Quick answer: Medication-Assisted Treatment (MAT) uses FDA-approved medications — buprenorphine (Suboxone), methadone, and naltrexone (Vivitrol) for opioid use disorder, and naltrexone, acamprosate, and disulfiram for alcohol use disorder — combined with counseling and behavioral therapy. MAT roughly doubles treatment retention, dramatically reduces overdose mortality, and is the standard of care for opioid and alcohol use disorders. BetterChoice provides MAT during and after treatment. Call (725) 550-5655.

Medication-Assisted Treatment, commonly called MAT, combines FDA-approved medications with counseling and behavioral therapies to treat substance use disorders — primarily opioid and alcohol use disorders. Decades of research show that for the right patients, MAT dramatically reduces overdose risk, lowers relapse rates, and supports lasting recovery. Yet myths about it persist, even among well-meaning families and recovery communities. This guide walks through the most commonly used MAT medications in plain English.

The Big Picture: What MAT Is and Is Not

MAT is not "replacing one drug with another." That phrase has done real damage to public understanding of opioid treatment. The medications used in MAT do not produce the high of heroin or fentanyl. They are taken on a stable schedule, prescribed by a licensed clinician, and combined with therapy to address the behavioral and psychological aspects of addiction.

The relevant comparison is to insulin for diabetes, or SSRIs for depression. The medication addresses a measurable biological problem so the person can do the work of recovery without the constant pull of cravings or the constant risk of overdose.

Buprenorphine (Suboxone, Subutex, Sublocade)

Buprenorphine is a partial opioid agonist. In plain English: it activates the same brain receptors as heroin or fentanyl, but only partially, and with a built-in ceiling that prevents the typical opioid high. It also has a high binding affinity, which means it sits firmly on the receptor and blocks other opioids from attaching.

Suboxone is buprenorphine combined with naloxone in a film or tablet placed under the tongue. The naloxone component is inactive when taken correctly but discourages misuse by injection.

Subutex is buprenorphine alone, used in specific clinical situations.

Sublocade is a monthly injection of buprenorphine, useful for patients who struggle with daily dosing or want the convenience of monthly clinic visits.

Who is it for? Patients with opioid use disorder who want a maintenance medication that reduces cravings, prevents withdrawal, and dramatically lowers overdose risk. Most patients tolerate it well. Side effects are typically mild.

How long do people stay on it? Anywhere from several months to several years, sometimes indefinitely. The decision is individual and clinical. There is no medical urgency to come off it, and patients who taper off too early are at meaningfully higher risk of relapse and overdose.

Methadone

Methadone is a full opioid agonist used for opioid use disorder. It is older than buprenorphine and remains highly effective, particularly for patients with long histories of heavy opioid use.

In the United States, methadone for addiction treatment is dispensed only through licensed methadone clinics, with daily in-person dosing during the early phase. This regulatory structure is more restrictive than buprenorphine but provides the high level of supervision some patients need.

Who is it for? Patients with severe opioid use disorder, especially those who have not done well on buprenorphine, those with very high tolerance, or those who benefit from the structure of daily clinic visits.

Naltrexone (Oral) and Vivitrol (Injection)

Naltrexone is an opioid antagonist. It does the opposite of buprenorphine and methadone — it blocks the opioid receptors entirely so that opioids have no effect. There is no euphoria, no pain relief, no respiratory depression. If a patient on naltrexone uses an opioid, nothing happens.

Naltrexone is also FDA-approved for alcohol use disorder. It reduces the rewarding effects of alcohol and lowers cravings.

Oral naltrexone is a daily pill. It works, but adherence is the challenge — missing a dose leaves the patient unprotected.

Vivitrol is an extended-release injection of naltrexone given once a month. This solves the adherence problem and is increasingly preferred for both opioid and alcohol use disorders.

Who is it for? Patients who are fully detoxed from opioids (a critical requirement — naltrexone given to someone with opioids in their system causes severe precipitated withdrawal). It is well-suited for patients who want a non-opioid maintenance medication, including those who have been told by family or employers that any opioid-based MAT is off the table.

Acamprosate (Campral)

Acamprosate is FDA-approved for alcohol use disorder. It does not block alcohol or cause adverse reactions to drinking. It works by stabilizing brain chemistry that has been disrupted by chronic alcohol use, reducing the lingering anxiety, sleep disruption, and dysphoria of post-acute withdrawal that often drives relapse.

Who is it for? Patients in early sobriety from alcohol who are struggling with persistent anxiety, sleep problems, or cravings.

Disulfiram (Antabuse)

Disulfiram is the oldest medication for alcohol use disorder. It works by causing a severe, unpleasant reaction — flushing, nausea, vomiting, headache — if alcohol is consumed. It is essentially a chemical deterrent.

Who is it for? Highly motivated patients in stable situations, often as a short-term tool during high-risk periods. It requires daily adherence and is not appropriate for patients with certain heart conditions.

How MAT Decisions Get Made at BetterChoice

The choice of medication, if any, is individualized. Factors include the substance, severity, prior treatment history, co-occurring conditions, patient preference, family considerations, work situation, and insurance coverage. Our medical team — board-certified in addiction medicine — discusses options openly with each patient and respects patient choice within clinical safety.

