Choosing a therapist or counselor for opioid use disorder

Opioid use disorder (OUD) is a medical condition characterized by a chronic use of opioid drugs, including prescription opioid medications and/or illegal drugs. People with OUD experience an intense physical and psychological need to take opioids, often developing tolerance over time and experiencing withdrawal symptoms when they reduce or stop opioid use. This leads to significant distress and harm to many aspects of a person’s life—relationships, employment, finances, physical health, and mental health are all impacted by OUD.

In the United States, OUD affects several million people, has been declared a public health crisis since 2017, and has resulted in hundreds of thousands of deaths.

OUD is treatable. While barriers to treatment persist, there are effective treatments available, and treatment options have improved over the past decade. Treatment can help people avoid death from overdose, maintain recovery, and return to functioning in the areas of their life that have been affected by OUD.

How is OUD treated?

Treatment for OUD can vary from person to person, and should take into account an individual’s needs and experiences. Medications have become a mainstay of treatment, and research strongly supports a combination of medications used along with counseling and behavior therapy.

This can include working with an addiction counselor, a psychiatrist, psychologist, or other type of licensed mental health professional. The type of mental health professional a person works with will involve several considerations:

• The providers they have access to. For example, opioid treatment programs, outpatient programs, residential programs, or primary care providers. Also, what services are covered by insurance.
• The type of therapy they are seeking. For example, cognitive behavioral therapy, trauma-informed therapy, family counseling, and group therapy.
• If they are treating a co-occurring mental health disorder. Mental health disorders like depression, anxiety, or post-traumatic stress disorder often occur alongside OUD. The need for treatment for a mental health disorder can also influence the type of healthcare provider a person works with.
• If they are treating with medications. If a person is treating OUD with medications, they will want to work with a provider who is also licensed to prescribe medications for opioid use disorder (MOUD).

How can you find a mental health professional?

There are a number of ways to go about finding a counselor or therapist:

• Recommendations from a healthcare provider you are already working with or have worked with in the past.
• State and county websites, which often list substance abuse treatment services.
• Employee assistance programs, which may offer counseling or referrals.
• Counseling services available through a school or university.
• For people with health insurance coverage, an insurance provider’s website should have a listing of services.
• An internet search for "find addiction treatment" can also provide suggestions.
• The website for the Substance Abuse and Mental Health Services Administration (SAMHSA) also provides information.

Choosing a treatment provider

Once you have a treatment provider in mind or a list of potential providers, there are a few things you will want to consider:

• What type of therapy do they offer?
• What type of training, education, and years of experience do they have? Are they licensed to practice therapy?
• Do they have experience treating people with similar challenges to your own? For example, do they have experience treating people your age, or people with similar backgrounds?
• What type of treatment do they recommend for you? Does this treatment plan make sense?
• How did you feel after talking to the therapist?
• What is the cost and do they accept your insurance?
• What are the goals of therapy, what is the timeframe for those goals, and how will progress be measured?

One of the most important things to consider is how you and a potential counselor or therapist get along. In order for therapy to work, you must be honest with your healthcare provider and be confident that they will be able to help you. If you don’t feel that you are making progress, you want to feel comfortable enough to bring up your concerns.

Remember, finding the right treatment provider might take some work, and you might speak with a few different providers before you find the one that is right for you.