Using willpower to change a behavior means working hard to achieve something; Merriam Webster defines will power as “energetic determination.” If I need willpower to accomplish something, then I am attempting a task that I feel some level of conflict about doing. Like a part of you knows that you need or should do something, but another part of you feels resistance to doing it.

This holds true for someone who also has decided to stop using drugs, yet when the choice to use is no longer an option, resistance drops. However, perhaps the most important part of getting to this place of diminished resistance is creating an environment conducive to succeeding.

How Opioid Addiction Occurs

Many times individuals that use opioids even for a short period of time can often find themselves in an addictive cycle and all too often, overdose. While this may be shocking to some, it's true that the length of time you use opioids is no indication of who is vulnerable to addiction or dependence. Substance Use Disorder in itself is a disease which starts as a pleasurable sensation and ends in an irresistible urge to use and crave the drug.

Opioids are in fact highly addictive and this is due mainly to the way in which they trigger endorphins of your brain and activate the infectious "reward centers". By releasing these endorphins, an individual's perception of pain vs. pleasure is masked by the drug and often enough when the drug does wear off it leads the individual wanting more and navigating through a toxic road towards addiction.

Known risk factors of opioid use and addiction may include:

  • Family history of drug abuse
  • Young age
  • Heavy tobacco use
  • Stressful circumstances
  • Prior drug or alcohol rehabilitation
  • Contact with high-risk environments or people
  • Legal issues
  • History of criminal activity

  • Opioid Treatment Options

    Regardless of a patients experience with opioids, misuse, or addiction; there are treatment options available and behavioral therapies that can change lives. To provide some perspective, at the Coleman Institute I put a third naltrexone implant in my patient, Sandro. Now, Sandro had just over a year off of fentanyl-laced heroin. He had spent six of his 37 years behind bars for crimes directly related to his addiction. He never wanted to be inside a jail again. He went on to tell me that in past attempts to get off opioids he tried to stay in contact with his old friends who were actively using.

    These were friends he spent his childhood with and was related to many of them. However, with extraordinary willpower, he was able to stick to his decision not to use when he was with them for brief periods of time. But when stress was high, the feeling of deprivation was overwhelming, and willpower waned, he invariably relapsed.

    During his last stint in prison, he worked in earnest on his sobriety. He went to every meeting that was offered and took advantage of one-on-one time with sober leaders. He made it a point to hang out with clean guys as much as possible. He read recovery literature. Even given the constraints of being in prison, he found ways to change his environment. He said that as soon as he started keeping the commitment to himself, he was rarely bothered by other prisoners to buy drugs.

    He says eventually, “It was kind of like I was wearing a new set of glasses, and the only things I could see were things associated with being clean. Like everything else was filtered out. My brain felt peaceful. It was weird—but wonderful.”

    The most important thing he learned during this time was the importance of changing who he hung out with on the outside. (Changing his environment) He made plans to meet up with the people who brought meetings to the prison when he was released. He made and kept a promise to himself not to contact old friends that might still be using.


    Accelerated Opioid Detox Treatment

    For many patients, like Sandro, the Coleman Institute provides an Accelerated Opioid Detox that removes the opioids from the brain in the fastest, most comfortable means possible. In Sandro's case, he agreed to come into the Coleman Institute every two months for his opioid detox and gain what we call a "naltrexone implant". Naltrexone is a pure opioid blocker that does not cause physical dependence, unlike some other medication-assisted treatments (MAT), such as buprenorphine or methadone. The small implant, about the size of a pill, is placed under the skin in the abdominal area and lasts for about two months, sharply reducing physical cravings from opioid addiction.

    The implant works for people who are not only stopping drugs like heroin, but also for pain medications such as fentanyl, Percocet®, Vicodin®, Oxycontin®, and other variations of oxycodone and hydrocodone. (It is also extremely effective for blocking alcohol cravings). Using naltrexone therapy has been the focus of treatment at the Coleman Institute for over twenty years.


    In addition, the Accelerated Opioid Detox plan provides patients with the ability to detox in as little as three days, rather than the typical ten days you would spend self-detoxing. Like Sandro, you can be on your way to writing your own success story, changing your environment, and holding a healthier lifestyle.

    Just look at Sandro, to date, he remains highly motivated, and it is paying off for him in all areas of his life. He was recently promoted at his job. His children love that their dad is hanging out with them, attending their sports events, and helping them with homework. His fiancé, pregnant with their first child together, has a new level fo trust for this man she loves. But perhaps the most touching testimony this 6'2, 200-pound man gives is when he talks about his mother and the pride and gratitude she feels, having her son back. Sandro talked about this as I placed his implant ,and there wasn't a dry eye in the room, including Sandro's.

    As Benjamin Hardy, author of Willpower Doesn’t Work says, “ If you remain in an environment conflicting with your personal rules, you have only two choices: Conform to a bad environment or battle it through willpower. Both of these are very poor options and ultimately lead to the same place.”

    At the Coleman Institute, we know that opioid addiction is a chronic disease and treat it as such. We would be happy to walk you through what that process and treatment plan would look like for you and create an environment worth fighting for. A life of recovery is waiting for you.

    Joan R. Shepherd, FNP