What Is Medication-Assisted Treatment (MAT) for Opioid Use Disorder?

Reviewed by Josie Desmarais, PMHNP-BC · Board-Certified Psychiatric-Mental Health Nurse Practitioner · Last updated June 2026

Medication-assisted treatment (MAT) is the use of FDA-approved medications, combined with counseling and behavioral support, to treat opioid use disorder (OUD). MAT is the evidence-based standard of care — not a shortcut, not a substitute for “real” treatment. It reduces overdose deaths by 50–60%, decreases illicit drug use, improves social functioning, and keeps people alive long enough for recovery to become possible. The access gap is the remaining problem. The evidence gap closed years ago.

Learn how our medication-assisted treatment program supports lasting opioid recovery.

The Three FDA-Approved Medications for Opioid Use Disorder

Three medications are specifically approved by the FDA for OUD. Each works differently and is appropriate for different clinical situations.

Buprenorphine (Suboxone, Sublocade, Subutex)

Buprenorphine is a partial opioid agonist — it activates opioid receptors, but only partially. This partial activation prevents withdrawal and reduces cravings without producing the euphoric effect of full agonist opioids like heroin or oxycodone. For more on this, see our guide to whether Suboxone shows up on a drug test.

The most commonly prescribed formulation is Suboxone, which combines buprenorphine with naloxone (an opioid antagonist added to deter injection misuse). Sublocade is a monthly injectable buprenorphine formulation useful for patients who benefit from not managing daily sublingual dosing.

How it is prescribed: Office-based prescribing by any DEA-licensed provider, since the MATE Act of 2023 eliminated the X-waiver requirement. This includes psychiatric nurse practitioners, physicians, PAs, and other qualified providers. Trust Psychiatry & Wellness in West Palm Beach provides buprenorphine-based MAT as a core service.

Who it is appropriate for: Most people with opioid use disorder. Office-based availability and telehealth access make it the most accessible MAT option in Florida and nationally.

Naltrexone (Vivitrol)

Naltrexone is an opioid antagonist — it blocks opioid receptors entirely with no agonist effect. When someone on naltrexone uses an opioid, no euphoric effect occurs and no physical reinforcement happens. This removes the neurobiological reward that drives continued use.

Vivitrol is the extended-release injectable form, administered once monthly. The oral form (ReVia) is available but has substantially lower adherence rates. The monthly injection is the clinically preferred delivery. We cover why Suboxone can make you tired in a separate article.

Critical requirement: The patient must be completely opioid-free for 7–10 days before starting naltrexone. Starting too early — while any opioid is in the system — causes immediate, severe precipitated withdrawal. This is the primary barrier for patients in active use.

Who it is appropriate for: People who are already detoxed and opioid-free, those with high abstinence motivation, or those transitioning from a controlled environment (inpatient completion, incarceration). Also FDA-approved for alcohol use disorder.

Methadone (OTP-Only — Not Office-Prescribable)

Methadone is a full opioid agonist — it fully activates opioid receptors, which suppresses withdrawal and cravings completely. For people with severe or refractory OUD who have not stabilized on buprenorphine, methadone is often the most effective available option.

Critical distinction: Methadone for OUD is dispensed exclusively through federally certified Opioid Treatment Programs (OTPs) — specialized methadone clinics. It cannot be prescribed at an office-based practice or called in to a pharmacy. Patients attend the clinic daily for observed dosing initially, with take-home doses earned over time through demonstrated compliance.

Who it is appropriate for: Patients with severe or refractory OUD, those who have not stabilized on buprenorphine, and patients where full agonist coverage is clinically appropriate. If that applies to you, read more about how long Suboxone blocks opiates.

Trust Psychiatry does not dispense methadone — OTP certification requirements apply — but provides referrals to appropriate OTP programs for patients who need this level of care.

How MAT Works: Medication and Counseling Together

MAT is not “just medication.” The evidence consistently shows that medication combined with counseling and behavioral health support produces better outcomes than either component alone.

What medications do: Stabilize opioid receptor activity. Eliminate the craving cycles that drive relapse. Reduce the reward value of illicit opioid use. Prevent overdose deaths during the highest-risk period — early treatment and periods of instability.

