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Our Experience

Our experience with opioid use disorder (OUD) is that the prevalence of OUD has always been a significant problem in the US. Over the last 15 years, the use of fentanyl and more concentrated opiates has made it more of a public health care crisis as well. This is due to the overwhelming number of overdoses and the causing of untimely deaths in the younger population. 


Opioid use disorder, previously known as Opioid Abuse or Opioid Dependence, is a condition characterized by a problematic pattern of opioid use that leads to clinically significant impairment or distress. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines criteria for this condition, which include the following:

  • Taking opioids in larger amounts or over a longer period than intended

  • Having a persistent desire or unsuccessful attempts to reduce or control opioid use

  • Spending excess time obtaining, using, or recovering from opioids

  • Craving opioids

  • Continued opioid use causing an inability to fulfill work, home, or school responsibilities

  • Continuing opioid use despite persistent social or interpersonal problems

  • Lack of involvement in social, occupational, or recreational activities

  • Using opioids in physically hazardous situations

  • Continuing opioid use despite awareness of persistent physical or psychological problems


Additionally, exhibiting tolerance symptoms, which can be defined by either of the following:

  • A need for markedly increased amounts of opioids to achieve intoxication or desired effect

  • Markedly diminished effect with continued use of the same amount of an opioid


Withdrawal symptoms may also be exhibited, as manifested by either of the following:

  • The characteristic opioid withdrawal syndrome

  • Opioids (or a closely related substance) are taken to relieve or avoid withdrawal symptoms


Medication treatment plays a crucial role in addressing Opioid Use Disorder (OUD). Here are the FDA-approved medications for treating OUD:

When considering which medication to recommend, clinicians take into account factors such as patient preference, practical access to care, prior treatment experience, and individual risk-benefit assessments. Offering evidence-based medications is essential, especially for patients with moderate or severe OUD. For clinicians unable to provide treatment directly, arranging care through specialized providers or certified opioid treatment programs is crucial for effective management



  • Type: A partial mu-opioid receptor agonist.

  • Mechanism: It suppresses and reduces cravings for opioids.

  • Prescription: Clinicians with a current, standard DEA registration with Schedule III authority can prescribe buprenorphine in any clinical setting


  • Type: A full mu-opioid receptor agonist.

  • Mechanism: It reduces opioid cravings and withdrawal symptoms, and it can blunt or block the effects of opioids.

  • Prescription: Methadone can only be provided for OUD through a SAMHSA-certified opioid treatment program (OTP)


  • Type: An opioid receptor antagonist.

  • Mechanism: It blocks the euphoric and sedative effects of opioids, preventing feelings of euphoria.

  • Timing: Naltrexone should be started after a minimum of 7 to 10 days free of opioids to avoid precipitating severe opioid withdrawal.

  • Prescription: Any clinician with an active license to prescribe medications can prescribe naltrexone

Remember that individual patient factors, preferences, and risk assessments play a crucial role in determining the most suitable medication. Offering evidence-based treatments is essential for effective management of OUD .

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Psychology Today
Association of Intervention Specialists
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