Opioid Use Disorder
Whether it started with a prescription after surgery, or with something you bought from someone you trusted, or somewhere in between — the path here is rarely the one anyone planned. The way out usually involves both medical care and somewhere safe to talk about the rest of it. We do the second part.
Opioid Use Disorder (OUD) covers prescription painkillers (oxycodone, hydrocodone, codeine), heroin, and fentanyl exposure. The Los Angeles fentanyl picture has changed dramatically over the past five years — many clients we see did not knowingly start with fentanyl. We work alongside addiction-medicine providers who can prescribe medication-assisted treatment (buprenorphine, naltrexone) when appropriate, and we provide the therapy half of the picture.
What this can feel like
- You started after a real injury or a real surgery, and somewhere along the line "for the pain" stopped being the whole truth.
- The first thing you check in the morning is whether you have enough for the day.
- You've hidden withdrawal — sweat, restless legs, GI symptoms — at work, around family, on dates, for longer than you'd like to admit.
- You've Narcan'ed someone you love, or someone has Narcan'ed you, and the conversation afterward never quite happened.
- You've tried to taper alone and it didn't hold.
- You're scared of fentanyl in particular, but the fear hasn't been enough on its own to stop.
How therapy can help
Modern OUD treatment is most effective when medication-assisted treatment (MAT) and behavioral therapy work together. We coordinate with addiction-medicine prescribers in the LA metro for medication, and we provide the therapy: Cognitive Behavioral Therapy for cravings and trigger work, Motivational Interviewing for ambivalence, and trauma-informed therapy when there's a history of pain, injury, or events that drove use in the first place.
Group therapy is particularly powerful here. The shame around opioid use is heavy and specific — different from drinking, different from cannabis. Sitting in a room with other people who have lived this version of it, who don't moralize and don't perform shock, undoes a lot of work the shame has been doing.
If detox is the right next step, we refer to a trusted residential or medical detox partner first, then meet you on the other side. Our IOP is often the right level of care for the first 6–12 weeks post-detox.
You don't have to figure this out alone
This is one of the diagnoses we most often see people delay reaching out for. Don't. Call when you can — even a short conversation with our coordinator helps map what comes next.