Opioid use disorder is a life-changing condition that some people may have trouble admitting that they struggle with. It’s important to remember that substance abuse disorder doesn’t just happen to other people; it can happen to you, someone you care about, or someone you treated with prescribed pain relief.
While opioids can be a valuable tool in managing pain for many, when prescription opioids or illicit opioids become more than ongoing physical pain relief, you’re touching on opioid disorder issues, opioid addiction. This article will walk you through how opioids affect your body and mind, how healthcare providers identify opioid dependence and opioid use disorder diagnosis, and what evidence-based treatment options exist. You will discover what medications exist for opioid use, what behavioral therapies help, and a realistic plan to treat opioid use disorder.
At our outpatient treatment facility in New Jersey, our care team at New Chapter Recovery speaks directly to you as someone facing this challenge, applying our expertise to help you understand how effective disorder treatment can rescue you from drug addiction.
Key Points
- Opioid use disorder (OUD) is a chronic condition involving opioid dependence that requires addiction counseling to avoid the risks of overdose.
- Diagnosis for managing opioid abuse is based on DSM-5 criteria and must be done by a qualified health care provider.
- Medications for opioid use disorder (methadone, buprenorphine, naltrexone) reduce mortality and improve outcomes.
- Behavioral therapies and psychosocial interventions are essential alongside medication to build a solid foundation for recovery.
- Managing chronic pain while treating OUD requires an integrated plan, not just stopping opioids cold.
Understanding Opioids and the Brain
Opioids are a class of drugs that include prescription opioids, illicit drugs, and any substance related to what is derived from the poppy plant. It is used to treat moderate to severe pain, as well as illicit substances like heroin. They act by binding to opioid receptors in the brain and your central nervous system, reducing pain but also triggering reward and euphoria. When taken repeatedly, they can shift from pain relief into opioid use, opioid dependence, and eventually opioid use disorder.
When you start taking opioids for chronic pain or severe pain, the risk of developing a problematic pattern increases over time. Your natural tolerance builds, meaning you need higher doses to recreate the same effect. As your physical dependence develops, you become trapped by the relief you feel, contrasted with the withdrawal symptoms when you stop.
Some people with certain genetic, environmental, or mental-health risk factors, such as co-occurring mental disorders like post-traumatic stress disorder, are more vulnerable to moving from opioid use into opioid abuse or opioid disorder. Studies involving twins and family members have shown a strong link between genetic heritability and the risk for developing substance abuse, which a 2021 study estimated accounts for nearly 50% of the risk for opioid addiction.
What is Opioid Use Disorder (OUD)?
When the term is used in a clinical setting, it means more than just occasional misuse. Instead, it identifies a condition in which you’re caught in a persistent pattern of opioid addiction, or opioid use disorder (OUD), that causes harm and distress.
In the diagnostic world, healthcare providers and organizations like the American Psychiatric Association refer to the Diagnostic and Statistical Manual (DSM-5) to determine the criteria for opioid use disorder:
- Withdrawal symptoms
- Dangerous use
- Physical tolerance
- Unable to stop using or cut back on use
- intense opioid cravings
- Taking more than intended
- Spending significant time obtaining opioids or recovering from use
- Difficulty performing daily activities and essential duties
- Decreased desire to socialize while choosing to use
- Continuing to use despite relationship and social consequences
- Continuing to use despite physical and psychological consequences
If you meet at least two of those criteria within a 12-month period, you may be diagnosed with opioid dependence. The severity is rated mild, moderate, or severe depending on how many criteria you meet, with six or more defining severe OUD.
Risk Factors and Complications of Opioid Addiction
There’s no single cause for opioid misuse. If you’re reading this, you might have encountered some of the risk factors for developing an addiction:
- a prescription opioid regimen for severe pain
- taking higher doses
- mixing with other substances,
- untreated mental health issues
- environmental stresses.
