However, the use of CBT alone in opioid dependence has declined due to the lack of efficacy, and many are relying on medication therapy or medication therapy with CBT, since both were found to be more efficacious than CBT alone. A form of CBT therapy known as motivational interviewing (MI) is often used opioid use disorder. MI leverages a person intrinsic motivation to recover through education, formulation of relapse prevention strategies, reward for adherence to treatment guidelines, and positive thinking to keep motivation high—which are based on a persons socioeconomic status, gender, race, ethnicity, sexual orientation, and their readiness to recover. Twelve-step programs
While medical treatment may help with the initial symptoms of opioid withdrawal, once the first stages of withdrawal are through, a method for long-term preventative care is attendance at 12-step groups such as Narcotics Anonymous. Narcotics Anonymous is a global service that provides multilingual recovery information and public meetings free of charge. Some evidence supports the use of these programs in adolescents as well.The 12-step program is an adapted form of the Alcoholics Anonymous program. The program strives to help create behavioural change by fostering peer-support and self-help programs. The model helps assert the gravity of addiction by enforcing the idea that addicts must surrender to the fact that they are addicted and be able to recognize the problem. It also helps maintain self-control and restraint to help promote ones capabilities.
Signs and symptoms
Signs and symptoms include:
Drug seeking behavior
Increased use over time
Legal or social ramifications secondary to drug use
Multiple prescriptions from different providers
Multiple medical complications from drug use (HIV/AIDS, hospitalizations, abscesses)
Opioid cravings
Withdrawal symptomsAddiction and dependence are components of a substance use disorder and addiction represents the more severe form. Opioid dependence can occur as physical dependence, psychological dependence, or both. Withdrawal
Opioid withdrawal can occur with a sudden decrease in, or the cessation of, opioids after prolonged use. Onset of withdrawal depends on which opioid was used last. With heroin this typically occurs five hours after use, while with methadone it might not occur until two days later. The length of time that major symptoms occur also depends on the opioid used. For heroin withdrawal, symptoms are typically greatest at two to four days, and can last for up to two weeks. Less significant symptoms may remain for an even longer period, in which case the withdrawal is known as post-acute-withdrawal syndrome. Treatment of withdrawal may include methadone and buprenorphine. Medications for nausea or diarrhea may also be used. Opioid intoxication
Signs and symptoms of opioid intoxication include:

Opioid overdose
Signs and symptoms of opioid overdose include, but are not limited to:
Pin-point pupils may occur. Patient presenting with dilated pupils may still be experiencing an opioid overdose. Decreased heart rate
Decreased body temperature
Decreased breathing
Altered level of consciousness. People may be unresponsive or unconscious. Pulmonary edema (fluid accumulation in the lungs)
Shock
Death

Cause
Opioid use disorder can develop as a result of self-medication.