Opioid Use Disorder (OUD)

Key Takeaways

• Opioid use disorder is a lifelong condition characterized by the unmanageable seeking and use of opioids despite harmful consequences. It involves a persistent pattern of opioid misuse leading to considerable impairment and distress in various life areas.
• Symptoms of OUD include powerful cravings for opioids, using more opioids than intended, and experiencing withdrawal symptoms upon cessation. Additionally, people with OUD cannot control their use, subsequently neglecting their responsibilities.
• Effective treatment for opioid use disorder involves medications such as methadone or buprenorphine to manage cravings and withdrawal, potentially for life. Combining these with cognitive behavioral therapy (CBT) and support groups like Narcotics Anonymous significantly improves outcomes and supports long-term recovery.

Understanding Opioid Use Disorder

Opioid use disorder (OUD) is characterized by the persistent use of opioids despite substantial suffering and dysfunction. Symptoms include an uncontrollable urge to use opioids, increased tolerance, and withdrawal when the drug is stopped. OUD can present with differing levels of severity, ranging from mild to dependence and addiction. ^[1]

Dependence is a physical adaptation to a substance that causes withdrawal symptoms if the drug is abruptly stopped, but does not result in compulsive behavior. On the other hand, addiction is a chronic disorder involving compulsive drug use and cravings despite negative consequences,and it is characterized by both physical dependence and psychological compulsion .

Dependence is likely to progress into addiction, with more severe cases of OUD (opioid addiction) fluctuating between relapse and remission, with the risk of relapse persisting throughout a person’s life. Like other chronic relapsing conditions, opioid addiction can lead to dysfunctional symptoms, and maintaining consistent treatment can be challenging. ^[1]

That being said, although opioid use disorder is a type of substance use disorder (SUD), it differs from other SUDs because its neurobiology (how brain chemistry and behavior are affected by opioids) is well understood, and there are FDA-approved treatments available. One such treatment is methadone, which decreases OUD mortality risks by 50%. ^{[1] [2]}

What Are Opioids?

Opioids are a class of nonsynthetic (natural) drugs derived from the opium poppy, as well as synthetic and semi-synthetic substances designed to mimic their effects. The most commonly abused types of opioids include synthetic drugs like fentanyl and oxycodone (OxyContin), semi-synthetic opioids like heroin, and non-synthetic opioids such as codeine and morphine. ^[1]

The use of synthetic (man-made) opioids like fentanyl and oxycodone (OxyContin) has contributed greatly to the ongoing opioid epidemic. However, non-synthetic opioids, including codeine and morphine, are also highly addictive, as is heroin, a semi-synthetic opioid derived from morphine. ^[3]

How Common Is It?

Opioid use disorder affects more than 16 million people worldwide, with 2.1 million individuals living with the condition in the United States. The staggeringly vast number of people using opioids regularly in the U.S. is on par with the number of people diagnosed with obsessive-compulsive disorder, epilepsy, and psoriatic arthritis. ^[1]

The severity of OUD differs by age and gender, with men being more likely to use and become dependent on opioids, which is tragically reflected in statistics of opioid-related overdoses. That said, women are more frequently prescribed opioids for pain relief than men, and these medications can also lead to overdose in some cases. ^[1]

Opioid Epidemic

Opioid use disorder (OUD) has been a social and medical concern in the United States for more than 150 years. Although the severity of the issue has fluctuated, recent years have seen a persistent and devastating rise in OUD cases. ^[4]

Despite advances in treatment, expanded care options, and efforts to limit opioid availability, addressing the widespread impact of OUD on individuals, families, and communities remains a complex challenge that is unlikely to be resolved with simple solutions. ^[4]

In the U.S. alone, opioids have caused more fatalities than any other drug to date. For this reason, OUD has become known as the opioid epidemic and has received increased attention in the United States since 2010, when the recreational use of opioids was at an all-time high. ^[1]

In the U.S., the opioid epidemic was originally declared a public health emergency under President Trump’s administration in October 2017 and was set to expire on March 21, 2025. However, on March 18, 2025, the health crisis declaration was extended for another 90 days. ^[5]

Before the public health emergency was declared, the CDC estimated that over 72,000 people died from drug overdoses in 2016, with this number rising to 114,000 in 2023. Provisional data from 2024 show that drug overdose deaths began to decrease for the first time since 2018, but synthetic opioids remain the leading cause. ^{[3] [5]}