People prescribed opioids for chronic pain may start with legitimate intentions but face the slippery slope into misuse as they start to depend on the relief and good feelings it provides them in their daily lives. Co-occurring mental disorders like anxiety, depression, or post-traumatic stress disorder increase the risk of moving from opioid use to opioid dependence.
The Drug Enforcement Administration (DEA) regulates opioids as controlled substances for a reason: misuse has life-threatening potential. According to the Centers for Disease Control, in 2024, there were approximately 54,000 drug overdoses related to opioids that resulted in death. While drug overdose deaths fell for the first time in decades in 2024, opioids still account for the majority of deaths, and these numbers are still cause for concern.
Opioid Use Disorder Medical Procedures and the Principles of Disorder Treatment Planning
Now that you know the diagnostic criteria and the risk for not getting treated, you may be asking: “What’s next?” The best way to think about opioid use disorder is as a chronic disease like diabetes, something that you can simply overcome with willpower. An OUD diagnosis means you’ll likely need ongoing management, not a one-time fix.
A robust treatment plan is individualized to your specific needs. You and your health care providers collaborate to screen for other conditions that could be influencing your addiction, to reduce opioid use, to prevent relapse or overdose, to restore function in life, and to manage co-occurring mental health issues. A plan might include medications for opioid use, behavioral therapy, peer support, and harm reduction strategies (like naloxone for overdose).
| Plan Component | Purpose | Common Methods |
|---|---|---|
| Medications for Opioid Use Disorder (MOUD) | Normalize brain chemistry & reduce cravings | Methadone, Buprenorphine, Naltrexone |
| Behavioral therapy | Address underlying issues & build coping skills | cognitive behavioral therapy (CBT), motivational interviewing, contingency management, family therapy |
| Harm reduction | Reduce immediate death risk (overdose, infections) | Naloxone, safe use, support networks |
| Long-term monitoring | Adapt plan, address relapse triggers, maintain recovery | At least yearly reassessment |
Medications for Opioid Use Disorder (MOUD)
One of the most powerful tools in treating opioid use disorder is medication for opioid use disorder (MOUD). The National Institute on Drug Abuse (NIDA) estimates that fewer than 1 in 5 people with OUD receive notes that approved medications.
How they work:
- Methadone: a full opioid agonist (effect mimicker) that reduces withdrawal symptoms and cravings by activating receptors more slowly than more dangerous opioids.
- Buprenorphine: a partial agonist that reduces cravings and blocks opioid effects; often combined with naloxone, which is an opioid receptor antagonist (opioid blocker).
- Naltrexone: an antagonist that stops the effects of opioids and may prevent a relapse.
Some patients might fear that taking “another opioid” is replacing one addiction with another, but medications like buprenorphine and methadone work by stabilizing brain chemistry, reducing harmful use, and allowing you to live a normal life. If you’re considering MOUD, talk openly with your provider about your pain, whether you’re still using prescribed opioids for chronic pain or severe pain, your lifestyle, and how the medication fits into your larger recovery plan.
Behavioral Therapies and Psychosocial Interventions for Addiction Treatment
Medication alone isn’t enough. For many people with opioid use disorder, especially those with co-occurring substance use disorder or mental disorders, behavioral support is essential. Cognitive-behavioral therapy, motivational interviewing, contingency management, and group therapy are all proven to help. The American Psychiatric Association has resources for combining medication with psychosocial treatment, which is seen as the standard for opioid addiction treatment.
Managing Drug Abuse Withdrawal and Early Recovery
One of the most intimidating parts of opioid dependence is the thought of opioid withdrawal and early recovery. However, medically supervised withdrawal combined with treatment planning makes it possible to avoid withdrawal symptoms and prevent relapse. Withdrawal symptoms like restlessness, muscle aches, insomnia, nausea, and intense cravings are real signs your body is adjusting away from opioids. That said, detox only (without effective treatment) has a high risk of relapse and overdose.
