Fentanyl use care, built around you.

Fentanyl use disorder is a form of opioid use disorder driven by use of illicitly manufactured fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine (NIDA). It is diagnosed when at least two of eleven clinical criteria appear in a twelve-month period, including tolerance, withdrawal, cravings, taking opioids in larger amounts than intended, and continued use despite consequences, with severity rated mild, moderate, or severe. Because fentanyl is now present throughout the illicit drug supply, many people develop fentanyl exposure without ever intending to use it, often through pills, powders, or stimulants that have been contaminated.

Yes, most adults with fentanyl use disorder can be treated effectively in outpatient care when the clinical picture is matched to the right level of care (ASAM Criteria). The Stepwell Center treats fentanyl use disorder across four outpatient levels in Lakeway, Texas: PHP for the most structure, IOP for daily clinical contact while continuing to work, Evening IOP for working adults, and Outpatient for maintenance. Patients whose assessment indicates a need for medically supervised withdrawal begin with that step before entering outpatient care, and Stepwell coordinates the handoff so the prescribed plan is in place when outpatient begins.

The three FDA-approved medications for opioid use disorder, buprenorphine, methadone, and extended-release naltrexone, all treat fentanyl use disorder, and methadone and buprenorphine are associated with reduced risk of overdose death (FDA). Because fentanyl is so potent, induction onto buprenorphine often calls for closer medical oversight and, in many cases, higher maintenance doses than the older standard 16 mg ceiling. Recent NIH-supported research found that more than 16 mg of buprenorphine is safe and well tolerated, and that higher doses are associated with improved retention in treatment (NIDA). At Stepwell, medication selection and dosing are informed by your clinical interview, treatment history, and when indicated, pharmacogenetic testing.

Fentanyl is treated with the same FDA-approved medications and the same behavioral modalities as other opioid use disorders, but the higher potency and faster onset typically call for closer medical oversight, more careful buprenorphine induction, and often higher maintenance doses to suppress cravings and withdrawal. Tolerance builds faster, withdrawal can begin within hours of the last use, and overdose risk is meaningfully higher because of fentanyl's potency and the variability of street supply. Clinically, the disorder still meets the same OUD criteria and the same evidence-based plan applies, with dosing and pacing adjusted for the substance.

Yes, naloxone reverses fentanyl overdose, and all opioid overdose reversal medications are effective in reversing opioid overdose including overdose caused by fentanyl, in both adults and youth (SAMHSA). Because fentanyl is so potent and the illicit supply is unpredictable, more than one dose is sometimes required and rescue breathing may be needed while waiting for emergency response. Stepwell's care plans for fentanyl use disorder include naloxone access and education for the patient and a household member, alongside any FDA-approved medication for opioid use disorder that the prescribed plan calls for.

Yes, integrated treatment that addresses fentanyl use disorder and a co-occurring mental health condition in the same plan is the standard of care when both are present, and approximately 21.2 million US adults have both a substance use disorder and a mental illness in the same year (SAMHSA). Treating either condition alone tends to leave the other free to keep pulling the pattern back. At Stepwell, integrated dual diagnosis care is built into every plan when both conditions are present, written and delivered by a single care team rather than referred out.

The Stepwell Center offers same-day or next-day admission to its comprehensive assessment program, with treatment placement following the assessment, typically beginning within a week of your first call. Speed applies to getting you into the assessment, not to skipping it. Your prescribed plan is what determines your starting level of care, the right medication option if MOUD is indicated, and the modality mix that fits. Call 512.743.9285 or use the contact form to begin.