Synthetic opioids such as fentanyl, which is 50 times stronger than heroin, and OxyContin (a prescription medication 1.5 times more potent than heroin) are responsible for 90% of mortalities, with fentanyl becoming increasingly common. ^{[2] [3]}

According to Secretary of Health and Human Services Robert F. Kennedy Jr., “Although overdose deaths are starting to decline, opioid-involved overdoses remain the leading cause of drug-related fatalities”. However, while optimistic, the CDC also acknowledges a potential underestimation of the death count. ^{[5] [6]}

Symptoms

Opioid use disorder is diagnosed when a person suffers from a certain number of symptoms outlined by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). The severity of the disorder is defined according to the number of symptoms experienced: ^[7]

• Mild (2 to 3 symptoms)
• Moderate (3 to 5 symptoms)
• Severe (6 or more symptoms)

Symptoms of opioid use disorder include: ^[7]

• Using opioids in greater amounts or for a longer duration than prescribed or intended
• Feeling a strong craving or desire to use opioids
• Trying and failing to reduce or control opioid use
• Continuing opioid use despite experiencing ongoing social or relationship problems that are a direct result of drug use
• Spending significant time obtaining, using, or recovering from opioids
• Struggling to fulfill responsibilities at home, work, or school due to opioid use
• Reducing or giving up activities in order to prioritize using opioids
• Using opioids in dangerous situations (such as unsafe places, in the presence of strangers, or while driving, etc)
• Persisting in using opioids even when the drug use leads to (or worsens) physical or mental health problems
• Developing tolerance (needing more opioids to achieve the same effect)
• Experiencing withdrawal symptoms, or using opioids (or related substances) to prevent or ease withdrawal

Early Warning Signs

Opioid use disorder can develop rapidly, with the risk of progressing from dependence to addiction increasing every time opioids are taken. This happens because the parts of the brain that respond to the drug (called mu-opioid receptors) become familiar with opioid intoxication, resulting in tolerance where the receptors become less sensitive and no longer respond as they initially did. ^[1]

In OUD, physical dependence causes unbearable withdrawal symptoms when opioids are abruptly discontinued. As a result, individuals experiencing withdrawal typically seek relief by using more opioids, consequently reinforcing the vicious cycle of opioid use disorder. The symptoms of opioid withdrawal syndrome are: ^[1]

• Body aches
• Fever or chills
• Nausea or vomiting
• Diarrhea
• Sweating
• Increased heart rate
• Elevated blood pressure
• Agitation
• Restlessness
• Intense cravings
• Anxiety
• Insomnia
• Dilated pupils

Diagnosing Opioid Use Disorder

Opioid use disorder is diagnosed when an individual’s ongoing opioid use causes significant impairment or distress, typically due to intense cravings and subsequent difficulty controlling use. According to the DSM-5, OUD is defined as repeated opioid use over a 12-month period resulting in problems or distress, with at least two of the above-listed symptoms present. ^[1]

DSM-V vs ICD 10

The DSM-V (DSM-5) criteria for OUD were updated in 2022, as opposed to the criteria listed in the International Classification of Diseases, 10th Revision (ICD-10), which predates the ICD-11 (also published in 2022). As the most well-recognized guideline for mental health disorders like OUD worldwide, the DSM-5 is the gold standard for practitioners in the United States.

In terms of the differences between the ICD-10 and DSM-5, the classifications of OUD differ in how they define and classify opioid-related issues. The DSM-5 classifies opioid-related problems as “opioid use disorder” and presents a continuum of severity (mild, moderate, severe), while the ICD-10 includes both “opioid dependence syndrome” and “harmful use” as two separate categories.

One of the key differences is the inclusion of cravings as a symptom of OUD in the DSM-5, which is not explicitly listed in the ICD-10. Additionally, the DSM-5 provides a more comprehensive assessment by considering psychological and social factors alongside physical dependence, whereas the ICD-10 emphasizes physical symptoms like tolerance and withdrawal.

Despite both systems including tolerance and withdrawal as criteria, the ICD-10 frames dependence as a distinct condition, while the DSM-5 considers it as part of a broader spectrum of opioid-related problems. This inclusion in the Diagnostic and Statistical Manual of Mental Disorders is in line with current understandings of SUDs existing on a spectrum.