Policy, Access, and Barriers to Care
Even if you’re ready to fight opioid use disorder, there are system-level barriers: stigma, limited access to medications, and regulatory burdens (the DEA previously required special waivers for buprenorphine prescribing). You may also need to sort out insurance details and obtain prior authorization for your insurance to cover an OUD treatment program. Typically, your insurance will cover any medically necessary addiction services, but you would need to verify your insurance with a treatment center before you would be allowed to receive care. Be sure to always have your insurance information on hand when you or a loved one is considering treatment.
Overdose Risk and Emergency Response
If you have opioid use disorder, overdose risk is real. Coming off opioids (tolerance lower), switching drugs, combining substances, or after incarceration are dangerous times for opioid overdose. To be prepared, obtain medications for opioid use disorder and accidental overdose to reduce your risk significantly.
Learn how to use naloxone, and keep it accessible. Teach friends/family how to administer it. Know what to do in an emergency:
- Call 911
- Administer naloxone
- Continue supporting breathing and helping maintain consciousness until help arrives
How to Get Help: First Steps and Resources
If you are in an emergency, contact medical professionals immediately to help you or a loved one overcome opioid overdose or severe opioid withdrawal symptoms. As you look at your treatment options, here are some steps you can take now:
- Talk to your health care provider about your opioid use, whether it’s prescribed or illicit. Be honest about your pain, your patterns, your concerns.
- Ask for an assessment for opioid use disorder; screening tools exist, and early diagnosis makes a big difference for long-term outcomes.
- Ask about medications for opioid use disorder (MOUD) and behavioral therapies.
- Explore resources: the national helpline (1-800-662-HELP in the U.S.), treatment locators (FindTreatment.gov), peer-support groups.
- Build your recovery team of a physician, a therapist, a peer network, and friends/family you trust.
If you’re worried about cost, ask your provider or local clinic about insurance coverage, Medicaid, telehealth options, and community programs.
Frequently Asked Questions for Substance Use Disorder: Opioid Abuse Symptoms
What is an opioid use disorder?
An opioid use disorder is a medical condition where someone develops a problematic pattern of using prescription opioids or illicit opioids for pain management or relief that leads to cravings, loss of control, tolerance, withdrawal symptoms, and continued use despite harm. It’s diagnosed using DSM-5 criteria and ranges from mild to severe.
What are the physical signs of opioid use turning into addiction?
Physical signs include increased tolerance (you need more to get the same effect), withdrawal symptoms when you stop (sweating, nausea, muscle aches), cravings, spending lots of time using or recovering from opioids, and giving up activities you once did. These all point from opioid use toward opioid dependence or opioid use disorder.
How do medications for opioid use disorder help with recovery?
Medications for opioid use disorder (MOUD) like methadone, buprenorphine, and naltrexone stabilize brain chemistry, reduce cravings and withdrawal symptoms, block opioid effects, and reduce risk of overdose. They are often used with behavioral therapy as part of a treatment plan to support your long-term recovery.
What if I was on prescribed opioids for chronic pain and I now have OUD?
If you were taking prescription opioids to treat pain and now face opioid use disorder, you’re not alone. Your health care provider should shift toward a combined plan to address your pain with non-opioid options and treat your OUD with medications and therapy. You don’t have to choose between pain relief and recovery.
Get Help With New Chapter Recovery’s Outpatient Program
If you’re facing opioid use disorder, know this: you are not broken, you are not beyond help, and there is a way forward. From diagnosis through evidence-based treatment to long-term recovery, you can build a new story, one where medication, therapy, support, and your own determination come together.
That’s where New Chapter Recovery comes in. We offer a flexible outpatient experience with the best evidence-based treatment options, including Partial Hospitalization (PHP), Intensive Outpatient (IOP), and Outpatient Rehab (OD). The journey may feel overwhelming, and yes, there may be setbacks, but each day you engage in treatment, you’re reclaiming your confidence and future life. Reach out today, ask about medications for opioid use, ask about therapy, permit yourself to hope again.
