Choosing the Best Inpatient Painkiller Rehab Center
Painkillers are prescription medications provided by medical personnel to provide pain relief in patients. When used for a short period of time under a doctor's supervision, painkillers are rarely addictive. Addiction can develop however with extensive or recreational use, resulting in the need for a painkiller rehab program to quit the drug use in a safe manner. One study by the National Survey on Drug Use and Health found that 1.9 million people are estimated to have abused prescription pain relievers in the United States. Painkiller rehab programs can help greatly in stopping this painkiller abuse. According to the Prescription, Opioid Treatment Study run by the NIDA's Clinical Trials Network, 49 percent of study participants reduced their painkiller abuse with the tapering process used by most rehab programs.
Painkillers include a wide variety of drugs, but opioids and opiates are the most abused types. They range from fentanyl (and other drugs used in the management of chronic pain) to codeine cough syrup. Used appropriately, painkillers can provide soothing relief from the uncomfortable symptoms of bone breaks, cancers, and numerous other injuries. However, painkiller abuse and addiction is a growing problem.
Painkiller abuse affects people from all walks of life and socioeconomic backgrounds. No matter your reason for taking drugs, you can easily develop tolerance and dependency. This happens quickly before you even realize that dependence or addiction are taking hold. When tolerance leads to addiction, it can be difficult to quit the pattern of abuse.
Many painkillers have opioids as a major component, which is very effective when used appropriately and also very dangerous when abused. Depending on the type of painkiller being used, you could experience common effects such as an elevated mood, relaxation, analgesia, and euphoria. You might begin to use painkillers under the close supervision of a doctor, and then begin to use or abuse it for recreational purposes.
Overcoming painkiller abuse and addiction often require professional help. Painkiller abuse causes symptoms and effects that wreak havoc on the mind and body and can eventually prove fatal. When realizing that you or someone you love has a problem with painkiller abuse, it is essential to seek help as soon as possible.
What are Painkillers?
Painkillers are also known as analgesics, pain relievers or pain medicines, and are drugs designed to treat pain. There are a wide variety of painkillers available and they can be found under different brand names. Painkillers can be ingested via different methods: by mouth as a capsule, tablet or in liquid form; by injection; and through the back as a suppository. Other painkillers are available as creams or ointments.
Like other drugs, painkillers should only be used for a short period of time and at the lowest dose that can manage your pain. This method of administration can help you avoid any side-effects. If you’re experiencing toothache, you may only have to take painkillers for a matter of days or a few short weeks if you’ve pulled a muscle. Conditions such as chronic back pain or osteoarthritis could require you to take painkillers on a long-term basis.
Pain medicines are drugs that relieve or reduce headaches, arthritis, sore muscles, and other aches and pains. These drugs come in different forms, with each one having its advantages and disadvantages. Certain types of pain respond better to specific types of analgesics. Your response to pain relievers will also be different from the way someone else will respond to the same drug.
The most potent pain relievers are opioids. While they are extremely effective, they can also induce serious side effects. As a result of addiction and other risks associated with the use of painkillers, it is essential to only use these drugs under your doctor’s supervision. Pain can be alleviated in a number of ways, with painkillers being just one aspect of a comprehensive treatment plan.
Different Types and Forms of Painkillers
Even though there a large number of painkillers available, they can generally be classified into three main categories. Each works in a different way. They are:
- Paracetamol – Paracetamol is widely preferred as a pain medication and has very few side effects. However, it cannot be taken carelessly, because the side effects it can produce might be devastating. One of the main side effects is liver failure, especially when you use the drug on a long-term basis and in high quantities. Combining paracetamol with acute or chronic alcohol abuse can also result in liver problems. Some well-known brand names of this drug are Panadol and Tylenol.
- Aspirin and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) – This group of drugs is used for the treatment of mild to moderate pain, and as a remedy for inflammation and fever. They are therefore applied in cases of trauma, arthritis, dental pain, bone pain and dysmenorrhoea (painful menstruation). These drugs do not belong to the cortisone family and are effective against inflammation. Your doctor can choose the NSAID that will work best to suit your needs.
