Opioid Addiction Treatment — Inpatient Rehab for Prescription Painkillers

Opioid vs. Opiate — What's Covered Under "Opioid Use Disorder"

Opioid use disorder covers a broad category of substances — prescription painkillers (oxycodone, hydrocodone, morphine), synthetic opioids (fentanyl, tramadol, methadone), and illicit opioids (heroin). In current clinical practice, all are treated under the same diagnostic framework, but the medical protocols differ based on the specific opioid and duration of use.

Prescription Opioid Detox Timeline

Days 1–3: Early withdrawal onset depends on the half-life of the opioid. Short-acting opioids (oxycodone, hydrocodone) produce withdrawal within 6–12 hours; longer-acting opioids (methadone, extended-release morphine) may take 24–48 hours to produce symptoms.

Days 2–5: Peak acute withdrawal — muscle aches, vomiting, diarrhea, anxiety, insomnia. Buprenorphine induction usually occurs once COWS score indicates sufficient withdrawal.

Days 5–10: MAT stabilization. Acute symptoms subside. Transition to residential therapy begins.

MAT Options — Buprenorphine, Methadone, Vivitrol

• Buprenorphine (Suboxone, Sublocade): Partial agonist with ceiling effect. Can be prescribed in-office or via extended-release monthly injection (Sublocade). Most common first-line MAT in 2026.
• Methadone: Full agonist. Dispensed only through federally licensed Opioid Treatment Programs (OTPs). Strongest withdrawal suppression; clinically indicated for severe chronic OUD or when buprenorphine is insufficient.
• Naltrexone (Vivitrol): Opioid antagonist. Monthly injection. Requires complete detox first. Used in post-detox relapse prevention rather than during withdrawal.

PDMP Monitoring and How It Affects Treatment

All 50 states now operate Prescription Drug Monitoring Programs (PDMPs), which track controlled substance prescriptions. During inpatient admission, your clinical team will typically check your state's PDMP as part of the intake process. This helps identify all opioids you have been prescribed, coordinate with any existing providers, and ensure appropriate discharge prescribing. For people who have been obtaining opioids from multiple sources, the PDMP conversation is often a turning point — a framework for honesty with the treating physician.

How Opioid Use Disorder Is Diagnosed and Treated

The DSM-5 defines opioid use disorder by 11 criteria — tolerance, withdrawal, using more than intended, continued use despite consequences, and others. Severity is measured by the number of criteria met (2–3 mild, 4–5 moderate, 6+ severe). Treatment decisions flow from severity:

• Mild: Outpatient therapy, possible MAT
• Moderate: IOP or PHP, MAT typically indicated
• Severe: Inpatient detox and residential treatment with MAT

Most people who contact our line for help have moderate-to-severe OUD. Inpatient treatment with MAT is the evidence-based standard of care. Call (888) 368-3288 to identify available programs.