Assessments and Tests

Opioid use disorder cannot be diagnosed with a single test. Instead, doctors assess a person’s medical history and opioid use patterns, at times using drug tests and reviewing prescription monitoring reports.

Additionally, assessments such as the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) test, and the Rapid Opioid Use Disorder Assessment (ROUDA) are used to evaluate whether an individual has OUD. ^{[8] [9]}

Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS)

The TAPS tool is a two-part assessment that combines a screening and a brief self-report questionnaire for commonly used substances, including opioids. The first part, TAPS-1, screens for substance use over the past 12 months, while TAPS-2 provides a more detailed assessment for those who screen positive, focusing on problematic use in the past three months. ^[8]

Rapid Opioid Use Disorder Assessment (ROUDA)

The ROUDA is a quick, valid tool that can be administered by non-clinicians to screen for moderate to severe opioid and stimulant use disorders based on DSM-5 criteria. The eight-item test is highly accurate at detecting opioid use disorder, correctly identifying it more than 80% of the time and correctly ruling it out 100% of the time. ^[9]

Causes

Dependence and addiction to opioids can result from a combination of biological, environmental, genetic, and psychological factors. These factors make certain individuals more vulnerable to developing OUD than others. ^[1]

That being said, it is important to note that repeated opioid use causes changes in the brain’s reward and motivation systems even in people without vulnerabilities, which commonly leads to long-term disruptions in brain function and chronic addiction. ^[2]

Those at higher risk include people with low levels of brain chemicals like dopamine, and individuals with close relatives who struggle with substance use. Exposure to opioid use by friends or family or being prescribed opioids after an injury, can increase the risk of OUD. ^[1]

In other words, easy access to opioids, as well as cultural or community norms surrounding drug use, increases the likelihood of developing OUD. Additionally, people with a history of untreated mental health issues or those who experienced childhood trauma are also at risk. ^[1]

Opioids and Co-Occurring Disorders

Co-occurring disorders are physical or mental health conditions that present alongside another disorder (like OUD). The co-existing conditions can influence each other, impacting a person’s symptoms, treatment, and overall well-being. ^[10]

Many people with substance use disorders, such as opioid use disorder, also have mental health disorders, and the reverse is true as well. This means that SUDs and psychiatric conditions can lead to each other, although the exact cause of this is unknown. ^[11]

National surveys show that about half of individuals with a mental illness will go on to manifest a substance use disorder at some point, and vice versa. Among adolescents in treatment for various SUDs, over 60% also meet the criteria for another mental health disorder. ^[11]

Approximately one in four people with a serious psychiatric condition also has a substance use disorder. SUDs commonly co-occur with psychiatric disorders including: ^[11]

• Generalized anxiety disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Depression
• Bipolar disorder
• Attention-deficit hyperactivity disorder (ADHD)
• Psychotic disorders
• Borderline personality disorder
• Antisocial personality disorder
• Schizophrenia

Risks and Complications

Opioid use disorder is a complex condition that affects nearly every aspect of a person’s life and the lives of those around them. The consequences of OUD have an impact on both physical and mental health, as well as social stability. Sadly, opioids are responsible for the most drug-related fatalities in the U.S., due to the high risk of overdose linked to these drugs.

Here are some of the risks and complications of opioid use disorder: ^{[1] [2] [7]}

• Chronic brain dysfunction: Long-term changes to the brain can disrupt behavior, motivation, and decision-making
• Career and financial difficulties: Reduced job opportunities and earning potential due to impaired cognitive and emotional function
• Increased disease risk: Higher likelihood of developing other diseases, including HIV, hepatitis, and infections like sepsis
• Polysubstance use: Common concurrent use of stimulants like methamphetamine and cocaine can lead to further brain dysfunction, depression, and apathy
• Legal and social consequences: Increased risk of legal difficulties, loss of primary relationships, and social isolation
• Progression to addiction: Dependence can progress into compulsive drug-seeking despite negative consequences, due to changes in brain areas responsible for reward
• Withdrawal symptoms: Onset and duration vary by opioid type, with symptoms potentially lasting from days to weeks (can be severe and debilitating)
• Shortened lifespan: Increased risk of premature death due to overdose, health complications, accidents, and suicide

Suicide Hotlines

If you or someone with OUD that you know is struggling with thoughts of suicide or making plans to take their own lives, it is crucial to get help right away. In the United States, you can call the Suicide and Crisis Lifeline at 988. For additional resources, including hotlines for veterans, youth, and Spanish speakers, click here.

