Recovery National Institute on Drug Abuse NIDA

It is possible that escalation to a therapeutic dose may need to be more rapid. Growing evidence suggests that methadone is as safe and effective as buprenorphine for patients who use fentanyl. In a 2020 naturalistic follow-up study, 53% of patients admitted to methadone treatment who tested positive for fentanyl at intake were still in treatment a year later, compared to 47% for patients who tested negative. An earlier study similarly found that 89% of patients who tested positive for fentanyl at methadone treatment intake and who remained in treatment at 6 months achieved abstinence.

Reported use of most drugs among adolescents remained low in 2024

Read more about risk and protective factors that impact whether people use drugs or develop substance use disorders. Temporary returns to use after periods of abstinence are part of many recovery journeys, and relying exclusively on abstinence as an outcome in previous clinical trials may have masked beneficial effects of treatment. To help address this research gap, investigators analyzed data from previous clinical trials to study the effects of transitioning to reduced drug use or abstinence on a broad range of health measures. Over the past two decades, the opioid crisis has accelerated the integration of addiction care in the U.S. with mainstream medicine.

Family Factors

Counselors may select from a menu of services that meet the specific medical, mental, social, occupational, family, and legal needs of their patients to help in their recovery. Research shows that when treating addictions to opioids (prescription pain relievers or drugs like heroin or fentanyl), medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling. Medications are also available to help treat addiction to alcohol and nicotine. Patients themselves reported significant benefits from increased take-home methadone and other COVID-19 protocols. Patients at one California OTP in a small qualitative study reported increased autonomy and treatment engagement.

Many people—especially young people—use drugs out of curiosity and because of social pressure. The age at which people start using drugs—and whether or not they continue—depends on many different individual and societal factors across a person’s life. Over the past several years, the increasing prevalence of fentanyl in the drug supply has created an unprecedented overdose death rate and other devastating consequences.

When a person suddenly stops taking their medication abruptly, they may experience withdrawal symptoms. However, these effects are milder than those produced by dependence on other opioid drugs and can be managed by slowly reducing the medication dose rather than stopping it abruptly. Importantly, evidence-based prevention strategies can help people avoid substance use and substance use disorders. For those who do develop substance use disorders, safe and effective treatment can help. Treatment with methadone or buprenorphine is recommended for pregnant women with opioid use disorder.

Priority Scientific Area 1: Understand Drugs, the Brain, and Behavior

The National Recovery Month webpage provides a host of resources that can be used to help promote the observance. For people with addictions to drugs like stimulants or cannabis, no medications are currently available to assist in treatment, so treatment consists of behavioral therapies. Treatment should be tailored to address each patient’s drug use patterns and drug-related medical, mental, and social problems.

NIDA plays a leading role in the National Institutes of Health HEAL (Helping to End Addiction Long-term®) Initiative, an effort to develop new scientific solutions to the national opioid addiction and overdose public health crisis and to improve pain management. Developing and testing new, safe, effective, and sustainable strategies to prevent substance use or misuse and their progression to substance use disorders or other negative health effects is a key research priority for NIDA. NIDA funds research to understand risk and protective factors, to reduce risk factors and bolster protective factors, and to translate this understanding into evidence-based strategies and determine how best to implement and scale these strategies. This strategic plan reflects NIDA’s commitment to advancing all aspects of addiction science – from basic to translational, clinical, and health services research – in the service of enhancing fundamental knowledge and improving people’s lives.

NIDA will continue to support cutting-edge research informed by people with lived experience across all facets of our scientific portfolio, while remaining nimble enough to take advantage of new scientific opportunities and address emerging public health needs. Buprenorphine treatment can also be started in the emergency department to ease withdrawal and cravings after an overdose.13  This can help motivate people to begin long-term treatment. Here I highlight important work being done at NIDA and other news related to the science of drug use and addiction. NIDA Director Dr. Nora Volkow explains why we study teen drug use and shares a message to parents & teen influencers. Watch artist and advocate William Stoehr’s intimate testimony, as he shares his story of loss to an opioid overdose and… Visual representations of Monitoring the Future data, opioid misuse and other topics.

