Oxymorphone Addiction

General Information

Oxymorphone is an opioid pain reliever, widely prescribed to treat moderate to severe pain. According to the U.S. Drug Enforcement Agency, or DEA, pharmacists filled more than a million oxymorphone prescriptions in 2007. Many people never finish their prescriptions and keep extra oxymorphone on hand in case of an emergency. This makes oxymorphone widely available to recreational users, increasing the incidence of oxymorphone addiction in the United States.

More Americans are struggling with addiction to oxymorphone and other prescription drugs than ever before. The White House calls prescription drug abuse, "the nation's fastest-growing drug problem." Except for marijuana, prescriptions such as oxymorphone are the most abused drugs among young Americans.

According to a survey reported by National Institute on Drug Abuse, about 16 million people in the United States were using psychotherapeutic drugs like oxymorphone for non-medical reasons at least once in the previous year. This means they took the drug to get high or for a condition other than the one for which the doctor had intended.

Long-term abuse of some prescription medications, especially powerful opioids such as oxymorphone, can lead to physical dependence and addiction. Anyone can develop an oxymorphone addiction or dependence after taking this drug for a long time. Using large doses of oxymorphone, using it longer than prescribed, or using oxymorphone in an unsafe way can increase your risk for developing dependence or addiction. Physical dependence and oxymorphone addiction are serious neurological conditions, requiring the help of a qualified professional.

Prescription opioids are plentiful in the United States. Americans take more of these drugs than another other nation on earth. Even though Americans account for about 5 percent of global population, they consume 80 percent of the world's supply of opioids, according to the Institute of Addiction Medicine.

Admission rates for oxymorphone addiction and other substance abuse problems are rising in response to the increased drug use in America. The Substance Abuse and Mental Health Services Administration reports the U.S. admission rate for the abuse of opioids (aside from heroin) increased 414 percent between 1997 and 2007. Admission rates leaped from about seven cases for every 100,000 people to 36 per 100,000 in just ten years.

The Definition of Addiction

The American Society of Addiction Medicine says that addiction is a "primary, chronic disease of brain." In other words - oxymorphone is a medical condition and not a defect of moral character. Addiction is not necessarily an indication of criminal activity.

Oxymorphone addiction changes the central nervous system on a cellular level in a way that affects, among other things, the brain's reward system. Neurological dysfunction lead to the characteristic biological, psychological and behavioral changes associated with oxymorphone addiction. An addicted individual craves oxymorphone and pathologically pursues this drug.

Someone suffering from an oxymorphone addiction is unable to stop using oxymorphone consistently. He will feel persistent cravings for oxymorphone. He will be unable to recognize the negative impact his behavior has had on his life and his relationships with others.

He is likely to experience several cycles of relapse and remission during the course of his oxymorphone addiction, which could last months or years. Without treatment or engagement in recovery activities, his disease will grow worse and may even result in disability or premature death.

Addiction versus Dependence

Oxymorphone addiction and dependence are two independent medical conditions. With continuous or improper use, anyone can become addicted to oxymorphone, dependent on it, or both.

The human body responds to foreign substances, such as food, cigarette smoke or medicine like oxymorphone. The body adapts to the long-term presence of some compounds by adjusting its own chemistry, so that there is a safe chemical balance within the body. With continued oxymorphone use, the body starts to depend on a certain level of oxymorphone to feel "normal." When oxymorphone levels drop, the body struggles to maintain chemical stability. This chemical imbalance results in unpleasant, flu-like withdrawal symptoms. Physicians refer to this process as detoxification.

Doctors will diagnose a patient as being opioid-dependent if she experiences withdrawal symptoms after the level of opioids decline in her body. This decline may be the result of missing a dose of oxymorphone, taking a smaller dose than usual or by consuming a medication that causes opioid levels to drop. One such medicine is naloxone, used by doctors to bring opioids down to safe levels after an overdose.
Oxymorphone withdrawal symptoms are similar to other opioids and include:

  • Abdominal Cramping
  • Diarrhea
  • Fever, Runny Nose or Sneezing
  • Goose Bumps and Abnormal Skin Sensations
  • Hot Sweats and Cold Sweats
  • Insomnia
  • Low Energy Level
  • Muscle Aches or Pains
  • Nausea or Vomiting
  • Pain
  • Rapid Heartbeat
  • Rigid Muscles
  • Runny Nose
  • Shivering, Tremors
  • Teary Eyes
  • Yawning

An opioid-dependent person will experience unpleasant, flu-like withdrawal symptoms a few hours after the last dose of oxymorphone. A person struggling with oxymorphone addiction will express behavioral symptoms such as cravings and drug seeking when supplies run low.

