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A Guide to Opioid Rehab
Treatment & Recovery Options in Thailand

According to the World Health Organisation (2016), over 27 million people worldwide suffer from opioid use disorders – defined as the frequent use of opioids to the detriment of the person’s physical, psychological, and social functions. Pain medication can be beneficial under the right conditions, but abusing prescription drugs can lead to an addiction that may be hard to get away from. While taking the initial step to enrol in an opioid rehab programme can be difficult, you will be supported every step of the way. Rehab is an extensive process that aims to provide an intense programme of professional support and care for those struggling with drug abuse.

Opioid addiction and common prescription opioids

Opioids are a class of substances that include illegal drugs like heroin, as well as prescription medications used to treat pain such as oxycodone, codeine, hydrocodone, fentanyl, and morphine. These drugs are typically derived from opium poppy plants, but they can also be a combination of a synthetic drug in addition to opium. Opioids are highly addictive and very difficult to withdraw from if you’ve been using large doses for long periods of time.
This addictive quality may not be apparent at first, yet over time you may find your body building up a tolerance to the drug. This phenomenon occurs when your body learns to accept and expect the drug, and then alter its internal chemistry as a result. Eventually, your body’s natural opioid receptors come to rely on frequent interaction with the drug – and begin causing problems when they do not receive it. If you need to take opioids regularly and feel anxious when you run out of your supply, there’s a good chance you are suffering from Opioid Use Disorder (OUD) and that you would benefit from an opioid rehab programme.
In this article, you’ll learn more about:

What is opioid rehab?

The goal of opioid addiction rehab is to help you achieve a full recovery through three primary stages of treatment: Detoxification, therapy, and relapse prevention.

If you are receiving inpatient care, your day will begin with a nutritious breakfast, followed by morning activities to ensure the mind is fully relaxed before entering your therapy sessions. Most rehab centres in Thailand will also offer extracurricular activities such as sightseeing, sports, art, and cultural activities.

While no two rehab centres are exactly the same, they do tend to incorporate similar structures. Treatment typically includes a mixture of one-on-one behavioural therapy, along with group therapy and intervention sessions such as 12-Step facilitation therapy or family counselling. Some treatment centres focus more heavily on one or another of these methods, while others apply a more integrated mix.

The detoxification process is a method of cleansing the body of the opioid drugs by implementing specific medical and psychological strategies to ensure that you go through the withdrawal process in a safe and comfortable manner. To ensure the whole recovery process is a success, detoxification should be followed up with intensive therapy and comprehensive relapse prevention education.

Once the detoxification process is complete, you will embark on a period of therapy with addiction counsellors. Therapy is designed to help you examine your beliefs, self-conception, and patterns of negative behaviour, as part of a strategy to help you adopt new and more positive ways to go through life.

The aim of the relapse prevention stage is to ensure that you apply the necessary tools and skills to avoid any destructive behaviours that may lead back to substance abuse. The road to recovery from opioid addiction is a process of individual growth based on achieving developmental goals. At any stage of recovery, there is a potential risk of relapsing, which makes relapse prevention skills highly important to the recovery process.

When is opioid rehab needed?

According to the DSM-5, the presence of four or more of the following symptoms suggests a moderate level of opioid dependence, whereas six or more suggests that an individual has a severe dependence or an addiction, and would benefit from an opioid rehab programme.
  • Increased frequency or quantity of opioid use over the amount intended
  • Impaired control over use, or unsuccessful efforts to cut back
  • Devoting a lot of time to using and recovering from the effects of opioids
  • Persistent desire for opioid drugs, and needing to use to get through the day
  • Failing to meet work, school, family, or social responsibilities
  • Continued opioid use despite negative impacts on relationships with loved ones
  • Losing interest in other hobbies and activities that were important to you
  • Engaging in risky or dangerous behaviours; e.g. driving under the influence
  • Continued opioid use despite negative effects on physical and emotional health
  • Increased tolerance for opioids
  • Experiencing withdrawal symptoms after suddenly stopping opioid use
depressed women hand hold medicine with a glass of water, healthcare and medicine recovery concept

Opioid rehab programmes

There are many things to consider when it comes to selecting the right treatment setting for your needs. A primary consideration in any assessment is matching the level and type of intervention to the treatment needs of the individual.

