Medication for Addiction: Is It Real Treatment?

What is medication-assisted treatment (MAT)?

You may also see it called “medications for addiction treatment” or, for opioids, MOUD (medications for opioid use disorder). SAMHSA describes medication combined with counseling and behavioral therapy as a “whole-patient” approach, and says research shows the combination can successfully treat substance use disorders.¹ It can be part of care almost anywhere, from a regular office visit to residential treatment. For how those settings fit together, see the main types of addiction treatment.

Is medication just trading one drug for another?

No. SAMHSA says these medications are evidence-based treatment and “do not just substitute one drug for another.”¹ The worry usually comes from mixing up two different things.

Physical dependence means the body has adjusted to a medicine and would go through withdrawal if it stopped suddenly. Someone on methadone or buprenorphine can have withdrawal if they stop abruptly, but SAMHSA notes that this alone isn’t a disorder.² Addiction is compulsive use despite harm: chasing a high, losing control, lying, missing work. A person stable on a steady, prescribed dose is dependent on a medicine that relieves the cravings and withdrawal driving that cycle.¹

What medications treat opioid use disorder?

Three are FDA-approved, and they work in different ways.⁵²

As for buprenorphine versus methadone, neither is best for everyone. SAMHSA says the choice should fit the patient, shaped by their medical and substance use history, their preference and what’s available nearby.¹⁶ Their schedule, other health conditions and distance from a clinic matter too. What you can do is make sure the program your loved one picks can actually offer that choice.

Does medication lower the risk of overdose?

Yes. Medications for opioid use disorder help people stay in treatment, use fewer illicit opioids and survive, and methadone and buprenorphine in particular are associated with significant reductions in the risk of overdose death.¹²

That protection counts most after a break from opioids. Tolerance drops during detox, jail or a hospital stay, and SAMHSA lists returning to drug use after leaving one of those settings without medication as an overdose risk factor.² CDC provisional data put U.S. overdose deaths at 69,973 in 2025, about 44,564 of them involving opioids. That is the third straight yearly decline, though the figures may change as data are finalized.⁹

Medication doesn’t replace naloxone, which SAMHSA advises families of people who use opioids to keep at home.² Here’s how to use naloxone.

What medications help with alcohol use disorder?

Naltrexone, acamprosate and disulfiram are approved, and they are vastly underused, so ask about them by name.¹¹

• Naltrexone (a daily pill or monthly injection) can reduce cravings and how much someone drinks.¹¹⁸ It isn’t for people who currently use or depend on opioids, including opioid pain medicine.⁸
• Acamprosate helps people who have already stopped drinking stay stopped.¹¹
• Disulfiram causes an unpleasant reaction if the person drinks. It suits people aiming not to drink at all, and may work better if someone watches them take it each day.¹²

A primary care provider can prescribe any of these, alone or with counseling.¹⁰ The American Psychiatric Association also suggests gabapentin or topiramate as second-line options for some patients.¹¹ If your loved one drinks heavily every day, stopping suddenly can be dangerous, so read about alcohol withdrawal before they quit.¹⁰

What about meth, cocaine and other stimulants?

No medication is FDA-approved for stimulant use disorder yet.³⁴ Behavioral therapies can work, including cognitive behavioral therapy and contingency management, which gives vouchers or other rewards for not using.⁴ A clinician can still treat what often comes along with stimulant use, such as depression or anxiety; see treating addiction and mental health together.

How long does someone stay on medication?

There’s no set end date. SAMHSA says medications for opioid use disorder are safe to use for months, years or a lifetime.²⁷ Staying on long term is not a failure.

If your loved one wants to come off, that’s a plan to make with the prescriber, who can lower the dose gradually to prevent withdrawal.⁶ Quitting on their own is the risky version: tolerance falls, and with naltrexone the block wears off, so an amount they used to take, or even less, can be deadly.²⁸

What if a treatment program won’t allow medication?

Look for one that will. SAMHSA’s checklist for finding quality treatment tells families to ask about treatment with medication, because not every program offers or allows it.³

Where can my loved one get these medications, and who pays?

To find a prescriber or program, search FindTreatment.gov, SAMHSA’s locator of state-licensed providers.¹⁴ The free, confidential SAMHSA National Helpline at 1-800-662-4357 also gives referrals around the clock, in English and Spanish.¹⁵

Federal law requires state Medicaid programs to cover medications for opioid use disorder and related counseling,¹⁶ and a 2024 law made that permanent.¹⁷ Medicare Part B covers methadone, buprenorphine and naltrexone given in a doctor’s office or an opioid treatment program, plus counseling and drug testing at a program.¹⁸ With a private plan, ask member services how each medication is covered and whether it needs prior authorization. If the plan limits addiction medication more strictly than other medical care, read about appeals and parity rights.

How can families help someone stay on medication?

Make staying on it easier. Drive them to clinic visits, help set up a pharmacy routine, keep the medication locked away from children and pets, and notice that they keep showing up rather than counting days.¹⁷ If they use again, the next step is a call to the prescriber, who may adjust the dose or add support, not stopping the medication.¹⁷ Our guide to responding when a loved one uses again covers the rest.

What you say about the medication matters too.