Symptoms of oxymorphone addiction include:

  • Inability to Consistently Abstain from oxymorphone Use
  • Other Behavioral Control Problems
  • Cravings for oxymorphone
  • An Inability to Recognize Significant Problems with One's Own Behaviors and Interpersonal Relationships
  • Inappropriate Emotional Response

A person can be addicted to something and not dependent upon it, or dependent on it but not addicted. For example, someone may depend on insulin to control glucose levels; if he does not use the proper amount of insulin after a meal, his blood sugar will increase and his struggles to maintain chemical stability, but he would not feel cravings for insulin or engage in drug-seeking behaviors.

On the other hand, if he uses cocaine for a long time, he might become addicted to it but not dependent on it. In other words, he will crave cocaine but will not suffer the flu-like symptoms typically associated with opioid withdrawal.

An individual may also be both physically dependent on oxymorphone and addicted to it.

Drug seeking activity

A person addicted to oxymorphone will engage in drug seeking behavior, such as presenting phony prescriptions at pharmacies or altering prescriptions to get a stronger dose or more oxymorphone in each bottle. One drug-seeking tactic is to place an emergency call or visit just as the physician is closing up the office and then refusing examination, testing or referral to another facility. The DEA calls these types of activities "diversion" because of the way abusers divert medicine from legal to illegal use.

Other forms of diversion include losing prescriptions frequently, tampering with written prescriptions to get more pills in each bottle. Many people go "doctor shopping" to get as many written prescriptions as possible. Most often, an individual gets his oxymorphone free from friends, relatives, or buys it on the black market.

Addiction: What Family Members Should Know

Oxymorphone addiction is a disease that central nervous system. Oxymorphone addiction is not an indication of poor child-rearing skills or weak moral character. Like with any other neurological illness, a person facing oxymorphone addiction relies on the love and support to help him through the recovery process. Oxymorphone addiction is a chronic disease, so family members should anticipate several cycles of remission and relapse - commitment to recovery must last for weeks, months or even years.

Everyone directly related to the addicted individual shares a common risk for developing an addiction to oxymorphone, other opioids or drugs or alcohol. Scientists now know that heredity plays an important role in the development of addiction. Researchers have also established that stresses within the home environment raises the risk of addiction for everyone within the household.

Stress and Other Environmental Factors

Stress within the home or workplace increases the risk for addictive behaviors for everyone within that environment. These stresses can include chronic arguing or violence between individuals, financial strain or other substance abuse. Researchers think some individuals are hypersensitive to stress, which increases the changes for developing an addiction. Parents may pass this hypersensitivity onto a child.

Children also learn many positive and negative behaviors from their parents, including using drugs to relieve stress. Adults pass along coping mechanisms, good or bad, onto their children. A child who watches a parent deal with stress by drinking or taking drugs such as oxymorphone are likely to cope with pressure the same way when she grows older.

Every member of the family can lower his risk for developing oxymorphone addiction or other substance abuse problems by decreasing the ambient environmental stress within the home or office. It is important to learn how to resolve conflicts without resorting to arguments or violence. Family members can reduce environmental stress by reassessing each person's household responsibilities to ensure the workload is evenly distributed.

Collateral Damage

Oxymorphone addiction endangers everyone in the family. Oxymorphone addiction inflicts collateral damage onto a large radius surrounding the addicted person, including his children, spouse, family members, friends and co-workers.

Oxymorphone addiction steals money from the family's grocery budget, rent, healthcare and childcare. Oxymorphone addiction also steals time and compassion. A parent battling oxymorphone addiction is unable to give the guidance, support and financial care a child needs because the addiction steals an ever-increasing share of the adult's time and resources.

Oxymorphone addiction interferes with job performance; long-term addiction frequently results in lesser pay or even the loss of a job.
Someone struggling with oxymorphone addiction might begin associating with people he probably would have avoided in the past. Doctor shopping, filing phony prescriptions or other drug-seeking behaviors stop working after a while, forcing the addicted individual to get his oxymorphone from drug dealers. At first, he may keep his drug dealer at a safe distance from his family but as his disease gets worse, he drops his defenses and invites this criminal element into his home to get high or to buy and sell drugs. This endangers everyone in the residence, including children.

