Tell your prescriber or treatment team right away about ongoing opioid cravings on MAT. Share what changed and when the urges appear. Do not stop or change your medication without talking to them.
Cravings are a sign to look at your care. They are not proof you failed. They do not mean treatment cannot help.
MAT in this guide means medication treatment for opioid use disorder, not an exercise mat. We publish a treatment directory, not treatment services. We do not claim medical review.
If an overdose may be happening, call 911 now. Administer naloxone if you have it. Obey the dispatcher’s directions. For suicidal thoughts, call or text 988. For immediate danger, call 911.
Cravings on MAT: Managing Cravings During Opioid Use Disorder Care
Even on medication, many people still face opioid cravings. This is common. This does not show that your treatment has failed.
The FDA has approved three drugs for opioid use disorder (MOUD): methadone, buprenorphine, and naltrexone.[1] These help manage the condition. Opioid use disorder is a treatable medical condition.[2] If you are starting buprenorphine, our guide to buprenorphine side effects explains what to expect during treatment.
Share any cravings with your care team. They can look for the cause. They can also change your plan if needed.
3
FDA-approved medications for opioid use disorder[1]
General trends in large groups are what these numbers show. Your personal risk is not predicted by them. If you worry about a slip, see our guide on managing a slip on buprenorphine for more help.
Opioid Cravings That Go On: What to Do
Call your prescriber, clinic, or treatment team right away if cravings feel strong or hard to control. Do not wait for your next scheduled visit. If they are closed, follow the after-hours steps your clinic gave you.
- Pause and find support. Move to a place where you are safe and can access help.
- Contact your treatment team. Call or message them to say your cravings are continuing.
- Describe what you are feeling. Mention any new or worsening symptoms and ask when you should speak with your clinician.
- Do not change your medication. Only adjust doses or stop taking medication under the direction of your prescriber.
- Use a coping action while you wait. Reach out to a trusted person or peer support group. Try a simple grounding technique, such as changing your surroundings or taking slow breaths.
These actions help you stay safe now, but they are not a substitute for clinical care. Your treatment team guides your plan using full assessments, such as checking for other medical or psychiatric needs.[3] You can learn more about comparing opioid treatment programs if you want to try a different care setting.
Things to Share With Your Treatment Team
You have no duty to explain why you crave. Simply share this with your doctor. ASAM notes that doctors should check on patients often during treatment.[4] Your team wants you to call if anything shifts.
How to Discuss Opioid Cravings With a Prescriber
Speak clearly about your exact needs. You can say, “I’m still having cravings, and I’d like to review my treatment plan with you.” This tells your doctor what you need.
Tell them about any alcohol or other drug use as well. You do not have to worry about judgment. This info helps keep you safe. It also guides their care plans.
Get ready for your chat by using this list. Feel free to print it or save it.
What to Share With My Treatment Team
Your ticks are saved on this device only.
If cravings stick around, ask for a firm date to check back. If you want a new doctor, read our guide on requesting medication-assisted treatment.
Ongoing Cravings: What They May and May Not Indicate
Cravings on medication for opioid use disorder happen a lot. This does not mean your treatment is not working. Your care team uses these cravings as helpful clues. Telling them about your cravings helps the team understand your situation.
| What you notice | What it can help the team understand | What it does not prove |
|---|---|---|
| Cravings coming back | Which triggers are active now | That your dose is wrong |
| Cravings getting stronger | How your brain reacts to cues | That you need a new medication right away |
| Cravings at a certain time or place | Patterns in your routine to address | That the drug causes the craving |
| Cravings with withdrawal signs | If physical needs require adjustment | That you missed doses without checking |
Naltrexone functions by blocking opioid effects.[2] Its action on opioid receptors differs from that of methadone and buprenorphine. Your prescriber can evaluate which option works best for you. They will consider your background and objectives.
Medication works with behavioral therapies to back up your care.[5] Cognitive behavioral therapy helps you find the moments that push you toward use. It also teaches you new ways to react.[6] These skills help you deal with cravings. If you worry that cravings may lead to use, see our guide on managing a slip on buprenorphine.
Dealing With Opioid Cravings in Treatment
Cravings can feel intense. Their length and strength may shift up and down. If they persist or worsen, contact your care team. Try these steps while you wait to speak with them:
- Talk to a friend, family member, or peer you trust.
