Previous research has shown that various environmental aspects, such as a history of abuse, trauma, and pain can influence the incidence of opioid use disorder (OUD). The aims of this study were to determine risk factors associated specifically with opioid use disorder, and to identify factors that may predict treatment progress for opioid use disorder patients. Three-hundred six patients from an abstinence-based residential treatment center participated in this study. Participants completed a comprehensive battery, which included measures assessing quality of life, craving, abstinence self-efficacy, adverse childhood experiences, trauma exposure, and physical pain symptoms at treatment intake and again after 28 days of treatment. Independent t-test results showed significant differences between patients with and without opioid use disorders in social relationships, confidence abstaining from alcohol and drugs, pain intensity, and drug craving. Multiple regression analyses demonstrated that presence of an opioid use disorder predicted alcohol abstinence, social relationships, and baseline environment. Results revealed shifting attitudes towards substance use and social relationships during the opioid group’s time in treatment. Cravings and urges were identified as important focuses for future treatment of opioid use disorder. Hyperalgesia was seen as an effect of extended opioid use and its impact decreased through drug abstinence. Limitations included a small sample size, a large proportion of wealthy individuals, and age differences between the two groups.