Without a job, the addicted individual may have to resort to crime to pay for oxymorphone. Long-term criminal activity usually ends in arrest, jail time and conviction. Participating in the legal system is expensive, diverting money from the home to pay for lawyers, time away from work to attend court hearings and probation appointments. Prison takes countless years away from drug addicts.
Oxymorphone addiction can also drive up the family's medical costs, especially if it results in overdose or an infectious disease commonly associated with drug use.

Addiction: What Parents Should Know

Anyone can become addicted to oxymorphone, even children, teenagers and young adults. Parents should know that teenagers and young adults are abusing prescription painkillers now more than ever. Prescription drugs are widely available and there seems to be less of a social stigma attached to prescription drugs than to illegal ones.

In a national survey, the majority of teenagers said they usually get opioids such as oxymorphone free from the family medicine cabinet, from friends or relatives. Opioids are widely prescribed, and many people do not throw away old prescriptions just in case they need it to treat another illness.

Parents of teens or young adults should look for warning signs including:

  • Unusual loss of interest in things that once were important
  • Drop in academic or athletic performance
  • Loss of motivation or energy
  • Finds ways to sneak off
  • Money issues
  • Items missing from the home

Caring for a Family Member with an Addiction

Caring for a family member with an oxymorphone addiction takes teamwork and dedication. The family can act as a supportive network for the addicted individual, just as any family would for someone battling another neurological disease.

A family can take over household responsibilities while the addicted individual engages in treatment. It may be helpful to reassign household duties appropriate to an individual's age and abilities. For example, a grandparent can prepare meals, younger child can do some light housework while an older child with a driver's license can run errands.

Caring for a family member with an addiction requires open lines of communication. This communication can happen between just two or three individuals, but regular family meetings are best to share ideas and viewpoints regarding treatment options and progress.

The person battling oxymorphone addiction does not have to participate in family meetings at first - he may even be resistant to talking about his illness in the beginning. He might even become angry when he learns his family wants to become involved in his oxymorphone addiction. Family members should know these feelings of anger and resentment typically fade as treatment restores neurological function.

While oxymorphone addiction has a negative impact on any family, recovery can have a positive effect as each member discovers new strengths in himself and in others.

The family plays a critical role in recovery from oxymorphone addiction. Family pressure to seek treatment is a powerful force. It is common for a family member to have chosen the treatment facility the addicted individual eventually attends. Every person in the family should then encourage the addicted individual to seek and complete treatment.

The treatment and recovery experience works best when the individual feels physically, emotionally and spiritually safe in his own home. Family members need to remind themselves that oxymorphone addiction is a disease and avoid the temptation to blame a loved one for his illness.

When to Suggest Treatment

It is possible to stop the progression of oxymorphone addiction at any time. Like other medical conditions, recovery from addiction may be easier with early treatment, before the disease can make lasting changes to the nervous system.

It is not necessary to hit rock bottom before seeking treatment. The rock bottom of oxymorphone addiction could include a lengthy prison sentence, disease, toxic overdose, divorce, unemployment, homelessness or even death. Each one of these deadly consequences of hitting rock bottom makes recovery from oxymorphone addiction that much further away.

Recovery often starts when the individual feels the full brunt of the problems oxymorphone addiction causes. Frequently, caring family members try to cushion their loved one from the consequences of oxymorphone addiction, which allows the addictive behaviors to continue. It is important to know how to support a loved one without enabling addiction. Family counseling can give family members the skills they need to help a loved one deal with oxymorphone addiction without worsening the condition.

Signs of Addiction

Oxymorphone addiction causes neurological changes that affect the way a person thinks, feels and behaves. Doctors use these cognitive, emotional and behavioral changes to diagnose a patient as suffering from an oxymorphone addiction.

Behavioral, Cognitive and Emotional Changes

Behavioral:

An oxymorphone addiction causes the individual to use this opioid excessively, frequently at higher doses and more often than intended. The addicted person may say he wants to cut down or stop completely, even while he is taking more oxymorphone. He may try to quit oxymorphone several times but have trouble staying away permanently. It may seem that he is unable or unwilling to quit oxymorphone.

Oxymorphone addiction causes the individual to spend a great deal of time looking for this opioid, getting high or recovering from drug abuse. Oxymorphone addiction takes time away from work, engaging in a relationship or taking care of a child.

