Non-Medication Treatment Options

Evidence-Based Treatment Options (Without Medication) for Substance Use Disorders

While medications such as buprenorphine and methadone are considered the “gold standard” (highly effective) for treating people with opioid use disorder (OUD), some individuals prefer or need non-medication approaches. Evidence shows that behavioral therapies, structured programs, and recovery supports can play an important role in both treatment and recovery.

In California, treatment programs follow national standards from the American Society of Addiction Medicine and are overseen by the California Department of Health Care Services.

    What Are Non-Medication Treatment Options?

    Non-medication approaches focus on changing behaviors, building coping skills, and improving overall well-being. These services are often provided in outpatient clinics, intensive programs, or residential settings.

    Behavioral Therapies

    Behavioral therapies are a core part of treatment and are included in all levels of care.

    • Cognitive Behavioral Therapy (CBT): Helps people recognize triggers, manage cravings, and develop healthier thinking patterns
    • Motivational Interviewing (MI): Supports individuals in resolving ambivalence and strengthening motivation to change
    • Contingency Management (CM): Provides incentives or rewards for meeting recovery goals (such as negative drug tests)

    These approaches are widely supported by research and national treatment guidelines.

    Structured Treatment Programs

    Treatment programs provide varying levels of support depending on individual needs:

    • Outpatient Treatment: Regular counseling sessions while living at home
    • Intensive Outpatient Programs (IOP): Several hours of therapy per week
    • Partial Hospitalization Programs (PHP): More intensive daytime treatment
    • Residential Treatment: 24/7 structured care in a supportive environment

    California uses the ASAM Criteria to determine the appropriate level of care for each individual.

    Peer Support and Recovery Communities

    Peer support connects individuals with others who have lived experience to learn how to navigate life without drug use. Common options include:

    • Narcotics Anonymous: a self-help fellowship designed for people who want to stop using drugs and seek ongoing support in their recovery
    • SMART Recovery: free self-empowering mutual support group meetings focused on reducing addictive behaviors

    These programs provide encouragement, accountability, and a sense of community.

    Trauma-Informed and Mental Health Care

    Many people with OUD have experienced trauma or have co-occurring mental health conditions. Treatment may include:

    • Trauma-focused therapy: focuses on understanding the role of trauma in symptoms and avoids re-traumatizing people in treatment
    • Counseling for anxiety, depression, or PTSD: a structured form of talk therapy that helps individuals understand and change negative thought patterns and behaviors
    • Stress management and emotional regulation skills: the ability to recognize, manage, and respond to emotions in a healthy way to cope with stress and avoid impulsive behaviors)

    These approaches are widely supported by research and national treatment guidelines.

    Harm Reduction Services

    Harm reduction focuses on safety and saving lives. Services may include:

    These services are widely supported in Marin County and help reduce overdose risk.

    How Treatment Decisions Are Made

    In California, providers use the ASAM Criteria to assess:

    • Substance use severity
    • Physical and mental health needs
    • Readiness for change
    • Risk of relapse
    • Living environment and support system

    This helps match each person to the right level of care.

    Important Considerations

    • Non-medication approaches can be effective, especially when combined with strong support systems
    • Research shows that medications often improve outcomes and reduce overdose risk, particularly in the current fentanyl environment
    • Learn about Medication-Assisted Treatment

    Sources