Opioid treatment in Colorado

The terms “opiate” and “opioid” are often used as if they mean the same thing, but there is a key distinction. Opiates refer specifically to naturally occurring substances derived from the opium poppy, such as morphine, codeine, and heroin. Opioids is the broader category, which includes both natural opiates and synthetic or semi-synthetic drugs made in a laboratory.

This means all opiates are opioids, but not all opioids are opiates. For example, fentanyl is a fully synthetic opioid and does not come directly from the poppy plant. Many prescription pain medications, sometimes called opioid analgesics, may be natural, semi-synthetic, or synthetic, but all fall under the opioid classification.

For many people entering opioid addiction treatment, the first step is medical detox. Detox provides a safe, structured environment where withdrawal from opioids can be managed under professional supervision. This process is especially important for those who have been using opioids for a long period, whether from prescription drugs or illicit sources.

A detox program typically includes three phases: evaluation, stabilization, and transition to ongoing care. During the evaluation, the care team reviews the person’s substance use history, current health status, mental health needs, and any co-occurring conditions. This information helps the clinical staff develop a detox plan that is both safe and effective.

In the stabilization phase, withdrawal symptoms are closely monitored and treated as needed. Symptoms can range from muscle aches and nausea to severe anxiety and insomnia. In some cases, medication assisted treatment (MAT)—including buprenorphine treatment or methadone treatment—is introduced during detox to reduce cravings and ease discomfort. Medication assisted treatment (MAT) uses FDA-approved medications in combination with counseling, behavioral health services and additional resources to support stability and prepare the person for the next stage of treatment. Treatment centers may also offer harm reduction services, provider training, and additional resources for different patient populations, including pregnant women and community members at risk of opioid overdose.

Medical detox and medication assisted treatment (MAT) are not standalone solutions for opioid addiction. The goal is to help patients safely complete withdrawal and then transition into a comprehensive substance use program that may include therapies, individual counseling, group sessions, family involvement and additional resources. Successful detox is often followed by treatment in a treatment center, either in an inpatient or outpatient setting, where the focus shifts to long-term recovery and relapse prevention.

Addiction medicine: medication-assisted treatment

Medication-assisted treatment (MAT) is widely recognized as one of the most effective strategies for treating opioid addiction. MAT combines medications with counseling and behavioral health services, allowing treatment providers to address both the physical dependence and the psychological factors that keep substance use disorders going.

MAT can be introduced during medical detox to ease the discomfort of withdrawal or used as part of a long-term maintenance plan. In both cases, it is typically paired with therapies such as cognitive behavioral therapy (CBT), motivational interviewing, or contingency management. These approaches help patients learn how to manage triggers, build coping skills, and maintain progress through each stage of their recovery journey.

Medications commonly used in MAT include:

• Buprenorphine. Reduces withdrawal symptoms and cravings while blocking the effects of other opioids.
• Methadone. Decreases cravings, eases withdrawal, and helps stabilize brain chemistry for those who are physically dependent.
• Naltrexone. Blocks the euphoric effects of opioids and may help reduce cravings over time.

MAT is not a one-size-fits-all approach. The choice of medication, dosage, and length of treatment depends on the patient’s health history, treatment goals, and response to therapy. For some, MAT is a short-term bridge through detox. For others, it remains an important part of ongoing care within an opioid treatment program.

Expanding access to MAT is a public health priority in Colorado. Programs supported by the Colorado Department of Public Health and Environment, and other community partnerships aim to reduce overdose deaths and connect patients to comprehensive addiction care. These efforts often include provider education, pilot programs to reach rural treatment locations, and training for nurse practitioners and physician assistants to prescribe buprenorphine in office-based opioid treatment settings.

MAT can also be a safe and effective option for opioid dependent pregnant women when managed by experienced clinicians. In these cases, it supports maternal health while reducing the risks associated with untreated opioid addiction and protecting the health of the developing baby.

Behavioral health and mental health services are essential parts of any effective opioid addiction treatment plan. While medication-assisted treatment (MAT) can help manage withdrawal and cravings, therapy addresses the underlying behaviors, thought patterns, and life circumstances that contribute to substance use disorders.

Therapies can take place in individual, group, or family settings. Individual counseling gives patients a private space to work one-on-one with a treatment provider on personal challenges, triggers, and coping strategies. Group therapy brings people with shared experiences together to build peer support, share progress, and learn from each other’s recovery journeys. Family therapy can help repair relationships, improve communication, and engage loved ones in the recovery process.

Common approaches used in opioid addiction treatment include:

• Cognitive behavioral therapy (CBT). Helps patients identify and change unhelpful thinking patterns and behaviors.
• Motivational interviewing (MI). Encourages commitment to positive change by exploring personal goals and motivations.
• Contingency management (CM). Uses structured rewards to reinforce healthy behaviors, such as attending appointments or maintaining sobriety.

Behavioral health services often work hand-in-hand with mental health services for patients with co-occurring conditions like depression, anxiety, or post-traumatic stress disorder. Addressing both mental health needs and substance use at the same time can improve treatment outcomes and lower the risk of relapse.

Colorado treatment services frequently integrate counseling into every stage of care, from inpatient and residential programs to outpatient and office-based opioid treatment settings. This ensures patients have consistent support, access to additional resources, and the opportunity to build lasting skills for recovery.

Residential and inpatient programs provide 24-hour care in a structured environment. This setting is designed for people who need intensive support, a break from daily triggers, or help managing severe withdrawal and cravings.

During inpatient care, patients live at the treatment center and follow a daily schedule that can include individual counseling, group therapy, education on addiction, relapse prevention training, and support for co-occurring mental health conditions. The goal is to create a safe, stable space where recovery can become the main focus.

This level of care is often recommended after medical detox or for individuals with a history of relapse, unstable living situations, or significant physical or mental health concerns.

Outpatient treatment offers structured support for recovery while allowing people to live at home and maintain work, school, or family responsibilities. Services are provided through scheduled appointments at a treatment center, clinic, or other outpatient facility. While the focus remains on evidence-based therapies and peer support, the level of time commitment can vary depending on individual needs.

Partial hospitalization program (PHP)

Often called “day treatment,” PHP is the most intensive form of outpatient care. It typically involves about five days of treatment each week, totaling 20 hours or more. The schedule often includes individual and group therapy, education about substance use, and relapse prevention skills. At the end of each day, participants return home or to a sober living environment.

Intensive outpatient program (IOP)

IOP provides a step down from PHP with fewer required hours while still offering consistent structure and support. Most IOP schedules include three to five days of programming per week, adding up to at least nine hours. Sessions focus on therapy, coping skills, and maintaining progress in recovery while balancing work, school, or family commitments.

Standard outpatient program (OP)

Standard outpatient care is the least intensive option, typically meeting once or twice a week. It can be a good choice for people with a stable support system and lower risk of relapse, or as a follow-up to more intensive treatment. This level of care focuses on continued counseling, recovery check-ins, and strategies for maintaining sobriety long term.