MAT is always combined with therapy. Medication addresses the chemistry; therapy addresses the behavior. Neither works as well alone.

A Word on the Stigma

Patients on MAT sometimes encounter judgment from people in recovery who view "real" sobriety as medication-free. This view is not supported by the medical evidence and has cost lives. A patient on stable Suboxone, employed, raising their children, and engaged in therapy is in recovery. Period.

Cost and Access

MAT medications are covered by most major insurance plans, including Aetna, Cigna, BCBS, Anthem, UnitedHealthcare, Humana, and Tricare. Generic versions are widely available. Our admissions team can verify coverage and walk you through options at (725) 550-5655, or in person at 198 Ebb Tide Cir, Las Vegas, NV 89123. The right medication, combined with the right therapy, can be the foundation of a recovery that holds.

Why MAT Became the Standard of Care

The shift toward MAT as the standard of care for opioid use disorder did not happen because of marketing or politics. It happened because the evidence accumulated to a point where ignoring it became indefensible. Multiple large studies and meta-analyses have shown that:

MAT roughly doubles treatment retention compared with abstinence-only approaches
MAT reduces overdose mortality by approximately 50 to 75 percent
MAT improves rates of legal employment and reduces criminal justice involvement
MAT reduces transmission of HIV and hepatitis C
MAT improves overall quality of life and functional outcomes

The argument that MAT "replaces one addiction with another" is no longer credible in clinical settings. The medications used in MAT do not produce the high of heroin or fentanyl when taken as prescribed; they stabilize the brain so the person can do the rest of recovery. Active substance use disorder is a life-threatening medical condition; MAT is the treatment that most reliably reduces that mortality.

The Three Medications for Opioid Use Disorder

Buprenorphine (brand names: Suboxone, Subutex, Sublocade, Zubsolv) is a partial opioid agonist. It activates the mu-opioid receptor enough to suppress withdrawal and cravings but with a built-in ceiling that prevents the typical opioid high. Key features:

Taken daily as a sublingual film or tablet, or monthly as an injection (Sublocade)
Most patients stabilize at 8 to 24 mg per day
Initiation requires the patient to be in mild-to-moderate withdrawal to avoid precipitated withdrawal
Effective for fentanyl-contaminated populations with appropriate dosing
Available through any waivered prescriber (waiver requirements have been substantially reduced in recent years)
Suboxone combines buprenorphine with naloxone to deter injection misuse
Generally well-tolerated; main side effects include constipation, sweating, and headache

Buprenorphine is the most commonly prescribed MAT medication and is appropriate for the majority of patients with opioid use disorder. It can be started during medical detox and continued indefinitely.

Methadone is a full opioid agonist with a long half-life. It is dispensed daily through federally regulated opioid treatment programs (OTPs) — historically known as methadone clinics. Key features:

Taken daily as an oral liquid or tablet at the OTP
Dosing typically ranges from 60 to 120 mg per day, with significant individual variation
Effective for patients with very high tolerance or those who do not stabilize on buprenorphine
Requires daily attendance at the OTP for the first months, with take-home doses earned over time
Highly effective; outcomes match or exceed buprenorphine in some populations
Carries higher overdose risk than buprenorphine, especially during induction

Methadone is appropriate for patients who need a structured daily dosing routine, those with very high opioid tolerance, or those who prefer the OTP support model.

Naltrexone (brand names: Vivitrol, Revia) is an opioid antagonist. It blocks the opioid receptor entirely, so opioids do not produce a high. Key features:

Available as a daily oral pill (Revia) or a monthly injection (Vivitrol)
Requires the patient to be fully opioid-free for 7 to 14 days before initiation
Excellent overdose protection — opioids cannot bind to receptors while naltrexone is active
No risk of misuse or diversion
Side effects can include nausea, headache, and at the injection site for Vivitrol
Not effective for patients still actively using opioids; requires complete detox first

Naltrexone is appropriate for patients who prefer a non-opioid medication, those who have completed detox successfully, those concerned about the stigma of agonist medications, or those who have had difficulty with buprenorphine.

Medications for Alcohol Use Disorder

Three FDA-approved medications support recovery from alcohol use disorder:

Naltrexone (oral or injection) reduces the rewarding effect of alcohol and reduces craving. The same medication used for opioid use disorder, often used at lower doses for alcohol use disorder. Effective for many patients, especially those with strong craving patterns. Can be started while the patient is still drinking, though full benefit emerges with abstinence.

Acamprosate (Campral) helps restore the brain's neurochemical balance after alcohol cessation. Particularly useful for patients with anxiety, sleep disturbance, or low mood in early recovery. Started after detox is complete; taken three times daily.

Disulfuram (Antabuse) creates a severe physical reaction (nausea, vomiting, flushing, palpitations) when alcohol is consumed. Acts as a deterrent rather than a treatment for craving directly. Best for highly motivated patients with stable supervision; less commonly used today but still appropriate for some.

These medications are often combined with counseling, mutual aid involvement (AA, SMART Recovery), and treatment of co-occurring conditions for full effect.

