Opioid Use Disorder Treatment Options

Opioid use disorder is a treatable condition, but the right treatment depends on the person's opioid use, withdrawal risk, physical health, mental health, overdose risk, support network and previous attempts to stop.

Opioids include heroin, morphine, oxycodone, codeine, tramadol, fentanyl and other prescription or illicit opioid drugs. Dependence can develop after medical prescribing, recreational use, trauma, chronic pain, emotional distress or relapse after earlier treatment.

If someone is very drowsy, breathing slowly, blue around the lips, difficult to wake, confused after opioid use or may have overdosed, call emergency services immediately. Naloxone can reverse opioid overdose but urgent medical help is still needed.

What treatment needs to address

Opioid treatment is not only about stopping a drug. It needs to reduce overdose risk, manage withdrawal safely, treat cravings, stabilise mental health, address trauma or pain where relevant, rebuild daily structure and create a realistic relapse prevention plan.

• Assessment of opioid type, dose, route, frequency and duration of use.
• Review of alcohol, benzodiazepines, stimulants or other substances used at the same time.
• Physical health review, including pain, sleep, nutrition and infection risk where relevant.
• Mental health assessment for depression, anxiety, trauma, self-harm or suicidal thoughts.
• A plan for cravings, high-risk situations, family support and aftercare.

Medically supported detox

Opioid withdrawal can be intensely uncomfortable and can drive rapid relapse if it is not planned carefully. Symptoms may include sweating, agitation, anxiety, insomnia, stomach cramps, diarrhoea, aches, restlessness, low mood and strong cravings.

A medically supported detox can help reduce risk and improve comfort, but detox alone is rarely enough. After detox, tolerance falls, which can increase overdose risk if a person relapses and uses the same amount as before.

Medication-assisted treatment

Some people benefit from medication-assisted treatment, such as opioid substitution or relapse-prevention medication, depending on clinical assessment and local prescribing arrangements. Medication can reduce cravings, stabilise the person and lower overdose risk while wider recovery work begins.

Medication decisions should be made with a qualified prescriber. The aim is not a one-size-fits-all approach; it is to match the treatment plan to risk, goals, history and safety.

Residential, day and outpatient treatment

Outpatient treatment may suit someone who is medically stable, has strong support and can attend regularly. Day treatment can add structure while the person remains at home. Residential treatment may be appropriate where relapse risk is high, home is unsafe, mental health is complex, multiple substances are involved or previous outpatient attempts have not held.

PROMIS can provide assessment and treatment planning across different levels of care, including detox support, residential care, therapy, psychiatric input, family work and aftercare.

Therapy and relapse prevention

Therapy helps people understand what opioids have been doing for them emotionally and physically. For some, opioids numb trauma, grief, shame, anxiety or chronic pain. For others, opioid use has become linked to identity, relationships, boredom, work pressure or loneliness.

• Identifying triggers, cravings and high-risk routines.
• Building alternatives for pain, distress, sleep and emotional regulation.
• Addressing trauma, depression, anxiety or relationship difficulties.
• Planning for lapses without allowing them to become full relapse.
• Involving family where it is safe and clinically helpful.

Questions to ask before choosing treatment

• Is overdose risk assessed and discussed clearly?
• How will withdrawal and cravings be managed?
• Is there psychiatric support if mood, trauma or risk are present?
• Does the programme understand prescription opioid dependence as well as heroin or illicit opioid use?
• What happens after detox or discharge?
• How are family members supported?

How PROMIS can help

PROMIS treats opioid addiction as part of the whole person's life, not as an isolated behaviour. Assessment can help decide whether the safest next step is outpatient support, day treatment, residential care, detox planning or a more integrated programme.

If you are worried about opioid use, you can contact PROMIS confidentially. You do not need to know exactly which treatment is right before asking for advice.