- Opioids – These drugs work on specific opioid receptors, located in the spinal cord and brain. Usually, oral opioids are prescribed to treat chronic pain. Some treatment methods involve combining opioids with other painkillers like NSAIDs and opioids to attack pain on different receptors. Used in this way, you can experience improved pain relief and reduce the risk of side effects, as your opioid requirements are typically decreased. Examples of popular opioids are morphine, codeine and pethidine.
Risk of Painkiller Abuse
Unfortunately, painkillers (including opioid prescription drugs) aren’t usually considered to be dangerous substances, as they are medically prescribed. Prescription drugs tend to create fewer stigmas when compared to illicit substances, as they are considered necessary for the treatment or management of pain. However, prescription opioids and an illegal drug like heroin affect the brain in the same way.
This similarity presents a risk of painkiller abuse and addiction, especially if used for recreational purposes. Also, as a result of consuming painkillers, you could turn to heroin as an alternative drug of choice. In many cases, opioid painkillers become gateway drugs to heroin use, dependence and addiction.
Painkiller abuse carries a wide range of potential side effects, depending on the type of drug being used. If you’re abusing stimulants such as amphetamines or cocaine, you could experience depression, lethargy and fatigue, as you come down from your ‘high’. Abusing opiate drugs such as prescription painkillers can lead to muscle aches, intestinal issues and nervousness.
One of the most serious risks of painkiller abuse is the potential for overdose, which can lead to death in some cases. If you suspect that you or someone you know has overdosed, call for emergency medical help as soon as possible. Prompt professional assistance can often limit the danger and may even save a life. The best way to prevent the risk of painkiller abuse is to seek help for drug abuse and addiction.
The Legal use of Painkillers
Previously, prescription painkillers were prescribed mainly for cancer patients, because of concerns about addictions developing. Now however, they are regarded as an essential treatment tool for cases of chronic pain. Opioids can also be of immense help if you’re suffering terrible injuries, recovering from surgery or experiencing debilitating pain.
However, the line between legal and illegal use is unclear when it comes to prescription painkillers. You can be prescribed drugs and take them home to use as directed. Prolonged use or abuse causes you to become addicted and you’ll likely return to the doctor to get more pills. Your family members could even find your stash and help themselves to it to get ‘high’. After they become hooked and can no longer access medical supplies, they could turn to buying pain pills on the street.
You may not realise, but it’s breaking the law to take a narcotic painkiller from someone or give one to your friend or family member. This seemingly innocent gesture is actually a crime. The exact laws vary from state to state but if you’re caught with medications that aren’t prescribed for you (illegal prescription drugs); you can be fined or imprisoned.
In certain states, doctors are criminally liable and may have their licences revoked for writing painkiller prescriptions that lead to overdose or end up on the street. Some require pharmacies to limit their supplies and restrict how painkillers are dispensed. Finally, some states have created controlled-substance prescriptions and computerised patient registries.
How Addiction Develops: Who is most at risk of Abuse?
A vast number of people engage in substance abuse and anyone can develop a problem with alcohol and drugs. The problem may even progress further and lead to a severe addiction. Drug use affects almost everyone, regardless of gender, age, economic status or ethnicity. However, a significant amount of people who use drugs, do not develop addiction – even with heavy or regular use. There are certain risk factors associated with addition that can put you at risk of abuse. They include:
- Genetic predisposition – this includes certain characteristics in the brain that can make you more or less vulnerable to addictive substances, such as prescription painkillers.
- Psychological factors – these include stress and personality traits, such as sensation seeking or high impulsivity, anxiety, depression, eating disorders and personality disorders.
- Environmental influences – these include starting drug use at an early age; exposure to substance usage or addiction in the family (or amongst peers); physical, sexual or emotional trauma; access to drugs; and exposure to fads and popular cultures encouraging drug use.
Having one or more of these risk factors means that there’s a greater chance you’ll develop a habit of drug abuse and addiction. However, vulnerability differs from one person to the next, and the presence of a single factor cannot determine whether you will become addicted to drugs. Typically, the more risks you face, the higher your chance of abusing drugs when you have access to them.
How Painkillers are Abused
You could begin to abuse painkillers in adulthood, without any risk factors present. In many cases, painkiller abuse begins with a simple prescription from a doctor for the treatment of a legitimate condition. However, certain drugs (especially prescription pain medication) have a higher tendency to cause tolerance. This then leads to a steady increase in your dosage to achieve the same effects, which can in turn result in abuse, dependence and addiction.