For international suicide hotlines, you can find a comprehensive list here. If your country isn’t listed, search for “suicide hotline” \+ “your country’s name” to find emergency contact details for immediate assistance. Remember, people with OUD who are experiencing suicidal thoughts need urgent care, and in some cases, hospitalization may be necessary.

Opioid Overdose

Opioid addicts, even when in recovery, are at a high risk of fatal overdose, especially during or after periods of detox, as a person has reduced tolerance to the drug. Opioids affect the brain areas that control breathing, making the substance extremely dangerous, especially when taken in large amounts. An opioid overdose can be recognized by three key signs and symptoms: ^[12]

• Unconsciousness
• Tiny pupils
• Abnormal breathing

Responding to an Opioid Overdose

Opioid overdose deaths can be prevented with the timely administration of naloxone (a medication that reverses opioid effects without impacting those who have overdosed from a different substance) and resuscitation. While naloxone access is often limited to healthcare providers, some countries offer it over the counter and through community programs. ^[12]

In the event of witnessing an opioid overdose, call 911 for U.S. citizens or your local emergency services before beginning the resuscitation process. Keep in mind that naloxone only addresses an immediate overdose and does not manage the ongoing complications of opioid use disorder, so follow-up treatment is essential for long-term recovery. ^[2]

Prevention

While opioid use disorder cannot be prevented while abusing opioids, if an individual is in the early stages of dependence, avoiding medications or substances that contain opioids can prevent the condition from worsening into full-blown addiction.

In terms of recovering opioid addicts, in Narcotics Anonymous (NA), it is stated that “The only way to keep from returning to active addiction is not to take that first drug,” which applies to individuals who suspect that they may be developing opioid use disorder as well.

This is due to the fact that taking an addictive substance (even when medically prescribed for pain relief) can trigger the reward pathways in the brain and lead to an unintentional relapse or fatal progression.

That being said, certain circumstances (such as surgery) may require the unavoidable use of pain medications that contain opioids. In these situations, it is recommended to attend NA meetings for support and guidance.

Additionally, in the United States, there are prescription drug monitoring programs that track controlled substance prescriptions to guide the safer use of opioids and protect at-risk individuals. These programs allow clinicians to identify whether patients are already receiving opioids (or alternative addictive medications) from other healthcare providers.^[13]

Additionally, there are steps that can be taken within broader society that may help to prevent the onset of OUD, including: ^[13]

• Educating doctors on opioid prescription guidelines as well as how to discuss the risks and benefits of pain treatment with patients, and inform them about the safe storage and disposal of prescription opioids
• Raising public awareness about the risks of opioid use and the impact of overdose on individuals and families

Opioid Addiction Treatment Approaches

Opioid use disorder treatment can help to manage addiction to opioids by enhancing both physical and mental health, lowering the risk of overdose, and helping to prevent criminal behavior and related consequences. Various evidence-based methods are available for the rehabilitation and ongoing care of individuals with OUD. ^[1]

Medication for Opioid Use Disorder (MOUD)

The FDA has approved three medications that effectively and safely treat opioid use disorder, aiming to enhance the health and quality of life for those affected. Medication for Opioid Use Disorder (MOUD), also known as medication-assisted treatment (MAT), involves the ongoing, long-term use of medication. ^[14]

Opioid maintenance medications alleviate withdrawal symptoms and cravings without producing significant euphoria. Nearly half of those receiving medication replacement therapy can stay abstinent from other opioids. ^[1]

Treatment duration varies, with some clinicians advocating for lifelong maintenance to prevent relapse and overdose. If treatment is discontinued, gradual tapering is recommended to minimize withdrawal symptoms. ^[1]

Methadone

Methadone activates the mu-receptor (a type of brain-body receptor responsible for pain relief, euphoria, and addiction) and mediates the effects of opioids by binding to opioid substances. Methadone is particularly effective for fentanyl and has been found to decrease opioid-related mortality rates by 50%, while also reducing drug-related crimes and improving social interactions.^[1]