Oxymorphone addiction forces the individual to continue abusing this drug, despite the terrible toll it takes on his life. Left untreated or poorly treated, oxymorphone addiction will change the reward circuitry of the brain so that he eventually loses passion for everything he used to love. Soon, only oxymorphone brings him a sense of reward.

Cognitive:

Oxymorphone addiction changes how a person thinks and causes him to become preoccupied with oxymorphone use. Addiction slants his view of the relative benefits and risks of oxymorphone so that he eventually sees on the positive aspects of this opioid and none of the harm. He may blame other people or events for his problems rather than attributing them to hydromorphone abuse.

Emotional:

Oxymorphone addiction changes the way a person feels. An addicted person often expresses increased anxiety, unhappiness and emotional pain. Oxymorphone addiction often makes the world seem more stressful, especially to a person who is hypersensitive to stress.

Oxymorphone addiction makes it hard for someone to identify or express her feelings. Additionally, she may be unable to distinguish her emotions from her bodily sensations.

Symptoms of Addiction

Addiction manifests itself in a variety of physical and psychological symptoms. These symptoms can be obvious or subtle, and vary from person to person.

Physical Symptoms

While specialists normally describe oxymorphone addiction as a behavioral problem, a person addicted to oxymorphone does display certain physical symptoms.

Physical symptoms of drug addiction include:

  • Unexplained Weight Gain or Weight Loss
  • A Change in Sleep Patterns
  • Deteriorating Physical Appearance - Looks Sickly
  • Nagging Cough
  • Diminished Hygiene Care
  • Body or Clothing May Have an Unusual Odor
  • Bloodshot Eyes with Large or Small Pupils
  • Tremors
  • Slurred Speech

Psychological Symptoms

The psychological symptoms of oxymorphone addiction can be difficult to recognize because this disease often separates the addicted individual from the people who know him best and could therefore spot these symptoms. Psychological symptoms of oxymorphone addiction can perpetuate drug abuse and increase resistance to treatment. Left undiagnosed, untreated or treated poorly, psychological symptoms of oxymorphone addiction may prevent the individual from recovery.

Psychological symptoms of addiction to opioids include:

  • Inability to Abstain Consistently
  • Impairment in Behavioral Control
  • Cravings for Drugs or Intense Reward Experiences
  • Diminished Capacity to Recognize Significant Personal or Relationship Problems
  • Dysfunctional Emotional Response

Gender Differences

According to the 2010 National Survey on Drug Use and Health, men were twice as likely to abuse illicit substances or be dependent on drugs such as heroin, cocaine or marijuana as women. In 2010, 5.9 percent of females admitted to using illicit drugs, as compared to 11.6 percent of males.

While fewer women abuse illegal drugs such cocaine or heroin, females are more apt to use prescription drugs, such as oxymorphone, non-medically. Females are also more likely to combine prescription drugs like oxymorphone with alcohol, marijuana or other opioids.

Males abuse drugs differently than do females. Men frequently use drugs in social settings, while women get high alone at home. Females with substance abuse problems have fewer friends than addicted men. This could be because men feel comfortable getting high while there are strong social stigmas against drug abuse among women.
Men and women start using drugs differently. Males usually start using drugs to get high, while females start abusing drugs recreationally after using drugs as prescribed by a doctor.

Some studies suggest physicians prescribe mood-altering drugs more frequently to female alcoholics than to male alcoholics because the healthcare providers attribute the cause of the female's condition to be rooted in depression, anxiety or some other emotional difficulty. 

Cause of Gender Differences

Oxymorphone addiction affects men and women of all races, economic and educational levels. While anyone can become addicted to oxymorphone, science has revealed some surprising gender differences when it comes to substance abuse, dependence and addiction.

A woman's substance abuse problems may have its roots in her early childhood. Addicted women frequently come from homes where one or more relatives struggled with substance abuse problems or addictions. Addicted women sometimes report having to carry too much domestic responsibility as a child. Addicted females are also likely to come from a turbulent childhood home environment.

Addicted women often believe a difficult relationship or traumatic event lead them to drug abuse and addiction. Women are prone to name genetics, family history or environmental stress responsible for their drug abuse problems.