You could begin to abuse painkillers in adulthood, without any risk factors present. In many cases, painkiller abuse begins with a simple prescription from a doctor for the treatment of a legitimate condition. However, certain drugs (especially prescription pain medication) have a higher tendency to cause tolerance. This then leads to a steady increase in your dosage to achieve the same effects, which can in turn result in abuse, dependence and addiction. These issues include:
- Drug-related distress or dysfunction
- Spending significant amounts of time trying to obtain and use painkillers (or recovering from such use)
- Giving up activities that were once a priority, as a result of your use of painkillers
- Continuing to use painkillers in spite of the obvious negative effects
- Wanting to quit or reduce the intake of painkillers, but being unable to do so
- Continuing to use painkillers in spite of drug-related problems that affect your career or personal relationships
Signs and Symptoms of Painkiller Abuse
After determining the cause of your painkiller abuse, it’s essential to be able to identify the signs and symptoms. If abusing prescription drugs (or using them recreationally), you might notice that you’re going through your prescription at a faster rate than expected. This is also a sign of tolerance, as it means your body has become accustomed to the drug and needs more to feel any effects.
Becoming tolerant and continuing to take higher or more frequent doses can result in addiction. Furthermore, you could notice sudden and unexplained mood changes. Sometimes, you may feel ‘out of it’ for no reason at all. Erratic behaviour and jitteriness may also follow the changes in mood, accompanied by moments of sudden calm.
Financial problems could become more apparent, where large debts surface or money begins to disappear. Generally, the symptoms of painkiller abuse can be very subtle, but when something isn’t quite right, you’ll probably be able to notice it.
If you’re struggling with painkiller abuse or notice that your loved one constantly appears sedated, seek help immediately. Call a confidential helpline to speak to an addiction treatment expert and get the necessary assistance for you or your loved one today.
Physical and Psychological Effects of Painkiller Abuse
The psychological effects of painkiller abuse stem from your reasons for taking these drugs, as well as the changes that occur in your brain in the process. Initially, painkiller abuse may have started as a way to cope with pain or stress. However, the main psychological effect of abusing painkillers is the creation of a cycle whereby you feel the need to use drugs anytime you face stress or pain.
Other psychological effects of drug addiction include:
- Desire to engage in risky behaviour
- Complication of mental illness
- Paranoia, violence, wild mood swings, anxiety and depression
- Psychological tolerance to the drug’s effects, creating a desire to consume increasing amounts
Painkiller abuse also results in some physical effects which vary, but can be seen in different areas of the body. Usually, the primary physical effects of drug abuse occur in the brain. Substance abuse changes the way your brain functions and affects the way your body receives pleasurable feelings. These effects occur because of the increase in dopamine and serotonin in the brain. Consequently, your brain begins to expect and rely on these medications to produce a ‘high’ effect.
Other physical effects of drug addiction include:
- Vomiting, constipation, abdominal pain, diarrhoea
- Heart rate irregularities, heart attack
- Brain damage, seizures, stroke
- Changes in body temperature, appetite and sleeping patterns
- Kidney and liver damage
- Respiratory problems, such as emphysema and lung cancer
- Contraction of Hepatitis, HIV and other illnesses
Long-term Effects of Painkiller Abuse
Long-term painkiller abuse can have severe consequences for your physical and mental health. As your body adapts to the presence of drugs, it requires larger or more frequent doses to feel the same effects; this is known as tolerance. Dependence may develop as a result, which can lead to uncomfortable withdrawal symptoms when you stop taking the drug. This can be deadly in some cases.
The long-term effects that you may experience depend on how you’ve been taking the drug. Snorting, crushing and injecting the drug into your bloodstream can lead to long-term heart damage and other cardiovascular problems, in addition to the high likelihood of a heart attack. Injecting painkillers or other types of drugs with shared needles (or under non-sterile conditions) increases your risk of contracting complicated blood-borne diseases.
Furthermore, virtually all opiate painkillers – no matter the route of administration used during consumption – carry the risk of long-term addiction. Other unpleasant side effects can occur from painkiller abuse, including diarrhoea, vomiting and nausea. These they are caused by interactions between the drugs and the opioid receptors present in the digestive tract.