Buprenorphine

Buprenorphine is a long-acting medication used to manage opioid dependence. It works by partially activating opioid receptors, easing withdrawal symptoms and cravings without causing a strong high. It comes in various forms, including tablets, films, patches, and implants, and may be prescribed alongside other medications. ^[1]

Naltrexone

Naltrexone blocks opioid effects and helps maintain abstinence, but can only be taken once a patient has been opioid-free for at least 7 days. Both oral and intramuscular formulations are effective, with the intramuscular form offering monthly doses and higher compliance. Naltrexone was found particularly useful following buprenorphine treatment to sustain recovery in a 2024 review. ^[1]

Medication Considerations

Although recent data suggests the efficacy of naltrexone, a 2022 study stated that while all three MOUDs address OUD symptoms, only methadone and buprenorphine have been shown to prevent opioid overdoses. The findings highlighted that growing evidence suggests naltrexone may actually increase the risk of overdose in individuals using it to treat OUD. ^[14]

Adjunctive Medications for Withdrawal

Additional medications may be prescribed to address withdrawal symptoms alongside MOUD. Some of the most commonly recommended adjunctive pharmaceuticals for treating opioid withdrawal syndrome include: ^[1]

• Clonidine: Reduces withdrawal symptoms
• Tizanidine: Alleviates anxiety and muscle pain
• Bupropion: Helps with anxiety and depressive symptoms
• Loperamide and ondansetron: Manage diarrhea and nausea.

Access to Treatment in the USA

In the United States, there are government-funded treatments for OUD, which you can find here.

Psychedelic Medication as a Promising Future Treatment

While it may seem counterintuitive to treat opioid use disorder with psychedelic drugs, there is emerging research that indicates compounds like psilocybin and MDMA show promise for treating substance use disorders and other psychiatric conditions. ^[2]

A 2024 study stated that early studies on psilocybin and MDMA suggest reductions in substance use and cravings, while other psychedelics like LSD, ibogaine, and mescaline are also being explored as potential therapies for opioid use disorder. ^[2]

Cognitive-Behavioral Therapy (CBT)

Cognitive behavioral therapy is considered a key component in the treatment of OUD. The therapy is used alongside medication and other interventions to address underlying thought patterns and behaviors associated with opioid use. While CBT has been found to be more effective when combined with medications, the evidence on its effectiveness for OUD is mixed. ^[1]

The primary goal of cognitive behavioral therapy is to reduce the likelihood of relapse by helping patients change how they respond to triggers, develop coping skills, and adopt healthier behaviors. Group therapy is highlighted as a cost-effective way to deliver CBT, promoting self-control and accountability among participants. ^[1]

Narcotics Anonymous (NA)

Studies suggest that individuals living with opioid use disorder can benefit from engaging in self-help programs like Narcotics Anonymous (NA). NA is a free, globally active support group for addicts and recovering addicts who wish to abstain from using drugs. There are both in-person and 24/7 online meetings available, which have helped millions around the world.

Joining Narcotics Anonymous offers a supportive community where struggles are shared and newcomers are welcomed. Part of the NA program involves finding a mentor (or sponsor) who will guide the recovering opioid addict through challenging situations and offer advice in the event of powerful cravings and challenging life circumstances.

Detoxification and Rehabilitation

Opioid cravings can make it extremely difficult for people to cease using opioids. When individuals with severe OUD stop, they experience physical withdrawal symptoms like nausea, diarrhea, muscle pain, fever, shaking, anxiety, depression, and trouble sleeping. ^[14]

The fear of these symptoms is a common barrier for those trying to reduce or stop opioid use. For this reason, when a person is going through withdrawal in early recovery, it is ideal, but not necessary, to undergo short-term medically managed withdrawal (detox) in an inpatient facility. ^[14]

However, it is important to note that a 2023 Yale-led study found that abstinence-based treatments, including short-term detox and long-term rehabilitation programs without buprenorphine or methadone, are no more effective at preventing overdose deaths than no treatment. ^[15]

In comparison, methadone and buprenorphine reduced the risk of fatal overdose by 38% and 34%, respectively. The study also revealed that non-medication-based inpatient treatments increased the risk of death by over 77% compared to no detox or rehabilitation. ^[15]

This is due to the fact that without long-term maintenance medication, should a person relapse after detox or rehabilitation (where tolerance is lowered), using opioids again typically results in an overdose.