How Long Does Someone Stay on MAT

This is the question patients and families ask most often. The honest answer: it depends on the individual, but the data favor longer rather than shorter use.

Short-term MAT (3 to 12 months) is sometimes appropriate for patients with shorter use history, strong support systems, and clear goals around eventual taper. Tapering should be slow, gradual, and supervised — typically over months — to avoid the cravings and instability that come with abrupt discontinuation.

Long-term MAT (1 to 5 years) is appropriate for patients with more extensive use history, multiple prior treatment episodes, ongoing stress factors, or co-occurring conditions. Many patients in this category eventually taper successfully; others remain on maintenance medication for years.

Indefinite MAT is a clinically valid choice. Patients who have been on stable MAT for years, with documented improvements in functioning and quality of life, do not need to taper unless they choose to. The medication is doing what it was designed to do; discontinuing it because of an arbitrary timeline is not clinically supported.

The decision to taper should be made in consultation with the prescribing clinician, ideally during a stable period of life — not during a crisis or transition. Tapering during stress is a common cause of relapse.

Common Misconceptions About MAT

"MAT is just substituting one drug for another." Not clinically accurate. The medications used in MAT do not produce the cycle of escalating use, intoxication, and withdrawal that characterizes addiction. Patients on stable MAT function normally — work, drive, parent, exercise.

"You're not really sober if you're on MAT." A definitional argument that does not match clinical reality. Patients on MAT are not actively using illicit substances, are not impaired, are not seeking the next dose. Most modern recovery frameworks (SMART Recovery, science-based AA approaches, harm reduction) include MAT-using patients as full members of recovery.

"You should only need MAT for a short time." Not supported by the evidence. Length of MAT use should be individualized, not arbitrary.

"MAT prevents real psychological recovery." No evidence for this. MAT enables psychological recovery by stabilizing the brain enough that the person can engage in therapy and skill-building.

"MAT is for weak people who cannot handle real recovery." Carries no clinical weight. The strongest evidence-based recovery for opioid use disorder includes MAT.

"My loved one will get high from MAT." Buprenorphine and naltrexone do not produce a high in patients with opioid tolerance. Methadone, when properly dosed, does not either.

Practical Realities of Starting MAT

Starting MAT involves several practical pieces:

Initial medical evaluation. History, physical, lab work to identify any contraindications.

Induction. For buprenorphine, induction requires being in mild-to-moderate withdrawal. For naltrexone, full detox completion. For methadone, careful titration at an OTP.

Stabilization. Most patients reach a stable maintenance dose within 1 to 4 weeks.

Concurrent therapy. MAT works better with concurrent therapy. The combination is the standard.

Insurance coverage. Almost all commercial plans and Medicaid cover MAT, though prior authorization is sometimes required.

Privacy. MAT records are protected under federal medical privacy law. Employers, schools, and most other parties do not have access.

Common Questions About MAT

Will MAT show up on a drug test? Standard employment drug tests do not screen for buprenorphine or naltrexone. Methadone may show up on an opiate panel; documentation from the OTP usually resolves this.

Can I drink alcohol while on MAT for opioids? Generally not advised, especially with buprenorphine — interaction increases respiratory depression risk. For patients with both alcohol and opioid issues, MAT for both is the right approach.

Can I drive while on MAT? Yes, once stabilized. The medications do not impair when taken as prescribed.

What if I get pregnant while on MAT? Buprenorphine and methadone are both safer for pregnancy than untreated opioid use. Coordinate with high-risk OB and your prescriber. We have specific experience with this population.

What if I need surgery while on MAT? Coordinate with your surgical team and prescriber. Buprenorphine in particular requires planning around perioperative pain management.

Can I get MAT through telehealth? For buprenorphine, increasingly yes. For methadone, in-person dosing at an OTP is still the norm. Naltrexone is straightforward to prescribe through any provider.

What if I miss a dose? For buprenorphine, take the next dose as soon as you remember. For methadone or Vivitrol, contact the prescriber. Do not double up.

Will MAT make me dependent on the medication? You will be physically dependent — meaning if you stop abruptly, you will experience withdrawal. Physical dependence on a prescribed, supervised medication is fundamentally different from addiction. The same is true for many medications (insulin, antidepressants, blood pressure medications).

Where We Are

BetterChoice Treatment Center is located at 198 Ebb Tide Cir, Las Vegas, NV 89123. Our private estate is roughly 15 minutes from Harry Reid International Airport, 20 minutes from the Las Vegas Strip, and within easy reach of Henderson, Summerlin, North Las Vegas, Boulder City, and the broader Clark County area. We coordinate confidential transportation for clients arriving from anywhere in Nevada or out of state.

How to Reach Us

Our admissions line is staffed 24 hours a day, every day of the year. Call (725) 550-5655 for a confidential conversation, a free insurance verification, and a same-day intake assessment when appropriate. There is no obligation, no judgment, and no pressure — just a real conversation about whether we are the right fit for what you or your loved one needs.

Suboxone, Naltrexone, Vivitrol: A Plain-English Guide to MAT