It started with
a prescription.
It didn't end there.

Opioid use disorder is one of the most stigmatized and misunderstood conditions in mental health. Most people who develop it didn't see it coming — it built slowly, often from legitimate pain, and by the time it was a problem it already had its hooks in.

At Real Counseling in Baldwin Park, we work with men and veterans who are ready to do the real work — not just manage symptoms, but understand what's driving the pattern.

ADDICTION COUNSELING ORLANDO

4.8M

Americans currently have opioid use disorder — most of them never sought treatment

3 out of 4

People with Opiate Use Disorder receiving no specialty treatment whatsoever

43%

Of adults who need opioid treatment don't believe they need it

WHAT BRINGS PEOPLE HERE

It's not what most people picture

Opioid dependence has a public image — one that doesn't fit most of the people who actually have it. Many came through legitimate prescriptions. Some have been in treatment before and relapsed. Others are in maintenance programs but haven't touched the underlying reasons they started using in the first place.

What they have in common is that the substance started as a solution. Pain relief, emotional numbing, the ability to function under pressure, or a way to stop feeling something that felt unmanageable. That part rarely gets addressed.

WHAT YOU MIGHT RECOGNIZE

| "I've stopped before. I know I can. But I always come back."

| "I'm on Suboxone and stable — but I don't feel like myself."

| "The physical part isn't the problem. I don't know what to do with how I feel."

| "I'm not the kind of person who should have this problem."

| "I've done treatment. I don't need another program."

HOW I WORK

Psychodynamic therapy for opioid dependence

My approach isn't a protocol. It doesn't start with a relapse prevention worksheet or a list of triggers to avoid. It starts with a question: what has this been doing for you?

Opioids are extraordinarily effective at what they do — they blunt pain, physical and emotional, better than almost anything else available. That effectiveness is part of why dependence forms so quickly and why quitting through willpower alone rarely holds. The brain isn't broken. It learned something, and it keeps going back to what works.

Psychodynamic therapy addresses the psychological architecture underneath the use. The early experiences that shaped how you handle pain. The emotional states that became unbearable without chemical management. The identity questions that come up when you try to imagine a life without this as a reference point.

That's slower work than a 30-day program. It's also more durable.

A note on MAT and medication

If you're on Suboxone, methadone, or Vivitrol, I work alongside that — not against it. Medication-assisted treatment keeps people alive and stable. Therapy addresses what the medication doesn't.

I don't push sobriety as a goal over stability. What we work toward is something you define. That might mean abstinence. It might mean sustained recovery with support. The goal is that it's chosen rather than just managed.

I'm not a prescriber. For medication management, I'm happy to coordinate with your current provider or help you find one.

IS THIS A FIT?

Who tends to do well here

This work isn't for everyone, and I'd rather be honest about that upfront. It's not crisis stabilization and it's not detox support. It's ongoing individual therapy with a psychodynamic orientation.

  • Veterans managing chronic pain, PTSD, or the aftermath of military medical care

  • People who've tried willpower-based approaches and found them insufficient

  • Those who've relapsed and want to understand why before trying again

  • Adults prescribed opioids for pain who are worried about where that's headed

  • Adults managing opioid dependence who want to understand the pattern, not just stop it

  • People who've completed treatment and want deeper work than what a program offered

  • Those stable on MAT who feel like something is still missing

  • High-functioning individuals whose use is hidden from most people in their lives

WHAT TO EXPECT

What this isn't

If you've been through treatment, you know the format — group check-ins, handouts, stages of change. That model serves a purpose. It's not what I do.

NOT A PROGRAM

There's no curriculum, no workbook, no predetermined endpoint. The work is shaped by what's actually happening for you.

NOT ABSTINENCE-ONLY

Recovery means different things to different people. I don't have a predetermined definition of success that you have to fit yourself into.

NOT A LECTURE

You know what opioids do. You don't need someone to explain the risks. What's more useful is understanding why knowing that hasn't been enough.

NOT GROUP THERAPY

Individual sessions only. Confidential. No check-ins with other clients. No phone apps. No accountability partners unless you want them.

NOT CRISIS MANAGEMENT

I'm not a detox service. If you're in active withdrawal or medical distress, that needs medical attention first. Therapy comes after stabilization.

NOT INSURANCE-BILLED

Private pay only. That means no insurance company in the room, no treatment plan filed, no diagnostic codes tied to your name.

  • Yes, physically and psychologically. Kratom's active compounds bind to Yes. I work with people on MAT regularly and have no interest in pushing you off it. Medication keeps you stable enough to do the actual work. The two aren't in conflict.

  • It is. Programs focus on stabilization, psychoeducation, and getting you through acute crisis. Individual psychodynamic therapy is slower and goes deeper — it's less about learning what addiction is and more about understanding your specific relationship to it. Most people who've been through treatment and relapsed say they knew everything they were told. Knowing isn't always the problem.

  • No. You don't need to be sober to begin therapy. What I do need is that you're not in active medical withdrawal, because that's a medical situation — not a therapy situation. If you're stable enough to have a conversation, we can start from there.

  • I'm private pay only, which means no insurance billing and no treatment records filed with a third party. What you tell me stays between us, with the standard legal exceptions — imminent harm to yourself or others, and mandatory reporting requirements. I can walk you through exactly what that means before we start.

  • Honestly, it varies. Some people come for six months and feel like they've gotten what they needed. Others work for a few years. Psychodynamic therapy isn't a fixed program with a graduation date — it ends when you decide you're done. What I'd push back on is the expectation that opioid recovery has a finish line. For most people it's an ongoing relationship with themselves, and therapy can be part of that for as long as it's useful.

  • Relapse is common enough that it's essentially built into the pattern of opioid dependence. The more useful question isn't whether you've failed — it's whether any of the previous attempts addressed the reasons underneath the use. If they didn't, that's not a character failure. It means something else is worth looking at.

  • The first session is mostly me listening. I'll ask about what brought you in, what you've tried before, and what you're hoping is different this time. There's no intake packet, no formal assessment battery. I want to understand you — not categorize you. We'll also spend some time making sure the fit feels right on your end.

BEFORE YOU REACH OUT

Practical Details

Location: In-person, Orlando / Baldwin Park

Format: Individual therapy only

Approach: Psychodynamic, depth-oriented

Payment: Private pay (sliding scale may be available)

MAT: work alongside medication — not as a prescriber

Good fit: Post-treatment, MAT-stable, high-functioning, chronic pain histories



← Back to Addictions Counseling