How Does Medication Assisted Treatment Work?

Three medications are FDA-approved for the treatment of opioid use disorder: methadone, buprenorphine, and naltrexone. Methadone and buprenorphine work by reducing cravings and withdrawal symptoms, while naltrexone works by blocking the effects of opioids. These medications are most effective when combined with counseling and behavioral support, and the right choice depends on an individual's medical history and stage of recovery, which a medical provider determines.

Contrary to what some people may believe, MAT does not just replace one drug with another. Instead, it’s an evidence-based treatment method for several types of addiction. Although medication assisted treatment is most often used to help people recover from opioid addiction, the FDA has approved several medications to treat both opioid and alcohol use disorders. For example, the following medications may be used in MAT programs:

Medications used to treat alcohol addiction

Acamprosate, disulfiram, and naltrexone are used to treat alcohol addiction. Here’s how each medication helps people maintain their sobriety.

• Acamprosate works by decreasing cravings and urges to use alcohol.²
• Disulfiram prevents your body from properly breaking down alcohol, which makes a person very sick when they drink it.³
• Naltrexone works by blocking the effects of opioid receptors, which decreases cravings and urges.⁴

Medications used to treat opioid addiction

Buprenorphine, methadone, and naltrexone are used to treat opioid addiction. Here’s how each of these medications work.

• Buprenorphine prevents withdrawal symptoms and reduces cravings by knocking other opioids in the brain off their receptors and tightly binding to those same receptors to block other opioids.⁵
• Methadone changes how the brain and nervous system respond to pain. As a result, it reduces painful withdrawal symptoms and blocks the pleasurable effects of opioid drugs.⁶
• Naltrexone works by blocking the effects of opioid receptors, which decreases cravings and urges.

Additionally, naloxone is another FDA-approved medication that prevents opioid overdose.⁷

None of the medications listed above will cure opioid or alcohol addiction. However, they can help people recover from addiction and sustain long-lasting sobriety.

Ultimately, the goal of medication assisted treatment is to help individuals achieve full recovery from addiction. For example, treatment professionals want clients to be able to live a self-directed and sober life after they complete treatment. MAT plays a vital role in this process and it provides many benefits for people in recovery. Notably, some of the main benefits of medication assisted treatment include:

• Improving the likelihood that a person will complete a detox program
• Ensuring less pain and discomfort during detox and withdrawal
• Increasing the likelihood that a person will stay in treatment longer
• Reducing the likelihood of relapse
• Decreasing illegal drug use and associated criminal activities
• Improving patient survival

Is Suboxone or Vivitrol better for long-term opioid addiction recovery?

There is no single "better" option — the right choice between Suboxone and Vivitrol depends on the individual, and it's a decision made with a medical provider. The two work in opposite ways: Suboxone (buprenorphine/naloxone) is a partial opioid agonist that reduces cravings and withdrawal by partially activating opioid receptors, while Vivitrol (extended-release naltrexone) is an opioid antagonist that blocks opioid effects entirely. One key practical difference matters for getting started: Vivitrol requires a person to be fully detoxed from opioids before the first injection, whereas Suboxone is often started during withdrawal. Factors like a person's stage of recovery, medical history, prior treatment response, and ability to complete detox all influence which is appropriate. Both are evidence-based options, and a medical assessment is the best way to determine the right fit.

Can I start Vivitrol right after detox?

Vivitrol can be started after you have fully detoxed from opioids — typically a period of being opioid-free is required before the first injection to avoid precipitated withdrawal. This is one reason completing a medically supervised opioid detox is an important first step before beginning naltrexone-based treatment.

Do I need to detox before starting medication-assisted treatment?

It depends on the medication. Naltrexone-based treatment (Vivitrol) requires completing detox first, while buprenorphine-based treatment (Suboxone) is often initiated during the withdrawal phase. A medical provider can determine the right sequence based on your situation and the medication being considered.

What medications are FDA-approved for medication-assisted treatment of opioid addiction?

The FDA has approved three medications for treating opioid use disorder: methadone, buprenorphine (often combined with naloxone, as in Suboxone), and naltrexone (the extended-release form is Vivitrol). Methadone and buprenorphine ease cravings and withdrawal by acting on opioid receptors, while naltrexone blocks opioid effects entirely. Each works differently, and the right option depends on the individual and is determined with a medical provider.

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