Reduced drug use is a meaningful treatment outcome for people with stimulant use disorders

Some people use drugs to feel pleasurable, stimulating, or relaxing effects. Others who experience anxiety, stress, depression, or pain may use drugs to try to feel better. Some people use drugs to try to improve their focus in school or at work or their abilities in sports.

• Read more about how NIDA is advancing the science on effective prevention strategies.
• It remains the case that only a fraction of people who could benefit from medication treatment for OUD (MOUD) receive it, due to a combination of structural and attitudinal barriers.
• Department of Health and Human Services (HHS) advanced the most comprehensive Overdose Prevention Strategy to date.
• Research shows that when treating addictions to opioids (prescription pain relievers or drugs like heroin or fentanyl), medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling.
• A person is diagnosed with opioid use disorder if they have two or more of the symptoms and behaviors related to their opioid use listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer. Department of Health and Human Services (HHS) advanced the most comprehensive Overdose Prevention Strategy to date. Under this strategy, in 2023, HHS eliminated the X-waiver requirement for buprenorphine. But in the fentanyl era, expanded access to methadone too is essential, although there are even greater attitudinal and structural barriers to overcome with this medication. People in methadone treatment, who must regularly visit an opioid treatment program (OTP), face stigma from their community and from providers. People in rural areas may have difficulty accessing or sticking with methadone treatment if they live far from an OTP.

The authors note that the study did not include behavioral treatment trials, which were too varied to harmonize their data. In addition, the study featured only people who enrolled in clinical trials, which could limit generalizability. Additional research is needed to understand the potential clinical benefits of reduced drug use, along with other harm reduction-based indicators of clinical improvement in real-world populations. The authors also write that these new findings need to be replicated in other contexts with additional substance use disorders such as opioid use disorder. It is important to note that many risk and protective factors are not a result of choices an individual person makes, but rather are a facet of their inherited genetics, family, life circumstances, and other aspects of their biology and environment. Better understanding these factors is critical to developing prevention strategies that lessen the impact of risk factors and bolster or introduce new protective factors.

People with an opioid use disorder (OUD) urgently need treatment not just to protect them from overdosing but also to help them achieve recovery, but highly effective medications like buprenorphine and methadone remain underused. Amid this crisis, it is critical that methadone, in particular, be made more accessible, as it may hold unique clinical advantages in the age of fentanyl. Some people who use drugs go on to develop substance use disorders or experience other harms. However, evidence-based prevention strategies can help people avoid substance use, substance use disorders, and related health and safety problems.

NIDA uses multiple sources to monitor the prevalence and trends regarding drug use in the United States. The resources on this webpage cover a variety of drug-related issues, including information on drug use, emergency room data, prevention and treatment programs, and other research findings. When people enter treatment, addiction has often caused serious consequences in their lives, possibly disrupting their health and how they function in their family lives, at work, and in the community. Additionally, medications are used to help people detoxify from drugs, although detoxification is not the same as treatment and is not sufficient to help treatment and recovery national institute on drug abuse nida a person recover.

• For those who do develop substance use disorders, safe and effective treatment can help.
• Opioid use disorder is a complex, treatable chronic medical condition from which people can recover.
• Visual representations of Monitoring the Future data, opioid misuse and other topics.
• Critics of expanded access to methadone outside OTPs sometimes argue that the medication should not be offered without accompanying behavioral treatment.

Treatment for co-occurring disorders

Some studies have found elevated rates of overdose during the induction and stabilization phase of maintenance treatment, potentially due to starting at too high a dose, escalating too rapidly, or drug interactions. Locate the latest information about research priorities and progress, funding opportunities, research initiatives, and resources to support basic and clinical research addressing substance use disorders. There are many interrelated factors between chronic pain and substance use disorders.

NIDA-supported prevention research adapts to address evolving situations like the current drug overdose crisis; equitable access to health care; and social and structural influences on health. NIDA research also aims to promote and to capitalize on advances in basic and behavioral sciences, data science, and technology. NIDA plays a leading role in the National Institutes of Health HEAL (Helping to End Addiction Long-term®) Initiative, an effort to develop new scientific solutions to the overdose epidemic, including opioid and stimulant use disorders, and the crisis of chronic pain.