Treatment Options for Opioid Use Disorder

Opioid use disorder (OUD) is a medical condition that happens when someone has become dependent on opioids. A person with OUD cannot control their use of opioids.¹

Opioids are substances that relieve pain. They include prescription medicines like oxycodone and illegal drugs like heroin.¹

Opioids affect the brain as well as the body. This makes it hard for some people to stop using the drugs even when they want to. Thankfully, many treatments and harm-reduction practices can help people recover from OUD.¹

Medicines to treat opioid use disorder

Medicines are often a key part of treating OUD. These medicines can reduce cravings and withdrawal symptoms. They also help people focus on recovery. Here are 3 medicines used to treat OUD.²

Buprenorphine

Buprenorphine is considered the gold standard for OUD treatment. It has been used to treat OUD for decades. It partially activates opioid receptors in the brain. This helps reduce cravings and withdrawal symptoms but has a lower risk of misuse than opioid drugs.^2-4

Buprenorphine comes in the form of a pill or injection medicine. It is prescribed and given to you by your doctor. After some time, your doctor may allow you to take the drug at home. Sometimes, it is combined with naloxone to prevent misuse.^2-4

Methadone

Methadone is a long-acting medicine. It works by changing how the brain responds to pain. Methadone can reduce opioid cravings and withdrawal symptoms.^2-4

Methadone comes in the form of a liquid and is taken daily. It must be given at a special clinic certified by the Substance Abuse and Mental Health Services Administration (SAMHSA).^2-4

Naltrexone

Naltrexone blocks the effects of opioids. This means that if a person uses opioids, they will not feel the typical “high.” Naltrexone is usually given as a long-acting injection.^3,4

You cannot start taking naltrexone if you have opioids in your system. You must be completely free of opioids for about 6 to 10 days before starting naltrexone. Otherwise, you will have severe opioid withdrawal symptoms. There are a number of other medicines used to reduce the severity of withdrawal symptoms. Talk to a healthcare provider to understand your options.^3,4

Naloxone

In the case of an overdose, naloxone (brand name: Narcan®) is a life-saving medicine used to reverse opioid overdoses. It works by quickly binding to opioid receptors in the brain, displacing the opioids and blocking their effects. This restores normal breathing in people whose breathing has slowed to a dangerously low level.⁵

Naloxone is given as a nasal spray or injection. It acts within minutes. It is safe to use and has no effect if opioids are not present. This makes it a critical tool in combating the opioid overdose crisis. Its effects may wear off before the opioids leave the body, so emergency medical care is essential.⁵

If you are a loved one of someone living with OUD, it is recommended to keep naloxone on hand, in case of an overdose. Most pharmacies and community clinics have naloxone available without a prescription and at a low or no cost. Find out how to access naloxone where you live.⁵

Behavioral therapies to treat OUD

Mental health conditions – like depression and anxiety – and OUD often co-exist. The medicines listed above are frequently combined with behavioral therapies to treat OUD. Behavioral therapies help people change their thoughts and behaviors related to drug use. One common therapy is called cognitive behavioral therapy (CBT).^2,3

CBT teaches people how to:^2,3

• Recognize triggers for drug use and then avoid them
• Develop healthy coping strategies
• Set and achieve recovery goals

Therapists work with people to create a plan that meets their unique needs. Support groups and counseling are also helpful for many people. Counseling and therapy are also available for family and friends of those living with OUD.^2,3

Complementary and integrative medicine

Some people with OUD find relief through complementary and integrative medicine. These therapies are not replacements for medicine or behavioral therapy. But they can be helpful when used alongside them. Examples include:⁶

• Mindfulness meditation – These practices teach you to accept and stay in the present moment. They may help reduce cravings and relapses.
• Yoga – Yoga combines movement and breath practices to help you relax and connect with your body. It can also improve overall health and well-being.
• Acupuncture – Acupuncture is an ancient form of Traditional Chinese Medicine. It involves placing thin needles at specific points on the body. Many people use acupuncture for self-care and relaxation. It may be helpful for those living with substance use disorders.
• Hypnotherapy – This is a form of therapy in which you are guided toward the root cause of addiction. It may help you respond to triggers.
• Music therapy – Creative activities like music therapy can provide an outlet for strong emotions. They also can help reduce stress.

Emerging therapies for OUD

Researchers are always looking for new ways to treat OUD. Some emerging therapies show promise, including:^7-9

• Vaccines for OUD – Scientists are developing vaccines that may block opioids from entering the brain. This could reduce the risk of relapse for those with OUD.
• Digital therapies – Mobile apps and online programs can provide education, reminders, and support for people in recovery.
• New medicines – Researchers are exploring medicines that target different parts of the brain’s reward system.

Several new therapeutic approaches are being studied. While more research is needed, they may offer more options for people with OUD in the future. There are several clinical trials underway for OUD.⁹

Rehab and recovery programs

Rehabilitation and recovery programs create a structured and supportive environment for people with OUD. These programs often include medical care, counseling, and peer support.¹⁰

Inpatient rehab programs allow people to focus entirely on their recovery while living at a treatment facility. Outpatient programs offer a more flexible option. They allow people to receive treatment while still working or maintaining family responsibilities. These programs help people build skills, routines, and connections with others who are working toward recovery.¹⁰

The importance of a supportive environment

Recovery from OUD is a journey. A supportive environment can make a big difference. Friends and family can help by:³

• Encouraging treatment and attending support groups
• Learning about OUD to reduce stigma
• Offering patience and understanding during tough times

Healthcare providers, counselors, and peer support groups also play key roles in recovery. Help is available, and recovery is possible. If you or someone you know is living with OUD, reach out to a healthcare provider or support group. Find the treatment you need.³