If there is a single intervention with more peer-reviewed evidence behind it than any other in the SUD field, it is medication-assisted treatment for opioid use disorder. Yet fewer than 25% of Americans with OUD receive any MAT in a given year.
This is not for lack of medications. Three FDA-approved options exist:
- Buprenorphine — partial μ-opioid agonist, dosed sublingually or as a long-acting injectable. Can be prescribed by any waivered clinician.
- Methadone — full μ-agonist, dosed daily at federally regulated opioid treatment programs.
- Naltrexone — opioid antagonist, available as oral or monthly extended-release injection.
What the evidence shows
Patients on any of the three medications have dramatically lower all-cause mortality than patients receiving abstinence-only treatment. Long-term retention — often measured at 12 or 24 months — is the single strongest predictor of sustained recovery.
The myths that won’t die
“MAT is just trading one addiction for another.”
It isn’t. Therapeutic MAT does not produce intoxication at appropriate doses, does not impair function, and does not meet diagnostic criteria for SUD.
“You should be able to taper off MAT eventually.”
Some can. Many cannot. Indefinite MAT — for years, decades, or life — is a legitimate, evidence-based outcome.
“MAT is for people who can’t get sober.”
MAT is sobriety, by every clinical definition that matters.
What’s changing in 2026
- Telehealth buprenorphine prescribing remains in flux as DEA finalizes post-PHE rules
- Long-acting buprenorphine injectables (Sublocade, Brixadi) are slowly displacing daily dosing
- Methadone access reform has been proposed but stalled at the federal level
For the full guide to finding MAT in your area, see our treatment series.
Sources Cited
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- 02.A
Filed Under
treatmentpolicyscienceMAT — BuprenorphineStigmaThe Treatment GapPeer-Reviewed Research