I have to admit your latest posts don;t sound like you at all, and that's a worrying thing - I've been there.
There are lots of avenues besides inpatient rehab - there's outpatient rehab for one, you could speak to your Dr (with all the factors involved I really think you need to)...or you could go to any one of a dozen meeting based recovery groups, or look into a book orientated approach like Rational Recovery.
I think it's really important to do something and to get some help...and something more than simply cutting back Opio...unless you have a stringent timetable and you're cutting back to nothing, it can all get a little circular and airy-fairy. been there done that too.
D