In 2022, an average of 200 people a day died from an opioid overdose in the United States. Opioid use disorder (OUD) is a medical condition that makes it hard for people to stop using opioids, which include prescription opioids such as oxycodone and illegal drugs like heroin. Over time, the body gets used to these drugs, making it difficult to stop. When someone tries to quit, they may feel sick and experience withdrawal symptoms.

There are evidence-based treatment options for OUD. Medications and therapy can help people recover and regain control of their lives. This article will explain how medication-assisted treatment works and share other ways to get support.

Opioids and Opioid Use Disorder

Opioids, also called narcotics, are strong pain-relieving drugs. Prescription opioids, like oxycodone, hydrocodone, and fentanyl, are often used to manage pain after surgery or for serious health conditions like cancer. Other opioids, like heroin, are illegal. When used for a short time and exactly as prescribed, opioids can be safe, but they also have a risk of addiction.

Opioid use disorder happens when someone can’t stop using opioids, even when it causes problems in their daily life. People with OUD may have intense cravings and feel sick when they try to quit. This is called withdrawal, and it can cause symptoms like diarrhea, sweating, chills, and a runny nose. Some people develop opioid dependence, meaning their body needs the drug just to feel normal. OUD is not a sign of weakness — it’s a medical condition that can be treated.

Medications for Opioid Use Disorder

Treatment of opioid use disorder relies on three main types of medications approved by the U.S. Food and Drug Administration (FDA). These drugs help reduce cravings and opioid withdrawal symptoms. For many, they’re a crucial part of recovery.

Methadone

Methadone is a long-acting opioid agonist that helps reduce cravings and ease withdrawal symptoms. An agonist is a substance that binds to and activates receptors in the brain — in this case, opioid receptors. Methadone works by activating opioid receptors slowly and steadily to prevent the “high” that leads to addiction.

Methadone is taken orally (by mouth) once a day in a controlled opioid treatment program, such as a specialized clinic. Over time, providers may lower the dose until a person no longer needs it. When combined with counseling, methadone is considered the gold standard in maintenance treatment for substance use disorders.

When combined with counseling, methadone is considered the gold standard in maintenance treatment for substance use disorders.

Buprenorphine

Another medication, buprenorphine, is often recommended for people who don’t tolerate or improve with methadone or can’t access it. Buprenorphine only partially activates opioid receptors, which helps reduce cravings and withdrawal symptoms without causing a strong high.

Buprenorphine comes in many forms, such as pills, films that dissolve under the tongue, injections, and implants placed under the skin. Some forms of buprenorphine treatment also contain naloxone, a medication that blocks opioids to prevent misuse.

Naltrexone

Naltrexone, known as an opioid antagonist, works differently from methadone and buprenorphine — it completely blocks opioid receptors so that opioids have no effect. Someone who takes opioids while on naltrexone won’t feel the usual high.

Naltrexone is available as a daily pill or a monthly extended-release injection. Before starting naltrexone, a person must fully detox from opioids, which can be difficult. Doctors can help manage withdrawal symptoms during this process. Naltrexone is FDA-approved for both OUD and alcohol use disorder.

Behavioral Therapies for Opioid Use Disorder

Medication-assisted treatment works best when combined with behavioral therapy. These therapies help people change the way they think and act around drug use. The focus is on understanding addiction, breaking unhealthy habits, and avoiding situations that trigger cravings.

Many people are more likely to use opioids again if they’re reminded of places or routines that trigger cravings. Behavioral therapy helps individuals recognize these patterns and establish healthier coping strategies. Therapy also encourages positive reinforcement — rewarding progress to support long-term recovery.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) helps people identify and change negative thought patterns that lead to drug misuse. A therapist teaches coping skills to help manage stress, avoid triggers, and handle cravings. Practicing these skills can reduce the risk of relapse. CBT is usually done in an outpatient setting but also can be part of inpatient programs.

In cognitive behavioral therapy, a therapist teaches coping skills to help manage stress, avoid triggers, and handle cravings.

Contingency Management

Contingency management uses rewards to encourage staying drug-free. For example, people might earn vouchers, small prizes, or privileges for passing drug tests. This approach helps boost motivation and has been shown to improve engagement and retention in addiction treatment programs.

Inpatient and Outpatient Treatment Programs

People recovering from opioid addiction can choose to enroll in an inpatient or outpatient treatment program.

Inpatient programs require staying at a treatment center for several weeks or months. These programs provide medical care, therapy, and support in a safe place. They help people focus on recovery without outside distractions.

Outpatient programs allow people to live at home while attending treatment sessions. These programs typically include counseling, group therapy, and medication. Outpatient care is a good option for those who need treatment while keeping up with work, school, or family responsibilities.

Both types of programs can be effective, depending on individual needs. Access to treatment varies by location, and insurance coverage may differ. If you’re looking for a program, talk to your doctor or check with a local nonprofit that specializes in addiction and recovery.

Support Systems for Recovery From Opioid Use Disorder

Having a solid support system can make recovery easier. Support can come from family, friends, peer programs, and harm-reduction services.

Connecting with others who understand what you're going through can be life-changing. Programs like Narcotics Anonymous and SMART Recovery provide a sense of community through group meetings. Some programs also offer peer mentors — people who have overcome addiction and can provide guidance. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides resources to help people find peer support programs in their area.

Harm-Reduction Strategies for Opioid Use Disorder

Harm-reduction strategies focus on keeping people safe while they work toward recovery. One important approach is the distribution of naloxone (Narcan), an opioid antagonist. This nasal spray can reverse an opioid overdose and is available over the counter at pharmacies and community programs. In recent years, the FDA expanded access to naloxone to reduce overdose deaths.

Other harm-reduction strategies include:

• Nalmefene — This opioid antagonist reduces overdoses but requires a prescription.
• Syringe exchange programs — These programs provide sterile needles to prevent the spread of infections from sharing needles. They also connect people to healthcare and treatment services.
• Fentanyl test strips — These small strips detect fentanyl in other drugs. Since fentanyl is often mixed into substances without people knowing, these strips can help prevent accidental overdoses.

Together, these strategies aim to prevent opioid overdoses and reverse the effects if someone does take too much.

Help for Opioid Use Disorder Is Available

Recovering from substance use disorders is challenging, but with the right support, it’s possible. Medications like methadone, buprenorphine, and naltrexone help manage withdrawal symptoms and cravings. Combined with therapy, medication-assisted treatment can help people regain control of their lives.

If you or someone you know is experiencing opioid addiction or OUD, you’re not alone. Visit SAMHSA’s treatment locator, or reach out to your healthcare provider to find an addiction medicine specialist. Recovery takes time, but support is always available.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and other related mental health disorders. On MyDepressionTeam, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with mental health disorders.

What medications have you tried to treat opioid use disorder? What treatments and coping strategies do you find helpful? Share your experience in the comments below, or start a conversation by posting on your Activities page.