alone. Family relationships and friendships were understandably strained or may seem irreparably broken, which is why it is more important than ever to surround yourself with a support group as you work through your treatment program. As you begin to recover, your relationships with family and friends will begin to fall back into place with time.

We only treat patients with opioid or alcohol addiction, however we can direct those with other types of addictions to other appropriate resources. Individuals’ safety and well-being are held with high regard from our teams.