If you are still having opioid cravings on MAT, contact your prescriber or treatment team promptly. Explain what has changed and when the cravings happen. Do not adjust or stop your medication on your own.
Cravings are a reason to review your care. They are not proof that you have failed. They do not mean treatment cannot help.
This guide uses MAT to mean medication treatment for opioid use disorder. It does not refer to an exercise mat. We are a treatment directory publisher, not a treatment provider. We do not claim medical review.
If an overdose may be happening, call 911 now. Give naloxone if you have it. Follow the dispatcher’s instructions. For suicidal thoughts, call or text 988. For immediate danger, call 911.
Cravings on MAT: Cravings on Medication for Opioid Use Disorder
Many people still have opioid cravings on medication. This is common. It does not mean your treatment has failed.
Medication for opioid use disorder (MOUD) helps manage the condition. The FDA has approved three medications for this: methadone, buprenorphine, and naltrexone.[1] Opioid use disorder is a treatable medical condition.[2]
If you have cravings, talk to your care team. They can help you figure out why this is happening. They can also adjust your plan if needed.
3
FDA-approved medications for opioid use disorder[1]
These numbers show general trends in large groups. They are not a prediction of your personal risk. If you worry about a slip, see our guide on managing a slip on buprenorphine for more help.
What to Do When Opioid Cravings Continue
If cravings are strong or getting harder to manage, do not wait for your next scheduled visit. Contact your prescriber, clinic, or treatment team right away. If you cannot reach them during business hours, follow the after-hours instructions provided by your clinic.
- 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 steps help you stay safe in the moment, but they do not replace clinical care. Your treatment team uses comprehensive assessments to guide your plan, including checking for other medical or psychiatric needs.[3] If you need to explore a different care setting, you can learn more about comparing opioid treatment programs.
What to Tell Your Treatment Team
You do not need a reason for your cravings. You just need to tell your doctor. ASAM says doctors should check on you often during treatment.[4] Your team expects you to call when things change.
Talking to a Prescriber About Opioid Cravings
Be honest and specific. 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.
Also, tell them about any alcohol or other drugs. Do not worry about being judged. This info helps keep you safe. It helps them plan your care.
Use this list to get ready for your chat. You can save it or print it out.
What to Share With My Treatment Team
Your ticks are saved on this device only.
Ask for a clear date to follow up if cravings stay. If you need a new doctor, read our guide on requesting medication-assisted treatment.
What Ongoing Cravings Can—and Can’t—Tell You
Cravings on medication for opioid use disorder are common. They do not mean your treatment is failing. They are useful information for your care team. Sharing them helps everyone understand what is happening.
| 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 |
Methadone and buprenorphine work on opioid receptors differently than naltrexone. Naltrexone blocks opioid effects.[2] Your prescriber can review which treatment fits you best. They will look at your history and goals.
Behavioral therapies support treatment alongside medication.[5] Cognitive behavioral therapy helps you spot situations linked to use. It teaches you coping responses.[6] These skills help you manage cravings. If you worry cravings may lead to use, read our guide on managing a slip on buprenorphine.
Coping With Opioid Cravings During Treatment
Cravings can feel very strong. They may rise and fall, but their duration and intensity vary. If they persist or worsen, contact your care team. While you wait to talk to them, try these steps:
- Call a trusted friend, family member, or peer.
- Move to a different room or go outside.
- Focus on what you see, hear, and feel right now.
- Do a short task, like a walk or a shower.
If you think you may use opioids, contact your treatment team or a trusted support person now for help.
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]
When Cravings or Opioid Use Become an Emergency
If you think someone is overdosing, call 911 now. Do not drive them to the hospital. Give naloxone if you have it. Follow the dispatcher's steps while you wait.[9]
Look for these signs of overdose:
- Slow or shallow breathing
- Pinpoint pupils
- Hard to wake up
- Very sleepy or confused
- Slurred speech
- Slow heartbeat or low blood pressure[11]
You can learn more about spotting these signs in our guide on recognizing opioid overdose signs. It is also wise to keep naloxone nearby. Check out our guide on accessing naloxone for safety to find where to get it.
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 symptoms need quick medical help. Go to the ER or call 911 if you have:
- Seizures
- High fever
- Severe confusion
- Hallucinations
- Irregular heartbeat[8]
Do not handle these at home.
Cravings alone are not an emergency. But if they keep coming back, talk to your care team. They can help adjust your plan. This is a key part of overdose prevention and response.
Follow-Up, Support, and Finding Care
Managing cravings on MAT is an ongoing process. Here is a simple path to keep you connected 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.
You have other options for support for opioid cravings. Counseling can help you build skills to handle urges. You might also try peer support services. These are led by people with lived experience of addiction.[12] They offer recovery support but are not a replacement for medical care. Always talk to your prescriber about medication changes.
Need help finding resources? The SAMHSA National Helpline offers free, confidential treatment referral information.[13] It is a no-cost way to connect with 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]
