Evidence-based, compassionate care

Opioids are a class of natural, semi-synthetic and synthetic narcotics that are derived from the opium poppy and/or are synthesized in pharmaceutical laboratories.

Substances in the opioid family include both legal and illegal drugs:

When used correctly — as prescribed under a physician’s supervision — legal opioids are effective tools for pain management. They can be taken orally or intravenously.

Opioids are among the most commonly abused substances. Opioids affect the brain receptors that govern the release of neurotransmitters (e.g. dopamine), which regulate emotions and reduce sensations of physical pain.

Opioids are commonly abused orally or by snorting, injecting, or smoking. Repeated use/abuse of opioids creates the potential for addiction. Physical addiction can occur within 6 weeks of the initial opioid abuse, but psychological addiction can occur in as little as 48 hours.

Once addicted, individuals with opioid use disorder (OUD) cannot stop abusing opioids without triggering acute withdrawal. During acute withdrawal, the individual suffers from severe flu-like symptoms, pain, depression, and anxiety. Thereafter, post-acute withdrawal can last for months or longer.

We utilize a comprehensive counseling program to address the patient’s psychological dependence on opioids. Working with an on-site counselor, each patient develops an individualized treatment plan (ITP). The patient and counselor work together to identify issues and triggers that lead to damaging behavior, and develop non-damaging coping mechanisms to address those triggers. This process maximizes the patient’s strengths while shoring up their areas of weakness.

As part of a comprehensive treatment program, BHG can administer — or in some cases, prescribe — medications that are FDA approved for the treatment of opioid use disorder. We are not “medication only.”

We use these FDA-approved medications (methadone, buprenorphine, and naltrexone) to address patients’ physical dependence on opioids. These medications can minimize the painful symptoms of withdrawal and help clinically stabilize the patient. Abstinence-based OUD treatment models can leave patients more vulnerable to relapse, and even overdose. Additionally, patients respond better to behavioral counseling if they are not suffering from acute withdrawal symptoms.

MAT-based programs use medication as a stabilizing factor while administering comprehensive treatment services, including individual and family counseling. Medications — specifically methadone, buprenorphine, and naltrexone — have been shown in controlled trials to be superior to counseling alone, helping patients with opioid use disorder abstain from opioid use and stay in treatment. MAT also reduces the likelihood of an overdose in the case of a relapse.

Yes. Numerous research studies conducted over nearly 60 years have repeatedly shown that medications are effective in the treatment of opioid use disorder. Further, medications have been shown to help people stay in treatment so they have the opportunity to get into recovery.

Unfortunately, many people do not receive the treatment they need, either due to lack of access to providers, or due to misconceptions and stigmas about MAT programs.

This is a common misconception, but it doesn’t reflect the reality of what MAT actually does and how the medications work. When a patient receives MAT, they are moving from using opioids in an unsafe, destructive, and often illicit manner, to using a highly regulated medication that has been FDA approved for the specific purpose of treating addiction. 

At BHG treatment centers, medication is administered under the care of trained physicians and medical professionals. Additionally, the medications used in our Medication-Assisted Treatment programs are pharmacologically different from commonly abused pain pills or heroin. These FDA-approved medications provide relief from the physical withdrawal symptoms and cravings associated with opioid dependence, while preventing the euphoric effects of other opioids.

There are three FDA-approved medications available for the treatment of opioid use disorder: methadone, buprenorphine, and naltrexone. 

There is no scientific evidence showing that one medication is better than the others. The most appropriate medication and dosage will be determined by the preferences and needs of the patient in consultation with one of our physicians.

At a proper dose, these medications do not make the person feel “drugged” or “high” like other opioids. Each dose lasts for at least 24 hours and significantly reduces drug cravings. While taking their medication as prescribed, many people say that they feel “normal” for the first time in a long time.

Methadone is an FDA-approved medication that has been used for decades to treat opioid use disorder. Methadone-assisted treatment for opioid addiction is the most researched and proven form of treatment, effective for producing positive outcomes for those struggling with opioid addiction. In fact, the World Health Organization includes methadone on its List of Essential Medicines.

The medication acts as a “full agonist” on opioid receptors within the brain and central nervous system which allows it to provide relief for severe withdrawal symptoms and helps “normalize” the brain chemistry to reduce cravings. 

One of the things that sets methadone apart from other opioids is its long half-life. This means that the medication wears off much more gradually than other opioids such as morphine, fentanyl, or heroin. While the medication is able to provide relief for physical withdrawal symptoms and cravings, it blocks the euphoric high associated with other fast-acting opioids. 

Because of its effectiveness, methadone-assisted treatment has been recognized as the “gold standard of care.”

Buprenorphine has been approved by the FDA for the treatment of opioid addiction, and can help treat opioid addiction by providing relief from opioid withdrawal symptoms and cravings. In comparison with methadone, which is a “full-agonist” opioid medication, it is a “partial-agonist” opioid medication. This means that while it has opioid properties that allow for withdrawal relief, there is a “ceiling” in the dose effect. Buprenorphine assisted treatment has been shown to be an effective form of treatment for those suffering from opioid addiction. However, due to the limited relieving properties of buprenorphine, methadone may be the most effective form of treatment for those with a high level of dependency. Research continues to support the view that, like methadone, buprenorphine is most effective when part of a comprehensive treatment program that includes other support services such as counseling and case management.

Methadone and buprenorphine both activate mu-opioid receptors (MORs) in the brain. However, unlike other opioids, they do so in a way that provides withdrawal symptom relief and curbs cravings while blocking the high associated with other opioids. Methadone is a “full agonist” that fully activates opioid receptors. Buprenorphine, a “partial agonist,” only partially activates opioid receptors, creating a ceiling on the medication’s effect. 

In contrast to these opioid agonists, naltrexone is an opioid antagonist that simply blocks opioid receptors rather than activating them. Since opioid antagonists do not activate opioid receptors, they do not provide relief for physical withdrawal symptoms or cravings, and require full detoxification before starting treatment. 

The three FDA-approved medications for treating OUD are methadone, buprenorphine, and naltrexone. BHG is licensed to use all three to treat patients, depending on the type of program. 

At BHG, buprenorphine is almost always provided as a combination medication with the opioid antagonist naloxone. This combination is frequently marketed as Suboxone or Zubsolv, and is preferred by most regulatory bodies because it is less likely to be misused than buprenorphine alone.

All BHG treatment centers offer treatment in an outpatient setting. This allows the patient to receive treatment while they continue to live at home, attend work or school, and live a normal life. 

Regular counseling sessions and doctor visits are cornerstones to all of our programs. Certain programs also require on-site administration of medication. The frequency of on-site dosing is determined by federal and state regulations, direction from the doctor (with input from the treatment team), and the achievement of recovery milestones by the patient.

In addition to medical and behavioral treatment, BHG emphasizes abstinence from illicit substances. All patients are subject to scheduled and unscheduled drug tests, which are monitored by the clinic medical staff. This reduces the risk of relapse.

BHG’s approach is to “meet patients where they are” and offer the level of treatment that is appropriate for the challenges they are facing. Our treatments get more intense when people have more acute needs, and less intense when their clinical situation stabilizes. The goal is to partner with patients throughout their recovery journey, offering what they need when they need it.

BHG’s Comprehensive Outpatient Experience (COPE), provides patients with intensive outpatient support. 

Patients can move fluidly through different levels of care — including both Standard and Motivational Enhancement programs — based upon their individual needs. For example, a patient might transition or step down to BHG’s COPE program after completion of an inpatient or residential rehab program.

In case of relapse, COPE can also be used as a tool to help patients get back on track with their recovery.