Women suffering from addiction are frequently in relationships with a partner who also has a substance abuse problem. A woman who shares an oxymorphone addiction may believe she is abandoning her partner if she quits using drugs, or that she is breaking some sort of special bond between them. Abstaining from substance abuse and dealing with oxymorphone addiction is difficult, especially if there is an abundance of easily accessible drugs in the home. Finally, a woman may rely on her addicted partner financially, and feel she will lose this financial support if she quits doing drugs.

Females seek out help more frequently than males do but females do not complete rehabilitation as often. Women face additional barriers to recovery, such as being able to afford quality treatment or finding childcare while the mother is in rehabilitation.

Treatment Options

The American Society of Addictive Medicine Addiction says that addiction causes "disability or premature death, especially when left untreated or treated inadequately." According to the CDC, 27,000 people died in the United States from accidental drug overdose, about one person every 19 minutes. Since 2003, more people die from overdose of opioids such as oxymorphone than from cocaine and heroin combined. For every unintentional overdose, nine people are admitted for substance abuse treatment.

Treatment reduces the risk for overdose, adverse reactions and the spread of infectious diseases. Using oxymorphone for a long time increases the risk for contracting an infectious disease, such as HIV/AIDS, tuberculosis or hepatitis.

Treatment for oxymorphone addiction has two phases: detoxification and rehabilitation. Detoxification is the medical process of lowering oxymorphone levels in your body.

Detoxification treats opioid dependence, not oxymorphone addiction. Behavior modification addresses oxymorphone addiction.

Behavior modification teaches the individual how to live without oxymorphone by changing the behaviors associated with oxymorphone addiction. Rehabilitation restores the neurological function affected by oxymorphone addiction.

Detoxification

Many people try to overcome dependence on opioids through self-detoxification or "going cold turkey." Cold turkey refers to the skin's appearance during detoxification: pale, cold and clammy with goose bumps, similar to a plucked bird.

Self-detoxification entails several days of intense withdrawal symptoms and an increased risk for suffering complications. One such complication is aspiration, which vomiting then inhaling the stomach contents. Aspiration may cause in fluid in the lungs and lung infections. Excessive diarrhea or vomiting may result in dehydration when, left untreated, can cause electrolyte imbalances and other serious medical conditions.

The primary complication of detoxification is relapse to opioid abuse. Many people battling oxymorphone addiction go through countless cycles of relapse and remission. Overpowering withdrawal symptoms and uncorrected addictive behaviors make it difficult to overcome oxymorphone addiction without professional counseling.

Withdrawal symptoms, known in the medical world as opiate abstinence syndrome, occur several hours after your last dose of oxymorphone.

Symptoms of oxymorphone withdrawal include:

  • Abdominal Cramps
  • Agitation
  • Anxiety
  • Blurred Vision
  • Insomnia
  • Restlessness
  • Sweating
  • Tremor
  • Vomiting

Anyone attempting self-detoxification should anticipate five or more days of physical withdrawal symptoms, with the worst symptoms occurring on or about the fourth day. The only way to overcome withdrawal symptoms is to ride it out, take medicine that mimics the affects of oxymorphone, or take another dose of oxymorphone.

Some people create homemade treatment plans that include specific medicines to reduce individual withdrawal symptoms in hopes of improving their chances for success. One well-known remedy is The Thomas Recipe, which includes valium or some other benzodiazepine to calm the nerves and induce sleep. Imodium eases diarrhea while mineral supplements and hot baths relieve muscle aches.

On or about the fourth day, overwhelming fatigue sets it, making it nearly impossible to move around. L-Tyrosine with B6 provides a burst of energy. As symptoms fade, the individual weans himself from the valium or other psychoactive drug by taking successively smaller doses further apart.

The Thomas Recipe eases withdrawal symptoms somewhat but the patient is still at significant risk for complications such as aspiration, dehydration and relapse. Returning to oxymorphone addiction after even a short attempt at detoxification may result in toxic overdose. A person's body becomes less tolerant throughout the detoxification process; as a result, he can overdose on a smaller amount of oxymorphone than he used to take before experienced even moderate withdrawal symptoms.

Overdose

Oxymorphone overdose can be fatal. If you think you or someone you know has taken too much oxymorphone, seek emergency assistance immediately by going to the emergency room or calling an ambulance, whichever is quickest. If you need immediate help, contact your local poison control center at 1-800-222-1222.