Inpatient opioid rehab

An inpatient opioid rehab programme will provide care 24 hours a day within a residential treatment centre. Under this arrangement, clients can expect to receive all the psychological and medical support they need to overcome their opioid addiction, in addition to constant monitoring and physical distance from any everyday triggers.
Other benefits of inpatient opioid addiction rehab include regular access to professional medical experts, ensuring good health and safety throughout the whole treatment process. Inpatient centres also offer safety and security in a highly controlled setting, with a support system that encompasses fellow clients and professionals.

Outpatient opioid rehab

Outpatient drug rehab centres are generally less restrictive than their inpatient counterparts, while offering similar evidence-based treatment approaches. If you are suffering from a mild form of opioid addiction, day treatment may be a convenient method of care. These programmes last between 5-7 days, with up to 10 hours per week dedicated to pharmacological treatments as well as counselling.
Another avenue to explore is an intensive outpatient programme (IOP) – also potentially suitable for addressing mild opioid addiction. These types of outpatient programmes are generally done on a part-time basis over 3+ days per week, for a total of 10-15 hours per week. All forms of outpatient care require a certain level of personal discipline from the client, along with a positive home environment of social support, as there is no 24-hour supervision available for this type of treatment plan.

Who should receive residential treatment?

Generally speaking, residential service is appropriate for:
  • People who need medical support and close monitoring due to co-occurring mental health conditions 
  • People who require complex polydrug detoxification such as those with concurrent dependence on alcohol or benzodiazepines  
  • People who would benefit significantly from a residential programme during and after detoxification, such as those with unstable home environment or toxic relationships
  • Residential treatment may also be recommendable for people who have a mild and moderate form of opioid addiction, such as those in their early stages of drug use

Opioid detoxification

The goal of opioid detoxification is to allow the body to rid itself of opioid drugs, eliminating their effects in a safe and effective manner. Depending on the type of opioid you have been abusing and the amount of time you’ve been using, you can expect to experience serious and unpleasant withdrawal symptoms when you stop taking the drug. You should seek medical detox in a controlled environment when you decide to quit using the drug, so that your withdrawal symptoms can be managed by a team of medical specialists.

Complex polydrug detoxification

Sufferers from opioid addiction may develop a tendency to misuse benzodiazepines and/or alcohol to respond to withdrawal symptoms during the detoxification process. The effect of this tactic, of course, is to substitute one addiction (opioids) with another (alcohol).
  • If you are dependent on alcohol or are at high risk of becoming dependent, alcohol detoxification should be considered as a course of treatment. To ensure the best chance of success, alcohol detox ought to be carried out before you commence a similar process for your opioid addiction. It is possible for alcohol and opioid detoxification to be performed concurrently at an inpatient rehab centre.
  • If you are dependent on benzodiazepines, a detox process is also required. The decision to carry out dual treatment for benzodiazepine and opioid addiction will depend on your preference, as well as your level of dependency on both substances; however, the final say will rest with your medical team.
Confident doctor man holding a pill bottle and talking with senior patient and reviewing his medication at office room.

How long is opioid detox?

The length of the procedure can be impacted by many factors. Firstly, the type of medicine and the starting dose can significantly influence the rate of detoxification. In some severe cases, the detox can take months. However, generally, the period of opioid detoxification can range from 7-21 days and should ideally be completed within 30 days of staying at a residential treatment centre. Some clients opt to have ‘slow tapering’ treatment which can last up to six months or longer. Most slow tapering programmes are offered on an outpatient basis.
Following opioid detoxification, and irrespective of the setting in which it was delivered, opioid addicts should seek continued treatment, support and care to maintain abstinence. This process should ideally continue for a period of at least 6 months across the continuum of care.

How long does opioid withdrawal last?

Withdrawal symptoms typically begin between 6-12 hours of your last dose, and then peak within 24-48 hours. Symptoms may include vomiting, diarrhea, muscle pain, insomnia, and anxiety. Most opioid users find that their withdrawal symptoms ease after 72 hours. Depending on the severity of withdrawal symptoms or the level of opioid addiction, health care professionals can prescribe various medications to mitigate the most serious symptoms that may arise out of the detoxification process.

