Treatment Options

Finding the right treatment

Everyone is different

Opioid dependence is a chronic condition in need of long-term management, but there is no single treatment that is right for everyone. Before treatment begins, or following a relapse, people with opioid dependence should work with their doctors, counselors, and any others involved with their treatment to develop a plan based on their individual treatment goals. An effective treatment plan should include support and/or counseling that is designed to meet that person's specific needs and may also include medication.

Treatment settings

The most common ways to receive treatment for opioid dependence:

  • Inpatient setting: People receive treatment at a live-in facility for an extended period of time
  • Outpatient setting: Allows people to receive the treatment they need with a limited impact on their daily lives

Benefits of outpatient treatment

  • Private, confidential, and safe treatment experience often with the same doctor each time
  • Leaves more time for family and friends, work, and/or school
  • Being able to take medication without supervision
  • Eliminates the need for residential treatment, which can become expensive and time-consuming
  • Allows people to receive the treatment they need with a limited impact on their daily lives

Types of treatment

Two important elements of treatment for opioid dependence, which can be used separately or in combination, are:

  • Support and/or counseling
  • Medication for opioid dependence

Support and counseling

An active support network and counseling are key parts of an effective treatment plan. There are a number of different kinds of support and counseling available for the treatment of opioid dependence.

Cognitive behavioral therapy

  • Helps people become aware of inaccurate or negative thinking and how to better manage stressful life situations
  • People work with a mental health counselor (psychotherapist or therapist) in a structured way, with a limited number of sessions
  • Teaches people to view challenging situations more clearly and respond to them in a more effective way
  • Can be a very helpful tool in treating chronic disorders or illnesses, such as anxiety, depression, or dependence

Behavioral therapy

  • A structured approach that carefully measures what the person is doing and then seeks to increase chances for positive experience
  • Focused on helping an individual understand how changing his or her behavior can lead to changes in how he or she feels
  • Usually focuses on increasing the person's engagement in positive or socially reinforcing activities

Psychodynamic/Interpersonal therapy

  • Enables people to examine unresolved conflicts and symptoms from past relationship issues, which may surface as the need or desire to abuse substances
  • Focuses on a person's unconscious thoughts and how they are displayed in a person's behavior
  • Goals include helping a person find self-awareness and an understanding of how the past affects present behavior

Group/Family therapy

  • Involves 1 or more therapists working with several people at the same time
  • Widely available at a variety of locations, including hospitals, private therapeutic practices, mental health clinics, and community centers
  • Is sometimes used alone, but it is also commonly used as a part of a treatment plan that includes individual counseling and medication

Self-help groups

  • People who share a common problem, often a disease or dependence, and provide support for each other
  • Also known as mutual help, mutual aid, or support groups
  • Goal is to help each other to deal with or, if possible, to heal or to recover from the problem
  • Self-help groups may exist separately or as part of larger organizations

Personalized support programs

  • Programs are designed to meet a person's specific needs
  • May include frequent contact with doctors or loved ones
  • Allow people to customize their approach to treatment

Treating opioid dependence with medication

Opioid dependence can be treated

Medications for opioid dependence are available. This means that people with opioid dependence do not need to go "cold turkey" without the help of medication when they decide they want to be treated.

How medications for opioid dependence are used

  • Detoxification (commonly referred to as "detox"): Medication is used for a short period of time just to help people get through the withdrawal period
  • Maintenance treatment: A successful form of treatment that involves a sustained treatment period, during which medication is taken every day

Maintenance medication

Maintenance medication can help reduce cravings without making the person feel "high." These help give people a chance to change their habits and to avoid relapse.

  • During treatment with maintenance medication people take a dose of medication each day. Depending on the person and his or her goals for treatment, this step can last for weeks, months, or even years before tapering off is considered

Types of maintenance medication

Because opioid dependence is a chronic disorder, it is never really cured. Maintenance treatment is about managing the disorder so that people are able to regain control of their lives.

The goals of maintenance treatment are to:
  • Suppress withdrawal
  • Minimize cravings
  • Limit the effects of opioid misuse
  • Improve the ability to function
  • Help reduce the risk of relapse

"Waivered" doctors

Some medications for the treatment of opioid dependence are controlled substances; therefore, doctors have to become eligible to prescribe them.

  • Doctors who wish to treat opioid dependence with buprenorphine or buprenorphine/naloxone in their offices must qualify for a waiver
  • Waivered doctors may treat up to 100 patients for opioid dependence in their practices after one year

The Drug Addiction Treatment Act of 2000, commonly referred to as DATA 2000, enables doctors who meet certain qualifying criteria to receive a waiver to prescribe these medications for opioid dependence. Find a doctor in your area that can provide more information on treating opioid dependence.

Relapse is common and not a failure

Opioid dependence is a relapsing disorder

Relapse is a part of opioid dependence, just like symptom breakthrough is with other chronic conditions.

What is relapse?

  • Relapse happens when someone with opioid dependence who had stopped taking opioids begins taking opioids again
  • Long-term use of opioids causes physical changes in the brain that make someone with opioid dependence feel like he or she needs opioids in order to function properly
      – People are at risk of relapse even if it's been a long time since they stopped taking opioids

Relapse can happen for several reasons:

  • An improper dose of medication
  • Other drug or alcohol use
  • Other health issues
  • Stopping treatment for opioid dependence; medication, support, and/or counseling
  • Triggers

Triggers are things that can cause cravings for someone who had stopped taking opioids. If these cravings are acted upon, they may result in relapse. Triggers may include

  • Stress at work/school or home
  • Relationship problems
  • Emotional pain or difficult situations
  • Pain from an injury or medical procedure
  • Certain people

When people have a relapse, they sometimes feel they have failed. But that isn't always the case. Everyone has different needs, and a relapse can simply mean that a person isn't getting the support and/or counseling he or she needs or may need to try a different medication. Sometimes finding the right combination of support and/or counseling and medication can make the difference needed for a successful recovery.

Current treatments for opioid dependence offer options

Everyone is why should treatment plans be the same?

Choice of medication

Medications are available that offer advantages in

  • Taste
  • Dissolve time
  • Tablet size
  • Delivery (ie, tablet or film)
  • Cost

Personalized support

Some people lean on their friends and family during their recovery process while others prefer the confidentiality of a therapist or counselor. Some like to share their experiences, while others seek help privately.

Personalized support programs allow people with opioid dependence to customize their experiences to meet their specific needs and goals. Learn more about support and counseling.

The importance of a support network

People don't have to go through treatment for opioid dependence alone.

Involving people who address different social, emotional, and medical issues during the recovery process will help someone in treatment cope with difficulties, such as triggers and relapse, that may arise.

A support network may include:

  • A primary care doctor or addiction specialist
  • Therapist, psychologist, or counselor
  • Family and friends
  • Support groups

Involving the support network in the recovery process

A person's recovery from opioid dependence may require a variety of support and/or counseling and medical options. For someone with opioid dependence, it may help to have an open line of communication among his or her doctors, counselors, friends, and loved ones. Some support programs provide ways for people with opioid dependence to include their support networks. This may allow people with opioid dependence to share their thoughts and progress with their support networks, including their doctors, and for friends and family to gain a better understanding of what their loved one with opioid dependence may be experiencing.


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