- Change rooms or head outdoors.
- Look at, listen to, and feel what is happening right now.
- Try a quick job, such as a shower or a walk.
Reach out to your treatment team or a support person you trust now if you feel you may use opioids.
What Support Do I Need Right Now?
This self-check is for information only and isn't a diagnosis. It does not determine if you are safe.
For suicidal thoughts, call or text 988.[7] For immediate danger, a suicide attempt, thoughts of self-harm, seizures, severe confusion, hallucinations, a high fever or racing heart during withdrawal, call 911 or go to the nearest emergency room now.[8] If you suspect an opioid overdose, call 911 immediately and administer naloxone if available.[9] Naloxone can reverse an opioid overdose.[10]
Emergency Signs of Cravings or Opioid Use
Do not drive them to the hospital.If you think someone is overdosing, call 911 now. Give naloxone if you have it. Follow the dispatcher's steps while you wait.[9]
Look for these signs of overdose:
- Breathing that is weak or slow
- Tiny pupil size
- Cannot rouse them
- Heavy drowsiness or mixed-up thoughts
- Unclear or mumbled words
- A slow pulse or a drop in blood pressure[11]
Our guide on recognizing opioid overdose signs explains how to spot these signs. Also, it is wise to keep naloxone close by. Find out where to get it in our guide on accessing naloxone for safety.
If you have thoughts of suicide or self-harm, call or text 988. The 988 Suicide & Crisis Lifeline is free and open 24/7.[7] If you are in danger, call 911 or go to the ER.
Some withdrawal signs need fast medical care. Go to the ER or call 911 if you have:
- Seizures
- High fever
- Severe confusion
- Hallucinations
- Heartbeat that is not regular[8]
Do not handle these at home.
Cravings by themselves are not an emergency. But if they return again and again, talk to your care team. They can help tweak your plan. This is a key part of overdose prevention and response.
Staying in Care and Finding Help
Working on cravings on MAT is a steady job. Follow this simple path to stay tied to care:
Now
Contact your treatment team. Tell them what is happening. Share if cravings are continuing or returning.
During the clinical review
Talk with your clinician. Discuss your symptoms and safety. Mention any barriers you face.
After the conversation
Follow the plan you agreed on. This may include check-ins or new coping skills.
If cravings continue or worsen
Call the team again. Or seek another clinical check-up. Do not wait if things feel unsafe.
Other support options exist for opioid cravings. Counseling can help you build skills to handle urges. You might also try peer support services. People with lived experience of addiction lead these groups.[12] They give recovery support but do not replace medical care. Always discuss any medication changes with your prescriber.
Looking for help to find resources? The SAMHSA National Helpline gives free, private treatment referral details.[13] You can use it at no cost to reach local services.
Frequently Asked Questions
Does having cravings mean my medication is not working?
Not by itself. Cravings are a common part of recovery and do not mean you are failing. Describe the cravings and any other changes to your prescriber so the team can review your experience and care plan. This guide cannot determine the specific cause of your symptoms.
Should I take extra medication when cravings hit?
Do not take more medication or change how you use it unless your prescriber directs you to do so. Contact your treatment team and explain that cravings are continuing. They can help you adjust your plan safely.
What should I do if I used opioids while receiving treatment?
Tell your treatment team as soon as you can. This information helps them discuss safety and follow-up without judgment. After a period without opioid use, reduced tolerance can increase overdose risk if opioid use resumes.[14] If an overdose may be happening, call 911, give naloxone if available, and follow the dispatcher’s instructions.
Can counseling help when cravings persist?
Ask your care team whether counseling or another support would fit your needs alongside medication treatment. Counseling can address triggers and stressors that drive cravings. Do not delay or give up medication treatment because counseling is unavailable.
How can a loved one help with overdose safety?
Ask what support the person wants and help them contact their treatment team. Learn how to recognize an overdose and respond. Consider keeping naloxone available, as the FDA approved naloxone nasal spray for over-the-counter, nonprescription use in the United States.[15] Learn its use from the product instructions or a qualified source. Note that mixing buprenorphine with benzodiazepines or other CNS depressants can cause life-threatening respiratory depression.[16]