Opioid withdrawal medications

Opioids are central nervous depressants, so for the detoxification process to be successful, a substitute medicine is needed to mimic the effects that opioids have on the body. For example, methadone, buprenorphine, or naltrexone are commonly used in detox. Adjunct medications such as benzodiazepines (commonly known as ‘benzos’) can also be considered as an alternative in combatting the negative symptoms a patient may experience during detox.
For detoxification using methadone, the most rapid treatment options can last 7–21 days on average. However, detoxification with buprenorphine is usually faster, and can (in theory) be completed within less than a week – although 14 days to several weeks is typical.
Naltrexone can be used as an alternative to methadone or buprenorphine; however, initiating treatment among active opioid users is more difficult with this medication. The only issue with using naltrexone is the fact that you must have completely stopped your opioid use 7 days before commencing on a course of naltrexone. Therefore, if you have a strong addiction to opioids, it may be difficult to be treated with naltrexone.

Once the detoxification process is complete, these medications all exhibit a similar rate of effectiveness.

The type of medication used during the detoxification process, and the length of the treatment, depend on numerous factors, such as:

 

  • The severity of the opioid addiction
  • Any additional mental health disorders
  • The type of detox medication
  • And the environment in which detoxification is conducted

These factors can all have an impact on the length and success of the treatment. Therefore, it is vital that full medical disclosure is carried out before the detoxification process commences.

Opioid addiction treatment

The UK and USA addiction specialists suggest that attempts to treat opioid dependence using only pharmacological detoxification have been fraught with failure and associated with high rates of relapse to dependent use.

Such results can lead opioid users to believe that their condition is incurable – a belief which in turn can lead to further harmful behaviour. Detoxification should only be encouraged as the first short-term goal within a far longer treatment process. It must therefore be implemented as a precursor to relapse prevention education, along with the therapies which will then form the main pillar of rehabilitation.

Psychosocial interventions are an essential element within any comprehensive opioid addiction treatment programme. In addition to helping you prevent relapse, these techniques allow you to address the numerous psychological, social and relationship issues that may have led you to abuse opioids in the first place.

One of the key ways that opioid users learn to kick their habit is by channeling their negative physical and mental acts towards more positive ends. This outcome can be achieved through the following types of therapy and counselling.

CM uses positive reinforcement techniques to reward those undergoing treatment for addiction. For example, a patient may be treated to a gift after a particular milestone has been achieved.
Seeking the professional services of a counsellor can help you maintain your recovery in a relaxed, one-on-one setting. A counsellor can help you set further goals and maintain your momentum to be free from opioid use. Counsellors can also assist with other health, social, and relationship issues.
CBT uses principles of conditioning and learning as a way to instil positive thinking and self-control, giving clients the mental resources they need to resist cravings as they occur.
Opioid addiction can have a serious effect on family life, but family can also have a key role in the recovery process. Successful treatment requires stable and strong relationships, allowing immediate family and friends to play an active role in the treatment process. Studies have shown that family intervention measures can result in lower relapse rates, increased happiness in the family, and a more positive outlook overall.
The 12 Steps approach was developed by the founders of Alcoholics Anonymous to promote a set of guidelines which can help people overcome their addiction to alcohol. Since then, the concept has been adapted for use by those working through other addictions such as opioids. The 12 Steps model provides support, encouragement and accountability for people who are battling an addiction.
If you are addicted to opioids, there is a high probability you reached for the drug in order to ease symptoms of a mental illness such as depression, anxiety, PTSD or bi-polar disorder. Effective opioid rehab should focus on helping you not only overcome your opioid addiction – but also treat any underlying mental health issues that may be present alongside your addiction.

What happens after opioid rehab

Once your stay at an inpatient treatment centre comes to an end, you will receive additional post-treatment support to ensure that you have the necessary skills, resources, and guidance to avoid a relapse. You may also consider participating in additional treatment options, such as:

Self-help groups: These are a great way to share stories, tips and advice on how to deal with the problems of everyday life. Here, you will have the opportunity to share your story with other like-minded people, and receive their words of advice and encouragement.

Outpatient counselling: A qualified, professional counsellor will ensure that you have an experienced guide to help you on your road to recovery. Outpatient counsellors can deliver a variety of therapies to keep you on the path to sobriety.

