Drug Abuse and Substance Use Disorder Treatment in Portland, OR
Substance use disorders involving opioids, stimulants, benzodiazepines, cannabis, and other drugs each carry their own patterns, risks, and treatment considerations. What works for opioid use disorder is different from what works for stimulant use disorder or benzodiazepine dependence, which is why an accurate evaluation matters before any treatment plan is built rather than after the first prescription is written. Caroline Thiongo PMHNP-BC at Thrive Psychological Wellness provides psychiatric evaluation and medication management for drug-related substance use disorders, alongside treatment for co-occurring mental health conditions, at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon.
Substance Use Disorders We Treat
Why Different Substances Need Different Treatment Approaches
Substance use disorder is diagnosed based on a pattern of use that causes significant impairment or distress, regardless of which substance is involved. But the clinical picture, the withdrawal risks, and the available treatments differ considerably depending on what someone is actually using. Opioid use disorder has effective FDA-approved medications with strong evidence behind them. Stimulant use disorder currently does not, which means the treatment approach relies more heavily on behavioural support and direct treatment of co-occurring conditions. Knowing which substance is driving the problem determines which treatment path makes sense from the start.
Withdrawal risk varies considerably across substances and matters significantly for how treatment is sequenced. Opioid withdrawal is extremely uncomfortable but rarely medically dangerous in otherwise stable adults. Benzodiazepine withdrawal, like alcohol withdrawal, can be medically serious and typically requires a careful, supervised taper rather than abrupt discontinuation. Stopping benzodiazepines abruptly after prolonged use can cause seizures, which is why this is assessed as a priority in every evaluation Caroline Thiongo PMHNP-BC conducts.
Co-occurring mental health conditions are common across all substance use disorders and are not incidental to the addiction. Depression, anxiety, PTSD, and ADHD all increase the risk of substance use and frequently maintain it once it is established. Thrive Psychological Wellness addresses co-occurring conditions as a primary part of treatment rather than an afterthought, because leaving them unaddressed is one of the most reliable predictors of relapse.
Substance-Specific Considerations
- Withdrawal is uncomfortable but rarely dangerous. Buprenorphine and naltrexone are effective, FDA-approved treatment options that significantly reduce cravings and overdose risk.
- No FDA-approved medication currently exists. Treatment focuses on addressing co-occurring conditions like depression and ADHD, alongside behavioral support and relapse prevention strategies.
- Withdrawal can be medically dangerous, including risk of seizures. Requires a careful, gradual taper, often medically supervised. Should never be stopped abruptly after long-term use.
- Withdrawal is generally less severe but cannabis use disorder is real and increasingly recognized clinically, particularly with frequent high-potency use affecting daily functioning.
Evaluation and Medication Management for Drug Use Disorders
Treatment starts with identifying exactly which substances are involved, the severity of use, and any co-occurring conditions. From there the plan is built around what is actually effective for that specific substance.
Step 1: Detailed Evaluation
We assess which substances are involved, frequency and severity of use, withdrawal history, prior treatment attempts, and screen for co-occurring mental health conditions.
Step 2: Withdrawal Risk Assessment
We determine whether withdrawal from the specific substance involved carries medical risk and coordinate medical detox or supervised tapering when needed.
Step 3: Medication Management
For opioid use disorder, buprenorphine or naltrexone are discussed. For other substances, we focus on treating co-occurring conditions and supporting recovery through available means.
Step 4: Coordinated Ongoing Care
We connect patients to group counseling, family support when relevant, and refer to higher levels of care including residential treatment when clinically appropriate.
Medications for Substance Use Disorders
First-line treatment for opioid use disorder. Reduces cravings and withdrawal symptoms significantly. Requires a specific prescribing waiver, which our PMHNP holds.
Blocks opioid effects and reduces cravings for both opioid and alcohol use disorder. Available as a daily pill or monthly injection.
Antidepressants for depression, stimulant medications for ADHD when appropriate, and other psychiatric medications used based on what co-occurring conditions are identified.
No FDA-approved medication currently exists for cocaine or methamphetamine use disorder specifically. Treatment focuses on co-occurring conditions and behavioral support, often combined with contingency management approaches through referral.
Drug Use Disorder Treatment by Telehealth Across Oregon
Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for substance use disorder evaluation and medication management to patients anywhere in Oregon. When a higher level of care or medical detox is needed, Caroline Thiongo PMHNP-BC helps coordinate that referral so patients are not left to navigate the system alone at the point when they need support most.
📍 Locations Served
In-Person Offices
Multnomah Village, OR (Primary)
Portland, OR (Secondary)
Regional Areas
SW Portland, Lake Oswego, Beaverton
Gresham, Milwaukie, Clackamas
Questions About Drug Abuse and Substance Use Disorder Treatment in Portland
What medications are available for opioid use disorder?
Buprenorphine and naltrexone are both effective FDA-approved options for opioid use disorder. Buprenorphine reduces cravings and withdrawal symptoms and is often combined with naloxone in formulations such as Suboxone. Naltrexone blocks the effects of opioids and is available as a daily tablet or a long-acting monthly injection. Caroline Thiongo PMHNP-BC is a DEA-registered prescriber and can discuss which option is most appropriate based on your specific situation and history.
Is there medication for stimulant use disorder?
There is currently no FDA-approved medication specifically for cocaine or methamphetamine use disorder. Treatment focuses on addressing co-occurring conditions such as depression, anxiety, and ADHD directly, alongside evidence-based behavioural support strategies including contingency management, which has some of the strongest research evidence for reducing stimulant use. The absence of a specific medication does not mean treatment is ineffective. The behavioural and psychiatric approach can produce meaningful results when it is comprehensive and well coordinated.
Is it safe to stop benzodiazepines on my own?
No, not after regular long-term use. Benzodiazepine withdrawal can be medically dangerous, including risk of seizures. A careful, supervised taper is necessary. Please contact us or a medical provider before stopping benzodiazepines you have been taking regularly.
Can drug use disorder treatment be done through telehealth in Oregon?
Yes for psychiatric evaluation and medication management. Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for substance use disorder care to patients anywhere in Oregon. Contact the office to discuss which services are available through telehealth and what current prescribing regulations apply to your specific situation, as these can change.
Does insurance cover substance use disorder treatment in Oregon?
Yes. Most major Oregon insurance plans cover psychiatric evaluation and medication management for substance use disorders, including Oregon Health Plan. Thrive Psychological Wellness verifies your coverage before your first appointment so you know what to expect before care begins.
Accepting New Patients for Substance Use Disorder Treatment in Portland
Whatever substance has been part of the struggle, an accurate evaluation is the starting point for treatment that actually fits your situation. We approach this directly and without judgment. Book a time and we will go from there.
Crisis note below buttons: If you are in crisis, call or text 988. Cascadia Crisis Line: (503) 988-4888.