What counseling adds: Addresses underlying trauma and co-occurring mental health conditions. Builds coping skills and emotional regulation. Provides accountability. Supports social stabilization — employment, housing, relationships.

The correct frame: medication makes therapy possible. A person in acute withdrawal cannot engage meaningfully in any cognitive or relational work. Stabilized on buprenorphine, that same person can. Trust Psychiatry coordinates behavioral health referrals as part of every MAT treatment plan. Our team also explains how to maximize Suboxone absorption in detail.

What the Evidence Shows

The data on MAT is among the most robust in addiction medicine:

• 50–60% reduction in opioid overdose mortality in patients on buprenorphine or methadone vs. no medication treatment (multiple meta-analyses, Cochrane reviews)
• Significant reduction in illicit opioid use at 6 and 12 months compared to behavioral therapy alone
• Improved social functioning: employment, housing stability, and family relationships
• Reduced criminal activity associated with active OUD
• Better HIV and hepatitis C outcomes due to reduced injection drug use

SAMHSA, ASAM, the CDC, and WHO all identify MAT as the first-line standard of care for opioid use disorder. The science is settled. The remaining challenge is access — making sure people in Florida and everywhere else can actually reach a MAT provider when they need one.

MAT vs. Abstinence-Only Treatment

Abstinence-based programs without medication have consistently high relapse rates — studies show 40–60% relapse within the first year following residential treatment without MAT. The added risk: people who relapse after a period of abstinence have reduced opioid tolerance. Their first post-treatment opioid exposure, often in a fentanyl-contaminated street supply, is especially likely to be fatal.

MAT removes the high-risk abstinence-and-relapse cycle. Long-term medication maintenance is medically supported and evidence-based. Treatment decisions should follow clinical evidence — and the evidence favors MAT without ambiguity.

Frequently Asked Questions

Is MAT just substituting one addiction for another?
No. MAT involves physical dependence on a prescribed, monitored medication — which is entirely distinct from addiction. Physical dependence is a predictable physiological response that is managed through a planned taper when appropriate. MAT eliminates the compulsive, harmful use pattern that defines addiction while stabilizing the patient medically.

Which MAT medication is best?
Buprenorphine (Suboxone) is first-line for most people due to office-based and telehealth accessibility. Naltrexone/Vivitrol suits patients who are already detoxed and abstinence-motivated. Methadone is for severe or refractory cases via OTP clinics. Your provider recommends based on your clinical history and circumstances. Learn more about taking gabapentin with Suboxone here.

How long does MAT last?
There is no standard duration. ASAM recommends treatment for as long as it is clinically beneficial. Some people taper off after one to two years of stability; others remain on MAT long-term with excellent outcomes. The decision is made collaboratively between the patient and provider.

Does insurance cover MAT?
Most insurance plans cover MAT medications and associated visits under the ACA and Mental Health Parity Act. Trust Psychiatry accepts insurance — review insurance and fees for specifics.

Can I start MAT if I’m currently using opioids?
Yes. For buprenorphine, you need to be in mild-to-moderate opioid withdrawal at the time of your first dose to avoid precipitated withdrawal — but you do not need to be detoxed beforehand or abstinent for any set period. Your provider will guide you through the timing at your intake appointment.

This article is for educational purposes only. Suboxone (buprenorphine/naloxone) requires a prescription and ongoing medical supervision. Contact Trust Psychiatry & Wellness at (561) 849-4449 to discuss MAT treatment options.

Start MAT at Trust Psychiatry & Wellness in West Palm Beach

Opioid use disorder is a medical condition with effective, evidence-based treatment. MAT at Trust Psychiatry & Wellness combines Josie Desmarais’ psychiatric expertise with a structured, patient-centered buprenorphine program — and telehealth access for patients across Florida who cannot reach care in person. You may also want to understand who can prescribe Suboxone.

Learn more about our MAT and Suboxone program or call (561) 849-4449) to schedule an appointment. Telehealth available statewide across Florida.

Related reading: taking opiates after Suboxone and is Suboxone addictive. If symptoms are affecting your daily life, our medication management services can help.

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