Symptoms of oxymorphone overdose include:

  • Breathing that Stops
  • Cold, Clammy Skin
  • Confusion
  • Extreme Drowsiness
  • Fainting
  • Pinpoint Pupils
  • Shallow Breathing
  • Weak Pulse

Oxymorphone overdose is a medical emergency. In the emergency department, doctors administer naloxone and other medications to reduce oxymorphone to safe levels. The toxic effects of opioid overdose often outlast the benefits of naloxone, so doctors monitor the patient's opioid levels and administer more naloxone as necessary.

Nurses monitor the patient's vital signs, watch for complications and establish an airway to help the patient breathe. Nurses may pump the stomach or administer charcoal to absorb excess oxymorphone. If necessary, nurses and doctors perform CPR or other life saving procedures.

Someone struggling with oxymorphone addiction but is in otherwise good physical condition might benefit from DRT, or Drug Replacement Therapy. DRT replaces oxymorphone with methadone, Suboxone or buprenorphine. DRT drugs act similarly to opioids, so the patient does not suffer withdrawal symptoms, but DRT drugs do not cause euphoria. This allows the patient to put off the detoxification stage while he participates in behavioral modification. After he develops healthier life skills without oxymorphone, he weans himself from the replacement drug or goes through the detoxification process.

DRT enables patients to live normal lives while engaging in treatment. Opponents say DRT merely trades addictions.

Many people have trouble quitting the replacement drug. Harvard Medical School says that about one-quarter of methadone DRT patients eventually quit using drugs altogether while another 25 percent continues to take the replacement drug. About half of all DRT participants go on and off methadone for the rest of their lives.

DRT is just one kind of Medication-Assisted Treatment, or MAT that can help a patient overcome oxymorphone addiction. Medications reduce the overpowering symptoms of withdrawal, enabling him to tolerate the process long enough to successfully detoxify his body.

Rehabilitation professionals say that MAT is an important and effective treatment approach because it:

  • Improves Survival Rates
  • Increase Retention in Treatment
  • Decreases Illicit Opioid Use
  • Decreases The Risk for Hepatitis and HIV
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Standard detoxification requires an inpatient hospital or treatment center stay. During inpatient care, doctors administer naloxone and other medications to reduce oxymorphone levels along with drugs to ease withdrawal symptoms. While standard inpatient MAT relieves the strength and duration of withdrawal symptoms, the patient still struggles with psychological symptoms of oxymorphone addiction that can cause relapse after detoxification.

Rapid detox is the most humane form of detoxification available today. Rapid detox helps the patient avoid the negative experience associated with detoxification, which puts the patient in a better position to participate in behavioral modification.

During rapid detox, board certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs alongside sedatives and anesthesia, so the patient rests in a peaceful "twilight sleep." When she awakens, she will have no recollection of the grueling detoxification process. Instead of a few days, she is ready for meaningful behavior modification in a few hours.

Detoxification is only the first stage of treatment for oxymorphone addiction and by itself does little to change long-term drug use or addictive behavior. Rehabilitation and behavior modification is also essential in the treatment of oxymorphone addiction.

Rehabilitation

Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term oxymorphone addiction. Without prompt and effective behavioral modification, everyone struggling with oxymorphone addiction is at high risk for returning to those behaviors associated with oxymorphone addiction.

Each person experiences oxymorphone addiction in a different way, so no single treatment is right for everyone. There is a wide variety of treatment options available, from outpatient counseling centers to long-term, residential programs. Individual, family and group counseling and other behavioral therapies are the most commonly used forms of drug abuse treatment.

No matter what form of treatment the individual chooses, treatment needs to be readily available to improve his chances of completion. It is vital that the person remains in treatment long enough for the neurological dysfunction to return to normal.

Effective treatment attends to multiple needs of the individual, not just his oxymorphone addiction. Many patients have underlying mental disorders, social problems or other difficulties that interfere with recovery. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.

Rehabilitation professionals monitor the patient's progress and modifies the individual's treatment plan as necessary to ensure it meets the person's changing needs. The physician must monitor the patient for drug use continuously, as relapses are common. Treatment programs will assess the patient for the presence of HIV/ AIDS, hepatitis B and C, tuberculosis and other infectious diseases as well as provide targeted risk-reduction counseling to help a patient change those behaviors that places him at risk of contracting or spreading infectious diseases.

Treatment does not need to be voluntary to be effective. According to NIDA, individuals under legal coercion tend to remain in treatment longer than and do better than those not under pressure.