Aftercare and staying well after treatment

For most people on buprenorphine, methadone or naltrexone, staying on it is the most protective thing they can do. SAMHSA describes these medicines as safe for long-term use, from months to a lifetime.

Feeling well is a sign the medicine is working. It is not a signal to stop. Stopping too early raises the risk of relapse and overdose, because your tolerance to opioids is lower than it was.

If you want to come off at some point, raise it with your prescriber and plan it together. Do not stop on your own or because someone tells you that you are not “really” in recovery. Our medication treatment guide explains how long people usually stay on each one.

Some practical habits help: refill before you run out, tell your prescriber if you move or change insurance, and ask early if cost becomes a problem.

Regular check-ins

Visits with your prescriber or counselor space out over time, but keep them. They catch problems while they are small: a dose that no longer holds, poor sleep, a low mood, a stressful change at work or home.

Withdrawal can leave weeks or months of flat mood, tiredness and broken sleep. It has a name, and it passes. See post-acute withdrawal.

Peer recovery support

Peer support workers are people in recovery who are trained to help others. They can check in between appointments, help with practical problems and introduce you to a recovery community. Mutual-help groups do something similar, for free and for as long as you like. Our counseling page explains both.

Recovery tends to hold better when it includes ordinary things: steady sleep, work or study, people who are glad to see you, something to do on a Saturday night.

If going home means going back to a house where people use, recovery housing is worth a look. SAMHSA describes recovery houses as safe, healthy, substance-free places to live that are built around peer support and connection to services.

Residents usually pay rent, share chores and agree to house rules. Some houses are certified by a state body. Others are not, so quality varies.

Before you move in, ask:

• Do you accept residents who take buprenorphine or methadone? SAMHSA’s best practices say recovery housing should support people on prescribed medication.
• Is the house certified or licensed, and by whom?
• What is the rent, what does it cover, and what happens if I relapse?
• Is naloxone kept in the house?

A counselor, peer worker or your state substance use agency can point you to houses near you.

Returning to use is common. The National Institute on Drug Abuse describes it as often part of the recovery process, and as a sign to resume or adjust treatment. It does not mean treatment failed or that you did.

With opioids, a slip is also dangerous, because your tolerance has dropped. So make the plan now, while you feel steady:

• Write down your warning signs, such as skipping appointments, isolating yourself or contacting old sources.
• Pick two people you will tell, and tell them now that they are on the list.
• Keep your prescriber’s number in your phone. Call them the same day if you use. They will not be shocked.
• If you do use, do not use alone, and have naloxone within reach.

Our page on relapse explains what to do in the first hours and days. If treatment needs to step back up, you can find treatment in your state.

Naloxone is a medicine that reverses an opioid overdose. It comes as a nasal spray that anyone can use. The FDA approved it for sale without a prescription in 2023, and many pharmacies and health departments carry it. Some give it out for free.

The FDA recommends that people prescribed medicines for opioid use disorder carry naloxone. Keep it where others can find it, and show the people you live with how it works.

Naloxone wears off, so always call 911 after giving it and stay with the person. Our naloxone guide has the steps.

Call 911 if someone is not breathing or cannot be woken. For a crisis or thoughts of suicide, call or text 988. The SAMHSA National Helpline, 1-800-662-4357, is free and open 24 hours a day.