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Opioid use disorder (OUD) is a chronic, recurring disorder commonly characterized by the three "C's": (1) loss of control over drug use, (2) continued use despite harmful consequences, and (3) cravings/urges to use.
It is treatable and can go into remission. Remission means stopping opioid use and having no symptoms of OUD.
If you are looking for treatment options or recovery resources in your area, start here.
People with OUD who stop using opioids are at high risk for fatal overdose if they return to opioid use when not receiving medication treatment for OUD. Some medications for the treatment of opioid use disorder, particularly methadone and buprenorphine, lower the risk of death by at least 50%.
Medications for OUD can also
Click here to access our flyer that explains more about each medication approved by the FDA for the treatment of opioid use disorder.
The initial decision to take drugs is voluntary for most people, but repeated drug use changes many important networks in the brain involved in things like learning, motivation, reward, memory, mood, pleasure, and stress response. Repeated drug use causes changes in parts of the brain that are not under voluntary control. People can start to feel very sick physically and mentally when they go without the drug, can start to think more about drug use (even if they don't want to), and struggle with many aspects of life.
Medications like buprenorphine (e.g. Suboxone®) and methadone are helpful for the brain and body because they help stop repeated cycles of intoxication and withdrawal, greatly decrease cravings, and protect a person from fatal overdose if there is a return to use.
People starting treatment with medication for OUD may decrease or stop opioid use quickly or it can take time, and sometimes people return to use after starting treatment. Returning to use or taking time to slow or stop use does not mean that the medication is not working. As with other chronic health conditions, medication for OUD should be ongoing as long as the person needs it and should be adjusted based on how the person responds.
Opioids work at specific receptors in the brain. Think of a plug fitting into an outlet. People with OUD often feel sick and have strong cravings when no opioid is plugged in and activating the receptors.
Methadone and buprenorphine plug or bind into receptors in the brain and activate them, which helps treat withdrawal, cravings, and pain. Methadone binds to receptors and fully activates them. Buprenorphine is like a plug in a power strip that partially activates the receptors.
Naltrexone is like a child-safety cover that plugs into and blocks the receptor without activating it. Naltrexone can't be used for about 7 to 10 days after opioid use. Overdose risk is high during that time.
OUD is a chronic illness like diabetes or heart disease. It can require treatment over many years or even for life. Medication for OUD may continue as long as it is helping.
Stopping medication, especially without help from a health care provider, can increase the risk of overdose and death. Patients should discuss decreasing or stopping their medication with their health care provider.
The following chart provides information about each medication to help you understand a little bit more about each medication and which you might prefer. If you would like to watch a brief video that discusses this more, please visit https://www.youtube.com/watch?v=StaxOBLzUW8
Talk with a health care provider about which medication may work best for you. They can discuss with you which may be the best fit for your needs and goals. If you are having trouble with your medication, please discuss this with your provider and ask if a medication or other change may helpful for you. You should not stop taking the medication without the guidance of a health care provider, because it can increase the risk of overdose and death.
If you have a health care provider, start there. Ask them about methadone, buprenorphine, and naltrexone, and whether they offer these treatments and can help you get into treatment. If your health care provider is unable or unwilling to prescribe these medications, request a referral to another provider who can prescribe them.
If you do not have a provider or are unable to get a referral, there are other support and treatment locators available below. Please note that these treatment locators are not exhaustive. Providers often have to "opt-in" to be listed in these networks.