Opioids, sometimes called narcotics, include strong prescription pain relievers — oxycodone, hydrocodone, fentanyl, tramadol — and the illegal drug heroin. Providers may prescribe opioids after a major injury or surgery, for severe pain from conditions such as cancer, and sometimes for chronic pain. Taken briefly and as prescribed, they're generally safe — but opioid use disorder (OUD) remains a risk.
What OUD is
OUD is a problematic pattern of opioid use that causes significant distress and impairment, interfering with daily life. People also use related terms:
| Term | Meaning |
|---|---|
| Dependence | having withdrawal symptoms without the drug |
| Addiction | a chronic brain disease that drives a person to seek drugs compulsively despite harm |
Treatments
- Medicines — medications for opioid use disorder (MOUD);
- Counseling and behavioral therapies;
- Residential and hospital-based treatment.
The medicines
| Medicine | How it helps |
|---|---|
| Methadone and buprenorphine | act on the same brain targets as opioids, easing withdrawal and cravings — without the high |
| Naltrexone | blocks the high from opioids, to prevent relapse; it doesn't ease withdrawal or cravings. You must be off opioids for 7–10 days first, or withdrawal can be severe |
| Buprenorphine with naloxone | a combination; naloxone, which treats overdoses, makes the buprenorphine less likely to be misused |
Not a swap of one addiction for another. Methadone and buprenorphine are treatment: they restore balance to the parts of the brain affected by addiction, letting it heal during recovery. People can take them safely for months, years or a lifetime. Don't stop on your own — plan it with your provider.
Counseling
Counseling helps people change attitudes and behaviors around drug use, build life skills and stay with other treatment.
- Individual counseling — goals, setbacks, progress, and legal or family problems — often with:
- cognitive-behavioral therapy (CBT), to spot and stop negative thinking and behavior, manage stress and change the thoughts behind misuse;
- motivational enhancement therapy, to build motivation to stick with treatment;
- contingency management, which offers incentives for staying off opioids.
- Group counseling — you're not alone, and others' struggles and successes suggest new strategies.
- Family counseling — with partners, spouses and close family, to repair relationships.
Counselors can also connect people with peer support (including 12-step programs such as Narcotics Anonymous), faith-based groups, HIV and hepatitis testing, case management, employment and education support, and help finding housing or transportation.
Residential and hospital care
- Residential programs combine housing and treatment; residents support one another in recovery.
- Inpatient hospital programs combine medical care and OUD treatment for people with medical problems; hospitals may also offer intensive outpatient treatment.
These programs are highly structured, usually combining several kinds of counseling — and usually MOUD too.
Sources
Based on the MedlinePlus health topic "Opioid Use Disorder (OUD) Treatment," National Library of Medicine; a work of the United States government in the public domain. The source lists the MOUD medicines once as methadone, buprenorphine and naltrexone and then as methadone, buprenorphine and lofexidine; only the first list, which the rest of its text describes, is used here.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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