Opioid Use Disorder: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Opioid Use Disorder?
An addiction medicine doctor, who treats drug use problems, or a psychiatrist, who treats mental health, often treats opioid use disorder. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is opioid use disorder?
Opioids are a type of drug. The illegal drug heroin is also an opioid. Many people call opioid use disorder opioid addiction.
Opioid use disorder, or OUD, means a harmful pattern of using opioids. It causes a lot of distress. It gets in the way of daily life. It is a long-lasting medical condition. It can be treated.
Some people also say opioid dependence instead of OUD. In 2023, about 5.7 million people in the U.S. had opioid use disorder.
Symptoms
Doctors look for a pattern of problems linked to opioid use. Signs can include:
- Using more of the drug, or using it for longer, than you meant to.
- Wanting again and again to cut down or control your use.
- A strong desire to use the drug, called craving.
- Not meeting duties at work, school, or home because of drug use.
- Tolerance, which means needing a bigger dose or using the drug more often to get the same effect.
- Withdrawal symptoms when you stop using the drug.
Withdrawal can cause muscle aches, stomach cramps, anxiety, nausea, vomiting, chills, and diarrhea.
Causes and who gets it
Repeated use can change the brain. This pushes a person to keep using opioids, even when they cause harm.
Like illegal opioids, prescription opioids can be addictive, especially if they are misused. The risk of OUD is higher if you misuse the medicines.
Fentanyl is often added to illegal drugs and fake pills.
How doctors diagnose it
Doctors use a reference book called the DSM-5 to diagnose substance use disorders. A person has opioid use disorder if they have two or more symptoms and behaviors related to opioid use.
Treatment
Treatment options include medicines and behavioral therapy. Medicines are often combined with counseling. Medications are the standard of care for opioid use disorder.
These medicines can help you stop using the drug, get through withdrawal, and cope with cravings. The U.S. Food and Drug Administration has approved methadone, buprenorphine, and naltrexone. People who take methadone or buprenorphine are less likely to die or overdose than people who get no treatment.
- Methadone: In the United States, it is only available from approved opioid treatment programs. People usually go to the program every day or almost every day to get it.
- Buprenorphine: Many doctors, nurse practitioners, and physician assistants can prescribe it. There is no need to visit special treatment clinics.
- Naltrexone: It blocks opioid receptors, so opioid drugs can no longer cause feelings of pleasure. It comes as a long-acting injection given once a month.
Naltrexone is usually started after a person has fully stopped using other opioids. If not, it may cause withdrawal symptoms. Methadone and buprenorphine can be misused for a high. This can happen if they are injected instead of taken by mouth as prescribed. Stopping methadone or buprenorphine suddenly can cause withdrawal symptoms. Slowly lowering the dose can help. Behavioral therapy works best along with medicine.
Naloxone is a medicine that treats an opioid overdose. It can reverse the overdose and prevent death if it is given quickly.
When to see a doctor
Call 911 if you think someone is having an opioid overdose. Signs of an overdose include:
- Passing out or not being able to wake up.
- Slow, shallow, or hard breathing.
- Purplish skin, especially on the nails or lips.
- Small, pinpoint pupils that do not react to light.
Anyone can give naloxone to a person who may be overdosing. Naloxone is available over the counter, without a prescription. Call or text 988 right away if you are thinking about harming yourself. If you take prescription opioids, follow your doctor's instructions and contact your doctor if you have any concerns about taking the medicines.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can do an evaluation, follow your care over time, and help coordinate care with specialists and treatment programs.
Common questions
Can opioid use disorder be treated?
Yes, it is a treatable medical condition, and people can recover.
What medicines treat opioid use disorder?
Methadone, buprenorphine, and naltrexone are medicines approved by the U.S. Food and Drug Administration. Medications are the standard of care for opioid use disorder.
Can naloxone be bought without a prescription?
Yes. Naloxone is available over the counter, without a prescription. It can reverse the overdose and prevent death if it is given quickly.
Are medicines for opioid use disorder just trading one drug for another?
No. Taken as prescribed, methadone and buprenorphine ease cravings and withdrawal without the intense high that other opioids cause. Naltrexone is not addictive.
Are treatment medicines safe during pregnancy?
Yes. These medicines are safe and effective during pregnancy and breastfeeding. Methadone or buprenorphine is recommended for pregnant women with the disorder.
Sources
- MedlinePlus - Opioids and Opioid Use Disorder (OUD)
- National Institute on Drug Abuse - Opioids
- National Institute on Drug Abuse - Medications for Opioid Use Disorder
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
