Opioid Use Disorders

To make an appointment, please call (212) 305-6001 or submit our online form.

Facts to Know:

  • Opioids are a class of drugs that include heroin and pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
  • Opioid overdoses have quadrupled in the past two decades, becoming the main driver of drug overdose deaths.
  • Opioid use disorders are treatable with a combination of medications and therapy.

What are opioid use disorders? 

An opioid use disorder is defined as a pattern of opioid use that leads to serious impairment or distress. Opioid use disorders range in severity from mild to moderate to severe. Using opioids can change the brain’s chemistry resulting in physical dependence. In these cases, reducing or stopping drug use may cause withdrawal symptoms. The experience or fear of withdrawal symptoms often leads to continued use.

Another result of continued abuse of opioids is that, over time, the body develops an increased tolerance for the drug. As tolerance leads to higher and higher doses, the risk of an overdose significantly increases. In addition, if one develops a tolerance for the drug before a period of abstinence, they may resume taking the high dosages of the drug that their body is no longer used to, resulting in overdose. This is why detoxification alone does not constitute adequate treatment and actually increases the risk of overdose.

Opioid use disorders are seen in people from all types of educational and socioeconomic backgrounds. It is important to remember that opioid use disorder is a disorder - it is not simply a weakness or moral failing. Opioid use disorders and other mental health problems such as depression, anxiety, or post-traumatic stress disorder often co-occur. When this is the case, it is important to get treatment for both.


Symptoms of an opioid use disorder vary from person to person. They include a cluster of symptoms indicating ongoing use of the substance despite significant opioid-related problems.

Impaired Control

  • Taking opioids in larger amounts or for longer than was intended
  • Wanting to cut down, stop using, or control opioid use but not managing to do so
  • Spending a lot of time getting, using, or recovering from use of opioids
  • Cravings or a strong desire or urge to use opioids

Social Impairment

  • Not managing responsibilities at work, home, or school because of opioid use
  • Continuing to use opioids, even when it causes problems in relationships
  • Giving up important social, occupational, or recreational activities because of opioid use

Risky Use 

  • Using opioids again and again, despite resulting dangerous
  • Continuing to use opioids, despite having a physical or psychological problem that could have been caused or made worse by the substance

Pharmacological Criteria

  • Needing more opioid to get the desired effect (tolerance)
  • Development of withdrawal symptoms, which are relieved by taking opioids


A diagnosis of an opioid use disorder is best made by a doctor or mental health professional, such as a therapist. In order to meet criteria for an opioid use disorder an individual would typically experience some of the symptoms noted above, and their use of the opioids would cause significant impairment or distress.



Psychotherapy is an evidence-based treatment for opioid use disorders. Medication for opioid use disorders is best used in combination with therapy. Our providers are trained in the latest therapy modalities, such as motivational enhancement and cognitive behavioral therapies.

Psychopharmacology (Medication Management)

Medications may be an essential component of treatment, allowing people with opioid use disorders to regain control of their health and their lives. Medications can be used to treat physical symptoms during withdrawal, support long-term recovery, and treat co-occurring conditions such as depression or anxiety. Here at ColumbiaDoctors, our psychiatrists combine a thorough evaluation of each individual’s problems with the latest research to design a customized treatment plan. 

How Can I Receive Treatment for Opioid Use Disorders at Columbia?

The Smithers Center is a specialized service offered by ColumbiaDoctors that provides treatment for those who are looking to change their substance use and have co-occurring mental health conditions. We believe treatment approaches must be tailored to address each person’s individual needs and goals. 

Search our providers for a therapist or psychiatrist with expertise in opioid use disorders.

To make an appointment, please call 212-305-6001 or submit our online form.