Short-Term Effects of Painkiller Abuse
If abusing painkillers, any short-term effects will depend on the quantity of drugs you’ve consumed, as well as their purity or potency and whether combined with other addictive substances. Drugs can affect your energy level, mood, thinking and perception. They can reduce inhibition, impair motor functioning, interfere with decision making and problem solving and cause a wide range of other physical health problems.
The effects are similar: an intense ‘high’ that differs, based on the route of administration. For example, swallowed as a whole or crushed tablet; injected as a powder or liquid; or snorted. This intense ‘high’ is followed by a period of partial sedation and slowed reaction time. Other short-term side effects include nausea, vomiting, diarrhoea or constipation. You could also begin to experience more pain, muscle aches, headaches and other side effects.
Painkiller abuse can also lead to depression and anxiety, in addition to feelings of anger, hostility, confusion, paranoia, disorientation and a distorted perception of reality. Addiction is also a serious consequence of painkiller abuse, and can occur in less than three days due to the potent effect of opiates on the brain.
Painkiller Addiction: Top 18 Facts
- Prescription painkillers cause more deaths than traffic accidents.
- Prescription substances are the leading drug of choice in overdose-related deaths.
- According to The Substance Abuse of Mental Health Services Administration, 70% of people source their prescription drugs from a friend or relative.
- The second most commonly abused drug by teens is prescription pills.
- Admission to addiction treatment for prescription drug abuse has increased an astounding 400% between 1998 and 2008.
- As prescription drugs have become something of an epidemic, the number of people seeking treatment for their use has increased drastically.
- The non-benzodiazepines are used as a short-term remedy for sleeping problems. These drugs, which include zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata), can also foster chronic use due to rebound insomnia.
- Prescription drugs are abused most in rural areas.
- Prescription painkillers have increased the number of unintentional deaths across the United States. Between 1999 and 2007, there have been 28,000 deaths as a result of unintentional prescription drug poisoning.
- Over 100,000 people are hospitalised each year for overdosing on prescription drugs such as lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), or triazolam (Halcion).
- Statistics from the National Institute of Drug Abuse show that one out of every 15 people who take prescription painkillers for recreational use will try heroin within 10 years.
- People who are prescribed pain medication in high doses are at a greater risk of death.
- 60% of young adults who abuse prescription drugs tried them before the age of 18.
- Cough suppressants that containing dextromethorphan (DXM) can be addictive; ingesting large quantities can cause altered time perception, distorted awareness and hallucinations.
- Barbiturates are an older (but highly abused) class of prescription drugs. An overdose can be fatal, especially when mixed with alcohol or opiates.
- Three out of every ten teenagers do not think prescription drugs are addictive.
- Prescription drugs are just as (or more) addictive then any illegal street drug or even alcohol.
- It’s easy to overdose from prescription painkillers alone. Often, people combine prescription drugs with alcohol, which increases the chance of an overdose.
Prescription painkillers are the substances most abused by teens after alcohol, marijuana and tobacco. ADHD medication (Ritalin, Adderall, Concerta), tranquilisers and sedatives (Klonopin, Xanax, Valium), as well as opioid painkillers (Percocet, OxyContin, Percodan, Vicodin,) are also prescription medications frequently abused by teens.
According to the US National Institute of Health (NIH), abuse of Vicodin and all prescription opioids dropped dramatically in the last five years, from 7.5% to 2.9% amongst 12th graders. After marijuana and hash (36%), amphetamines (6.7%) like Ritalin or Adderall account for the bulk of drugs abused by 12th graders in the past year.
Roughly 15% of high school seniors admitted to prescription painkiller abuse during the previous year.
Generally, teenagers feel that abusing prescription medication is less dangerous than taking street drugs. This isn’t actually true, as painkiller abuse can prove to be extremely dangerous and sometimes result in deadly consequences.
Five of the 12 drugs that were surveyed amongst high school seniors were prescription drugs. The main prescription drugs abused by teens included stimulants like Adderall, tranquilisers, opioids like Vicodin, sedatives and cough medicines.
10 Myths and Lies told about Painkillers
There are a number of myths and lies surrounding the use of painkillers. The most common include:
- Only hard drugs are dangerous: Certain drugs (such as heroin and cocaine) are known for their powerful and highly addictive nature. However, they are not the only dangerous substances. Even medications with a low risk of addiction can cause mental and physical health problems, depending on how they are used.
