Opioid abuse is an epidemic in the United States with the number of deaths associated with this addiction growing each year, and yet, identification of a successful treatment plan is a major limitation to addressing this epidemic. Traditional treatment programs do not always fit for all addicts; however, equine assisted psychotherapy and learning (EAPL) shows promise as an alternative treatment option for those individuals where traditional treatment options have failed. Nevertheless, due to the novelty of this treatment option, literature concerning EAPL is limited. The purpose of this scoping review was to identify articles that address the characteristics and methodologies found in EAPL programs as it relates to opioid abuse treatment. Through the use of this scoping review, literature covering four key topics were gathered: 1) addiction treatment curriculums, 2) EAPL programs, 3) physiological effect of addiction treatment for humans, and 4) physiological effect of EAPL participation on the human and horse. Research associated with physiological effect was the most lacking of the topics covered during this review of literature. Reviewed literature pointed to a variety of populations that participate in addiction treatment programs that range from inpatient to long term recovery. EAPL programs offer an assortment of activity options to combat the challenges presented by the range of populations treated. Vital signs were mentioned in the literature reviewed as the leading way to track physiological changes but were not discussed in relation to addiction-specific treatment. Physiological measures showed change in both horses and humans who participated in equine programming but did not dictate concrete cause and effect instances. The limited literature identified through this scoping review validates the need to further explore the intentional relationship between EAPL and opioid abuse treatment programming.