Behavioral Therapies for Opioid Use Disorder

Reviewed by: HU Medical Review Board | Last reviewed: January 2025 | Last updated: February 2025

Treating opioid use disorder (OUD) often requires a combination of therapies. Behavioral therapies are an important part of treatment. These therapies are often used along with medication-assisted treatment (MAT).1

What are behavioral therapies?

Opioid use disorder is a serious condition in which someone cannot control their use of opioids. Behavioral therapies are treatments that can help people with OUD change their thoughts and actions.1,2

Behavioral therapies teach people new ways to deal with stress, triggers, and cravings. This type of treatment also helps people build healthier habits. This is key to recovering and staying drug-free.1,2

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) helps people identify negative thought patterns. These thoughts can lead to drug use. With CBT, people learn to replace negative thoughts with positive ones. They also learn strategies to cope with stress and avoid situations that trigger cravings.1-3

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Contingency management

Contingency management uses positive reinforcement to encourage healthy behavior. For example, a person might earn vouchers or prizes for attending therapy sessions or passing drug tests. This approach can help people stay motivated and focused on recovery.3,4

Motivational interviewing

Motivational interviewing (MI) is a counseling technique. It helps people explore their feelings about opioid use and their desire to change their drug habit. A therapist works with the person to help the person identify reachable goals for change. MI builds the person's confidence and motivation to stay on track.3,5

Family therapy

Family therapy includes loved ones in the recovery process. It helps improve communication and rebuild trust in a family. Loved ones learn how to support the person in recovery. They also learn how to care for themselves during what can be a difficult time.3

Group therapy

Group therapy brings people with similar experiences together. Sharing stories and challenges can reduce feelings of isolation. Group members support each other and learn from each other’s experiences.3

What is medication-assisted treatment (MAT)?

Medication-assisted treatment combines behavioral therapy with medicine. The medicine helps reduce withdrawal symptoms and cravings. This makes it easier for people to focus on therapy and recovery.3,6

MAT is a proven way to treat OUD. It can save lives and lower the risk of relapse. Here are 3 approved medicines used in MAT:3,6

  • Methadone – Methadone reduces cravings and withdrawal symptoms. It is taken once a day at a special clinic.
  • Buprenorphine – Buprenorphine has been used to treat OUD for many years. It works in a similar way to methadone. It reduces cravings and withdrawal symptoms.
  • Naltrexone – Naltrexone blocks the effects of opioids. It prevents people from feeling "high" if they use opioids. Naltrexone is not addictive and can be taken as a daily pill or a monthly injection.

How behavioral therapies and MAT work together

Behavioral therapies and MAT are most effective when used together. The medicine helps stabilize the person physically. This allows them to focus on therapy and make long-term behavior changes.1

Therapy helps people develop skills to manage their emotions, cope with stress, and rebuild their lives. Together, these approaches create a strong foundation for recovery.1

Support matters

Support from family, friends, and healthcare providers is essential. Recovery from OUD is not easy. But it is possible. Behavioral therapies and MAT give people the tools they need to succeed. With the right support, many people can live fulfilling lives.

If you or someone you love is dealing with OUD, reach out for help. There are many resources available to guide you through recovery.

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.