For this reason, if an individual is looking into inpatient treatment facilities, it is imperative to find institutions that offer MOUD for a sustainable recovery. Alternatively, taking medications for opioid use disorder without inpatient care can still be effective.

Home Management with Telehealth

Home-based opioid use disorder treatment provides care and support within a person’s home, using telehealth or mobile apps to connect them with the care team. This approach can be more convenient, private, and accessible, particularly for those in rural areas or with limited access to traditional treatment centers.

• Telehealth: Call 855-378-4373 for remote consultations, behavioral therapy, and medication management
• Mobile apps: After a healthcare provider has prescribed medication for OUD, the reSET-O app can be downloaded to a mobile phone for ongoing communication and access to resources

The benefits of home management with telehealth include:

• Convenience and privacy: Allows treatment at home, reducing travel and potentially improving treatment adherence.
• Customized care: Includes medication-assisted treatment (MAT) with buprenorphine, methadone, or naltrexone, tailored to individual needs.
• Psychosocial support: Incorporates counseling, behavioral therapy, and peer support to address underlying factors contributing to OUD.
• Overdose prevention: Provides naloxone and education on its use to patients and their families.
• Service integration: Connects patients to additional resources, such as mental health services and addiction specialists.

Long-Term Recovery

Long-term recovery from OUD involves more than simply abstaining from opioid use, it is a comprehensive, lifelong process aimed at achieving and maintaining physical, emotional, and social stability. Recovery is not a one-size-fits-all journey and involves putting in an equal amount of effort that was once spent on obtaining, using, and recovering from opioids.

Ongoing Medication Maintenance

Medication is the cornerstone of long-term OUD recovery and helps to stabilize brain chemistry, reduce cravings, and prevent withdrawal symptoms. Medication for opioid use disorder can last months, years, or even a lifetime, depending on individual needs and risk factors.

Continual Counseling

Medications are most effective when combined with behavioral therapies like CBT. This form of counseling helps individuals with OUD identify and change unhealthy thought patterns that may have developed alongside substance use, which leads to changed behavioral responses.

Addressing Co-Occurring Disorders

Many individuals with opioid use disorder also struggle with co-occurring mental and physical health conditions, and benefit from integrated treatment that addresses both OUD and any comorbid conditions.

Relapse Prevention and Coping Strategies

Developing a relapse prevention plan helps individuals identify triggers and implement coping strategies. Common strategies include stress management techniques, establishing a daily routine, and building a strong support network.

Social Support and Community Integration

Rebuilding relationships, finding employment, and engaging in meaningful activities are key components of long-term recovery. Support networks, including family, friends, and Narcotics Anonymous, play a critical role in providing accountability, guidance, and encouragement.

Holistic Approaches and Lifestyle Changes

Incorporating holistic practices like exercise, meditation, and healthy eating can support overall well-being. Sober living homes (or halfway houses) provide a structured, substance-free environment for individuals transitioning from intensive treatment back into society.

Ongoing Monitoring and Follow-Up Care

Regular medical and psychological follow-up helps monitor progress and address emerging issues. Adjustments to medication dosages, therapy approaches, and support plans may be necessary over time.

Final Thoughts

Opioid use disorder (OUD) is a serious and complex condition with significant personal and societal impact, including the ongoing opioid epidemic, which has caused widespread mortality in the United States.

Fortunately, OUD is the only substance use disorder with effective medication that can help to manage the condition alongside therapy and social support, such as Narcotics Anonymous. With these treatments, it is possible to maintain long-term recovery and lead a fulfilling life.

Author

Star Gorven

Star Gorven is a wellness and mental health writer with a talent for crafting evocative and evidence-based content across a wide range of topics. Her work blends analytical research with imagination and personality, offering thoughtful insights drawn from her exploration of subjects such as psychology, philosophy, spirituality, and holistic wellbeing.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Kaye SmithPhD

Dr. Smith is a behavioral health coach, clinician, writer, and educator with over 15 years of experience in psychotherapy, coaching, teaching, and writing.

Activity History - Medically reviewed on March 30, 2026 and last checked on March 19, 2026