Key takeaways:
Medications and therapy are both good options for substance use disorders.
For some people, therapy or medication may work well alone. But for other people, a combination of medications and therapy (called medication-assisted treatment, or MAT) might be the best choice.
The right treatment for you depends on your specific needs and personal goals.
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Substance use disorders affect more than 1 in 6 teenagers and adults in the U.S. If you — or a friend or family member — are dealing with addiction, you may be wondering what treatment is best. After all, getting treatment for a substance use disorder can take time and money. It’s normal to wonder whether or not it’s worth it.
Fortunately, when it comes to substance use disorders, there’s good evidence that treatment works. Your options include medications, therapy, or a combination of both.
Treatment isn’t one size fits all though. The best treatment for you will depend on your substance use, your mental and physical health, and your personal goals for recovery. Let’s take a closer look.
How does addiction treatment work?
A substance use disorder (addiction) is when you keep using drugs or alcohol, even though it’s causing problems in your life. Treatment can help you stop this cycle and recover from substance use problems. It can also help you learn to manage cravings and prevent relapses.
But, in truth, the type of treatment you need depends on many factors. This might include your unique symptoms, your substance use, and your personal goals. After all, even though two people might seem to have similar issues, under the surface things often look very different.
Generally, treatment starts with a thorough evaluation. This typically means talking to a healthcare professional about your substance use. The goal of this evaluation is to figure out which areas of your life need attention and to put together a treatment plan.
Substance use disorder treatment usually includes medication, therapy, or a combination of both. Treatment locations vary widely. They include:
Hospitals
Clinics
Community centers
Residential facilities
Can therapy help with addiction?
Yes. Therapy is a common treatment for substance use disorders. And there’s good evidence that therapy works well for many people too.
What causes substance use disorders? Read about who has a higher risk for substance use disorders and why.
Living with addiction: Motivational speaker Sam Anthony Lucania shares his journey.
Dependence versus addiction: Learn the difference between physical dependence and psychological addiction, and how they both play a role in substance use.
If you have a substance use disorder, therapy may be able to help you:
Discover issues that trigger and fuel your addiction
Understand your thoughts, feelings, and behaviors
Build new coping skills
Create a plan for managing cravings and preventing relapses
Cut down on substance use, or stop using completely
Improve your relationships at work, school, or home
What types of therapy are used for addiction treatment?
Therapists may use different techniques to help you manage your symptoms. Some of the best therapies for treating substance use disorders are:
Some therapists will choose only one of these approaches, while others will combine these and other treatments into one plan. As always, not all therapies will work well for all people.
In therapy, you’ll speak with a professional therapist in an individual, group, or family setting. Your therapist can act as a teacher, an advocate, and a support person who helps to understand your situation. Therapy can sometimes be challenging and uncomfortable, but great change can come from the process.
You can learn more about some of your options for substance use disorder therapy (as well as details about support groups like 12-step programs).
Can medications help with addiction?
Yes. Medications can also be used to treat substance use disorders — either on their own or combined with therapy or counseling. When medications are combined with therapy, it’s called medication-assisted treatment (MAT).
Depending on your substance use, medications may be able to help you:
Stop using substances
Reduce cravings
Manage withdrawal symptoms
Maintain sobriety and prevent relapse
MAT is also linked to positive outcomes for alcohol and opioid use disorders, including:
Longer lifespan
Higher likelihood of staying in treatment
Decreased criminal activity
Increased ability to get and keep a job
Better pregnancy outcomes
Better physical and mental health
What medications are available to treat substance use disorders?
So far, FDA-approved medications are available to treat the following substance use disorders:
Tobacco use disorder: Options include nicotine replacement therapy, bupropion SR (Zyban), and varenicline.
Alcohol use disorder: Medications for alcohol use disorder include acamprosate, disulfiram, and naltrexone.
Opioid use disorder: Medications for opioid use disorder include buprenorphine, methadone, and naltrexone.
Other medications are sometimes used off-label for substance use disorders too.
How can other medications help for addiction and recovery?
Many people with substance use issues also have other mental health conditions. Sometimes, alcohol and other drugs may be a way to self-medicate an existing problem. Other times, using drugs and alcohol can create new mental health challenges.
If you’re experiencing mental health problems, medications may be able to help. And taking care of your mental health can be another great way to support your recovery.
Options include:
Antidepressants: These medications work by interacting with chemicals like serotonin in the brain.
Anti-anxiety medications: If you have high anxiety, panic attacks, or extreme worries, anti-anxiety medications can help.
Mood stabilizers: These are used to treat depression, bipolar disorder, and other conditions. Examples of mood stabilizers are lithium and valproic acid (Depakote).
Antipsychotics: Despite the name, antipsychotic medications can help with many different conditions, including anxiety and post-traumatic stress disorder (PTSD).
Therapy vs. medication: Which is best?
Medication or therapy — which works better? It depends. For some people, medication is the way to go. This may especially be true for nicotine use disorder and opioid use disorder. Other times, therapy is the best option. It all depends on your unique situation.
One idea is to start with a trial of therapy to see if counseling alone can improve your condition. From there, you could meet with a prescriber — like a psychiatrist or nurse practitioner — to see if you’d be a good candidate for medication.
Keep in mind that addiction is a chronic condition that sometimes involves periods of relapse. No matter the tools you use, stick to your treatment plan and work with your treatment team to plan the next steps in your care.
Frequently asked questions
There are many ways to support someone with a substance use disorder. No matter what you do, staying involved can make a huge difference — and can help them succeed with treatment.
Read more about how to support a loved one in recovery.
It’s hard to say. Therapy, 12-step programs, and MAT are all common approaches in the U.S. But substance use disorder treatment varies from person to person. And, unfortunately, most people with substance use disorders don’t get treatment at all.
There are many ways to support someone with a substance use disorder. No matter what you do, staying involved can make a huge difference — and can help them succeed with treatment.
Read more about how to support a loved one in recovery.
It’s hard to say. Therapy, 12-step programs, and MAT are all common approaches in the U.S. But substance use disorder treatment varies from person to person. And, unfortunately, most people with substance use disorders don’t get treatment at all.
The bottom line
Though substance use disorders are common, many good treatments are available. Depending on your unique needs, these could include medications, therapy, or a combination of both. For some types of substance use disorders — like opioid use disorder and tobacco use disorder — medications may be especially helpful.
If you’re struggling with substance use, reach out to your primary care provider, psychiatrist, or another healthcare professional. They can help you define your goals for treatment and figure out which treatments are the best options for you as an individual.
Why trust our experts?
References
American Cancer Society. (2024). Nicotine replacement therapy to help you quit tobacco.
Centers for Disease Control and Prevention. (2024). Treatment of opioid use disorder before, during, and after pregnancy.
Coffa, D., et al. (2019). Opioid use disorder: Medical treatment options. American Family Physician.
Jhanjee, S. (2014). Evidence based psychosocial interventions in substance use. Indian Journal of Psychological Medicine.
National Institute on Drug Abuse. (2018). How effective are medications to treat opioid use disorder? National Institute of Health.
National Institute of Health. (2023). Mental health medications.
National Institute of Mental Health. (2024). Psychotherapies. National Institute of Health.
Substance Abuse and Mental Health Services Administration. (2024). Highlights for the 2022 National Survey on Drug Use and Health. U.S. Department of Health and Human Services.
Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. U.S. Department of Health and Human Services.
Substance Abuse and Mental Health Services Administration. (2024). Substance use disorder treatment options. U.S. Department of Health and Human Services.