- You cannot be addicted to a prescribed medication: It’s quite common to believe that all drugs prescribed by your doctor are completely safe and impossible to result in addiction. This is wrong, as many prescribed medications are extremely potent and have a high potential for addiction.
- There are no long-term consequences.
- Pain medication can cure your pain: Physical or mental pain cannot be ‘cured’ by pain medications. These drugs simply mask your symptoms and make them easier to cope with.
- Painkillers should be avoided altogether: Painkillers provide an effective method to treat pain resulting from injuries. They should therefore be used cautiously, instead of being avoided completely.
- Addicts can quit using painkillers whenever they wish.
- Everyone who uses painkillers becomes addicted: Developing an addiction to any drug depends on your personal risk of addiction. It’s therefore incorrect to believe that just because you take a prescription painkiller, you’ll become addicted.
- The more you take, the better they work: when it comes to taking painkillers, more does not always mean better. Tolerance can develop after prolonged use and worsen the pain.
- You can’t become addicted if you have a medical reason for taking painkillers.
- There is nothing friends or family can do to help: While you can’t force an addicted person to quit, there are many methods you can use to improve the situation.
Inpatient vs. Outpatient Facilities
The majority of painkiller rehabilitation facilities are run on an inpatient basis. This is to allow for constant medical supervision during the rehabilitation process. While outpatient clinics can offer the medication needed for the tapering process used to reduce the levels of drugs in a patient's system without causing withdrawal to occur, an outpatient clinic cannot prevent the patient from obtaining more of the painkillers of their choice. This leads to greater relapse chances than in an inpatient environment where access to drugs is restricted.
Do I Need a Residential Rehab Facility?
Successful rehab requires that you commit to getting clean of painkillers. The greater your commitment to the process, the higher your chances of quitting the painkiller use and also avoiding painkiller abuse in the future. With the 24-hour supervision available at a residential painkiller rehab program, you can avoid the temptations of relapse because the painkillers are simply unavailable. You'll be limited to only those medications the doctor prescribes, which may include a non-addictive painkiller if you still require medication for an injury.
Call us for more information about residential rehab facilities offering painkiller rehab treatment.
Tolerance vs. Painkiller Dependence
Prescription painkillers are usually opioids and can cause both psychological and physical dependency in a user. Physical dependencies are the result of a growing tolerance to the drug causing the user to increase the dosage amount over time to achieve the same high. Eventually the user's body becomes accustomed to having the high levels of painkillers present in the system, and becomes dependent on these levels.
Opioid Rehab Center
Heroin and methadone are the two most commonly abused opioids in the United States, according to MedlinePlus. Other opioids include oxycodone and opium. Opioid treatment centers have been established across the country to help people dealing with opioid addiction.
Are Painkiller Rehabs Confidential?
Painkiller rehab programs are both private and confidential. Rehabilitation is based in large part on being completely honest about your drug use. This requires a level of trust between the user and the program personnel, one built on the privacy offered by the rehabilitation program. Program administrators and other participants keep your presence in the program confidential, while your medical records are protected by law to ensure their privacy as well. Program privacy may extend to a private room during the rehab process as well. Private rooms may be limited, however, depending on program occupation levels, or program policy.
You can call us and speak to an advisor about the locations of programs offering private accommodations.
How Long Does Inpatient Painkiller Rehabilitation Take?
The length of treatment time for painkiller rehab varies widely according to the program entered and the patient's process through that program. Many residential programs occur in 30-day increments, with minimal participation being 30 days and residencies commonly lasting up to 90 days. Treatment can be further extended through stays in residential communities for up to a year. A patient is expected to remain in residence until the treatment process is complete, so even shorter program expectations may be extended to allow the patient to be successful.
What Happens During Treatment?
Treatments can vary significantly depending on the patient's severity of addiction, the presence of any additional conditions and the patient's reaction to the treatment process. A painkiller rehab program constantly reassesses the patient's progress and treatment effectiveness as the program continues to make adjustments where needed. Even with the modifications to treatment this creates, there are still some basic steps for all treatment programs.
- Treatment begins with the intake and assessment step, where the patient is given a medical exam and questioned about his or her drug history.
