ORT (Opioid Replacement Therapy)

Studies have shown that most people addicted to opiates will need professional treatment, which includes opiate replacement medication, to help them recover and lead a healthy life.

What is Opioid Replacement Therapy, or ORT?

Opioid replacement therapy is an evidence-based treatment option that helps people with opioid addiction break free from the harmful cycle of use and withdrawal by replacing dangerous drugs, like heroin, with safer and more controlled medications.

These medications have been used for decades to treat opioid use disorder, and they have been proven to be effective. They include Methadone and Buprenorphine.

To read more about these medications, click:

Why does ORT work?

To understand why opioid replacement treatments work, you must first understand that opioid addiction is a brain disease.

Opioid use significantly alters the chemical state of the brain, even after just a few uses.

These chemical changes occur when a person is using, but also when the person is in withdrawal. Like a seesaw, once a person becomes addicted they will swing between the emotional, physical and psychological symptoms of intoxication, and the emotional, physical and psychological symptoms of withdrawal.

  • Tolerance and cravings are other changes that occur in a person’s brain as a result of opioid use. Tolerance occurs when a person needs more of the drug to get the same effect. This is a change in how the brain is responding to the effects of the drug.
    • Tolerance can occur across opioids. This means that the brain reacts similarly to a pharmaceutical, like morphine, as it does to a street drug, like heroin.
  • Cravings and urges to use are intense emotional, psychological and physiological experiences that are often accompanied by strong negative emotions. As a person uses opioids over time, these cravings will intensify and “high-jack” the brain, often causing a person to return to using.

These chemical changes, and the seesaw effect of intoxication and withdrawal, can significantly alter the way a person thinks, feels, and behaves -- taking them further and further away from the person they were, or the person they want to be.

Similar to other chronic conditions, like heart disease and diabetes, once these changes have taken place, a person may require medications to help them break free from the cycle of intoxication and withdrawal, as well as keep them healthy while they work to make the lifestyle changes that will keep them in recovery.

Isn’t it just substituting one drug for another?

Some critics argue that replacement medications (ORT) keep people addicted because they simply replace one drug with another.

What these people may not realize is that recovering from opiate abuse is not simple.

Once a person’s brain has become addicted to opioids, the chemical changes do not allow them to “just walk away.” They have become physically dependent on opioids and their body will go into withdrawal without it.

Replacement medications, such as methadone and buprenorphine, help patients to reach a stabilized state by preventing them from going into withdrawal. Once on a replacement medication, they are no longer controlled by their emotions or intense cravings and they can think and act more effectively.

Also, because ORT is monitored by a medical professional, it is given in regulated doses that control the chemical reactions in the brain. This frees a person from the all-consuming urge to find and use opioids at any cost.

Addiction is a brain disease, similar to other chronic illnesses like heart disease and diabetes. For example, once a person develops diabetes they will most likely need medications or insulin replacement to manage the physical symptoms so they can move forward to make lifestyle changes like eating healthy and exercising. ORT medications allow people a chance to stabilize the physical and emotional aspects of opioid addiction, so they can actively participate in counseling and other rehabilitation programs that will lead to long-lasting recovery.

The reality is that without replacement medications, most people will stay stuck in the cycle of addiction and they will not have a chance to recover and lead healthy, happy lives.

How long do I need to be on ORT?

How long a person uses replacement medications is a personal choice, and one that should be discussed with a prescribing provider.

Sometimes ORT is used short-term to help a person detox in a more comfortable and humane manner. However, studies have shown that the longer a person remains on replacement medications, the better the outcome. This means that for many people, it may be necessary to remain on ORT for a number of years.

Is ORT right for me?

Some people have medical issues that contradict the use of an opioid replacement medication. That is why is very important to speak with a health care provider, or medication assisted treatment professional before deciding if ORT is right for you.

To learn more, click here.

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To search for an ORT prescriber in New Mexico, click here.

Facts for Families
Drugs, Brains and Behavior