Sober house programmes: Sober living facilities are semi-controlled and monitored living spaces, where recovering addicts can take steps toward re-integrating with society. They can be used as a transitional stage before returning to a fully independent lifestyle.

Human hands held together during group psychotherapy

What to look for in an effective opioid rehab

The following steps and features should be part of any high-quality opioid rehab centre:

This preliminary step will take place before the detoxification procedure can commence, and will bring to light the severity of your drug abuse as well as your physical and mental health condition.

This will take place inside the rehab centre and may take 3-7 days, under close 24-hour medical supervision. This arrangement is due to the complicated nature of the detoxification process, along with the impact this can have on a patient’s physical or mental well-being. Every opioid addiction programme should consist of an integrated and patient-centred approach to ensure that you are getting the help you need.

Depending on the severity of your withdrawal symptoms or your level of opioid addiction, health care professionals can prescribe and administer various medications throughout the detoxification process. Pharmacological should be made available to support treatment for drug misuse and other associated physical and mental health problems.

To ensure continuing support and progress, meetings with the medical team should be routinely held to review progress and challenges. To further encourage recovery and to take a holistic approach to your needs, medical professionals should be active in their suggestions and flexible in their approach to the treatment process.

The provision of integrated, accessible services by addiction specialists during treatment programmes should effectively address your comprehensive care needs through frequent communication and collaboration.

During the course of opioid addiction treatment, the programme should offer a range of therapies to ensure that you can reintegrate into society in a productive way following treatment. Psychosocial interventions can take the form of interpersonal or informational activities, techniques or strategies that target biological, behavioural, cognitive, emotional, interpersonal, social or environmental factors with the aim of improving general health functions and well-being.

How long is inpatient opioid rehab?

Most inpatient opioid rehab programmes last for 30 days, but you may need a longer programme of up to 90 days if you have a more complex case that includes substance abuse and mental illnesses or multiple addictions. Research shows that long-term rehab programmes (usually 90 days or longer) are more successful at helping people stay sober in the long run.

The length of treatment can depend on a multitude of factors including, but not limited to, the level of the opioid addiction, the length of detox period, pre-existing mental health conditions, and whether you have attended any form of therapy or rehabilitation for opioid addiction in the past. Long-term rehab treatment is associated with the highest rate of success.

How much does opioid rehab cost?

Depending on the length of treatment, the type of programme, the services and amenities offered, as well as the location, opioid rehab centres in the US, UK or Australia can cost between $10,000 and $100,000 for a 30-day programme. The general price tag for treatment is:

$3,000 – $5,000 per week for intensive outpatient programmes (IOPs)

$10,000 – $30,000 for standard inpatient rehab (30 days) 

$40,000 – $100,000 for luxury inpatient rehab (30 days)

$8,000 – $16,000 for inpatient rehab in Thailand (30 days)

Opioid rehab in Thailand set in resort-style facilities with swimming pool

Affordable opioid rehab in Thailand

Thailand is home to many excellent opioid rehab facilities that provide comprehensive drug addiction programmes. Many of Thailand’s addiction experts and qualified counsellors actually come from overseas, where they also received their education and professional training. The level of treatment in Thailand is therefore comparable to that of the US, UK, or Australia.

Thailand has a huge variety of rehab options for every budget – while its relatively low cost of living and high standard of medical facilities mean that the country’s addiction treatment programmes can provide better value than most rehab centres elsewhere.

Choosing a rehab programme in Thailand will allow you to seek sanctuary in this beautiful country, while taking some time away from your usual environment and the sometimes-negative influences that may stem from it.

FIND A REHAB

If you are ready to begin your journey to recovery, contact us today to find out how we can help you. We will have one of our clinical coordinators call you to discuss the best treatment plan.

Author
Cameron Brown
Psychologist
About the Author
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  6. Day, Ed & Bearn, Jenny & Keaney, Francis & Marshall, Jane & Myles, Judith & Sell, Louise. (2006). SCAN Consensus Project: Inpatient Treatment of Drug and Alcohol Misusers in the National Health Service. Available from: https://www.researchgate.net/publication/262876229_SCAN_Consensus_Project_Inpatient_Treatment_of_Drug_and_Alcohol_Misusers_in_the_National_Health_Service
  7. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006. Available from: https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf
  8. NIDA. “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse, 17 Jan. 2018, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition.

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