- After the intake process, the patient proceeds through detox, tapering down the painkillers in his or her system, oftentimes by taking a substitute opioid such as Subutex.
- After the intake process, the patient proceeds through detox, tapering down the painkillers in his or her system, oftentimes by taking a substitute opioid such as Subutex.
- Addiction therapy begins as soon as the patient is stable on the tapering drug. During therapy, the patient deals both individually with the addiction counselor and in a group setting with other program participants.
- Any specialized care required to deal with a concurrent illness is taken care of throughout the rehab process to avoid the illness interfering with the painkiller rehab.
- After completing the rehab process, the patient is released from the painkiller treatment facility. Aftercare may still be necessary, however, and it usually consists of additional therapy or a support group to help the user continue to avoid a relapse.
Paying for Painkiller Addiction Treatment
Painkiller rehab program cost varies significantly depending on the program length, location and quality level for inpatient care. Much of your stay may be paid using your health insurance, as rehab is a medical expense. There may be alternative methods of paying though, in case your insurance does not cover the entire expense. The program may offer to finance, allowing you to pay the cost in multiple payments. The program may also reduce the cost of rehab, providing an income-based reduction in the program price.
Should I Travel for Rehab?
With painkiller rehabilitation facilities throughout the country, you can often choose where you wish to go for treatment. A facility near your home offers you the benefits of remaining near friends or family. Unfortunately, a facility near home also fails to remove you far from the environment in which you became addicted, which may cause some issues with your commitment to seeing the treatment through to its end. When deciding on a facility location, take both issues into consideration, and base the decision on which choice you feel provides you with the best chance at success in the program.
I Want to Find an Executive or Luxury Rehab Center
If executive issues have been a stumbling block you, your husband or your wife from looking for help for a narcotic or prescription drug problem or behavior-related addiction, executive rehab facilities can be invaluable. Coupling high-quality substance abuse and behavior addiction treatments with the flexibility of occasional computer and phone access, an executive can get clean and sober away from the spotlight.
Much fine illicit substances and behavioral addiction treatment clinics grant the top-tier amenities you would expect only in America's finest hotels, with your success and well-being being the biggest priorities. From gym facilities and in-house massage therapy to housekeeping services and fine linens, you can get the top narcotic, prescription drug or behavior addiction treatment for yourself, your husband or your wife while enjoying rehab.
If you need help looking for excellent luxury treatment programs for addiction to painkillers, dial our toll-free hotline right away.
What Happens After?
After treatment in a painkiller rehab program, you'll need to continue to work on your sobriety. The psychological cravings of dependency often remain, increasing the temptation toward relapse. To avoid a relapse, aftercare in the form of therapy and support groups may be necessary.
Call us for information on aftercare options available in your area.
Are You, or Is the Addict, Ready?
If you know of someone who has a painkiller addiction then you should speak to him or her about the addiction and about getting help. If you're an addict and want to end your addiction, then you should enter into a painkiller rehab program as soon as possible. When you're willing to make the commitment to getting and staying clean, you're ready for help.
Additional Treatment Information
Whether you're an addict looking to start the rehabilitation process or a family member or friend looking to provide support, you should learn as much about the treatment process as possible. Research the painkiller rehab program that you're considering using for treatment. Many programs use a 12-step approach that helps the user approach their treatment from a spiritual angle. For non-spiritual patients, programs that are more secular make use of other methods. Several faith-based treatment programs exist as well, along with programs that provide a more holistic treatment approach. You should also look into the entire treatment procedure, from the assessment and detox processes to the therapeutic approach used by the program counselors. Research inpatient and outpatient treatment availability for programs that you're considering as well. Finally, look into any sober living residency options, along with any available aftercare for when you leave the treatment facility.
Addiction Rehabilitation Process
The journey to a healthy, sober life is not a quick and easy one. It is a lifelong commitment of dedication and hard work that is well worth the effort. Like any journey, the road to sobriety begins with simple steps forward.
It's Not Too Late to Turn Everything Around
Your addiction to painkillers may have started with an injury, or you may have begun taking prescription painkillers recreationally. No matter how it began though, or how long it's lasted, it's not too late to quit taking prescription painkillers. A painkiller rehab program can offer you the help you need to kick the habit and live a clean lifestyle. All it takes is a commitment to getting clean, and entry into a painkiller treatment facility.
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