Opioid Addiction Treatment in Ohio

Symptoms from short acting opioids, including heroin, oxycodone and hydrocodone, usually begin 8 to 24 hours after the last dose, peak in the first three days and settle over about a week. Methadone starts later and can last up to two weeks. What it looks like:

• Muscle and joint aching, stomach cramps
• Nausea, vomiting and diarrhea
• Sweating, chills, gooseflesh, runny nose and eyes
• Restless legs and insomnia

It is severe and rarely fatal on its own, though repeated vomiting and diarrhea can cause serious dehydration and electrolyte loss, which is dangerous in someone with heart disease. Craving and sleep settle more slowly than the physical symptoms.

Opioids, heroin and fentanyl are all within scope of ambulatory detox at both facilities. Nurse practitioners and registered nurses run it, with medication where it is needed. You sleep at home.

It covers mild to moderate withdrawal that does not need 24/7 medical supervision, and not everyone is a candidate. Leora has no beds and no overnight care, so if you need an inpatient setting the assessment will say so.

Detox that ends without ongoing medication carries a high risk of return to use, the SAMHSA position in TIP 63, so detox here starts a treatment plan. If you are pregnant, say so at the assessment. Withdrawal in pregnancy carries risk, and the standard of care is medication rather than detox.

Three medications are approved for opioid use disorder.

• Buprenorphine, a partial agonist usually combined with naloxone, suppresses withdrawal and craving. Leora's medication assisted treatment uses it. Taken too soon after a full agonist it can trigger precipitated withdrawal. Buprenorphine also comes as an extended release injection given by the care team: Sublocade once a month, and Brixadi once a week or once a month.
• Naltrexone, the monthly extended release injection, blocks the effects of opioids. It needs 7 to 10 days completely free of opioids first, so it usually follows detox.
• Methadone is also approved for opioid use disorder. Leora does not prescribe methadone as part of its MAT program. Leora can provide addiction treatment to people established on methadone with an outside provider.

Chronic pain is often the entry point and does not stop mattering during treatment, so it goes into the plan. Depression, anxiety and post-traumatic stress disorder are handled in the same plan by the same team. Anyone who has injected needs hepatitis C and HIV testing. Alcohol and benzodiazepine use raise overdose risk and change what can be prescribed safely.