Medication Treatment
Medication for Opioid Use Disorder
How Does Medication for Opioid Use Disorder Work?
Medication for opioid use disorder (MOUD) treats opioid addiction with one of three FDA-approved medicines: buprenorphine, methadone or naltrexone. NIDA reports that people treated with methadone or buprenorphine are less likely to die or overdose than people who get no treatment. SAMHSA lists 6,998 facilities that offer buprenorphine and 1,506 methadone clinics (October 2026). Search the treatment finder by ZIP code, or call SAMHSA's free National Helpline at 1-800-662-4357.
Medication for Opioid Use Disorder Is Standard Care
Medication for opioid use disorder, often shortened to MOUD, is the main evidence-based treatment for opioid addiction. The FDA has approved three medicines for it: buprenorphine, methadone and naltrexone. The FDA says all three have been shown to be safe and effective.
The strongest reason to consider it is survival. NIDA reports that people with opioid use disorder who take methadone or buprenorphine are less likely to die or to overdose than people who get no treatment. They are also less likely to inject drugs or share equipment, which lowers the risk of HIV and hepatitis C.
Even so, NIDA says less than 20% of people with opioid use disorder receive these medications. Distance to a clinic, pharmacies that don’t stock buprenorphine, and stigma all play a part. If you or someone you love uses opioids such as fentanyl, heroin or pain pills, this page explains how each medicine works so you can talk with a prescriber about the right fit.
SAMHSA’s FindTreatment.gov lists 6,998 facilities that offer buprenorphine, 6,742 that offer naltrexone and 1,506 methadone clinics (October 2026). You can filter by medication in the treatment finder.
Buprenorphine, Methadone and Naltrexone Compared
The three medicines work in different ways, come from different places and fit different situations. This table sums up what SAMHSA, NIDA, CDC and the FDA say about each.
| Buprenorphine | Methadone | Naltrexone | |
|---|---|---|---|
| How it works | Partial opioid agonist: eases cravings and withdrawal with a weaker opioid effect | Full opioid agonist: reduces cravings and withdrawal and blunts other opioids | Blocks opioid receptors; not an opioid and not addictive |
| Common brand names | Suboxone, Zubsolv, Sublocade, Brixadi | Methadose | Vivitrol |
| Forms | Film or tablet under the tongue or in the cheek, monthly or weekly injection | Daily liquid, powder or dissolving tablet | Monthly injection for opioid use disorder |
| Where you get it | Doctor’s office, clinic, telehealth, opioid treatment program | Only a SAMHSA-certified opioid treatment program | Any licensed prescriber |
| When you can start | In early withdrawal, usually after a short break from opioids | At the clinic after a screening exam | After 7 to 10 days or more with no opioids |
| Facilities listed by SAMHSA | 6,998 | 1,506 | 6,742 |
None of these is a better choice for everyone. NIDA says methadone and buprenorphine can be equally effective at reducing opioid use, and methadone may help some people stay in treatment longer. Naltrexone can be as effective as buprenorphine when taken long term, but it is harder to start.
How Buprenorphine Works
Buprenorphine is a partial opioid agonist. SAMHSA explains that it eases withdrawal and cravings, but its opioid effects are weaker than those of full agonists like heroin or methadone. That makes it safer in an overdose and less likely to be misused. Most products, including Suboxone, add naloxone to discourage misuse.
Its biggest advantage is access. Buprenorphine was the first opioid use disorder medicine that could be prescribed in a regular doctor’s office. Since the federal X-waiver ended, any clinician with the right DEA registration can prescribe it where state law allows. You can also start it through telehealth, and NIDA notes that emergency departments can start it after an overdose. The Suboxone doctors guide covers who can prescribe it and how to find one.
To start, you need to be in the early stages of opioid withdrawal. Starting while opioids are still active in your body can bring on sudden withdrawal, so your prescriber will tell you when to take the first dose.
How Methadone Works
Methadone is a long-acting full opioid agonist that has been used for more than 50 years. NIDA explains that it activates the same receptors as other opioids, but more slowly and for longer, so it relieves withdrawal and cravings without the intense high.
For opioid use disorder, methadone comes only from a SAMHSA-certified opioid treatment program (OTP), often called a methadone clinic. You usually visit daily at first. As you become stable, the clinic can give you doses to take at home. Federal rules updated in 2024 let clinics offer take-home doses from the first week of treatment under certain conditions, with safeguards against diversion. The methadone clinics guide explains the current take-home rules and what the first visits look like.
OTPs also offer counseling, medical care, drug testing and referrals under one roof. For some people that structure is exactly what helps.
Where to Find It: Buprenorphine (Suboxone) by State
SAMHSA's FindTreatment.gov lists 6,998 substance use treatment facilities with this service (buprenorphine (suboxone)) across 53 states and territories, checked October 2026. Pick a state for its facilities, cities and treatment agency.
How Naltrexone Works
Naltrexone works differently from the other two. It isn’t an opioid. It blocks opioid receptors, so opioids can’t produce their effects, and SAMHSA says it also reduces cravings. It isn’t addictive and doesn’t cause withdrawal when you stop it.
For opioid use disorder, the FDA-approved form is an extended-release injection (Vivitrol) given every four weeks. Any licensed prescriber can give it. The hard part is starting: SAMHSA says to wait at least 7 days after short-acting opioids and 10 to 14 days after long-acting ones, or the injection can cause sudden, severe withdrawal. Many people take that step after detox.
Naltrexone pills are also approved for alcohol use disorder. If you drink heavily as well as use opioids, ask about it; the alcohol rehab guide covers alcohol medications.
Is Taking MOUD Trading One Drug for Another?
No. This is the most common worry, and NIDA addresses it directly. Methadone and buprenorphine act on the same receptors as other opioids, but when taken as prescribed by a person with opioid use disorder, they prevent cravings and withdrawal without causing a high. That is why NIDA calls them less addictive.
Like many medicines, they do cause physical dependence. Stopping suddenly can bring withdrawal, which is managed by lowering the dose slowly with your prescriber. Dependence on a prescribed, steady medicine is different from addiction, which involves compulsive use despite harm.
CDC describes opioid use disorder as a chronic medical condition, like diabetes or asthma, and the choice to use medication as a personal medical decision backed by strong evidence. Taking MOUD is a form of treatment, and many people stay on it for years while they rebuild work, family and health.
Pregnancy, Pain and Other Situations
Pregnancy and breastfeeding. NIDA says methadone or buprenorphine treatment is recommended for pregnant women with opioid use disorder, and both are safe while breastfeeding because only small amounts pass into breast milk. Untreated opioid use and repeated withdrawal carry risks for the baby. Federal rules require OTPs to give pregnant patients priority for admission. SAMHSA lists 4,536 facilities that serve pregnant or postpartum women.
Pain and surgery. Methadone and buprenorphine both relieve some pain. Naltrexone blocks opioid pain medicine, so NIDA says you may be advised to stop it before a planned surgery. Tell every doctor and dentist which medicine you take.
Other medicines and alcohol. SAMHSA warns not to drink alcohol or take sedatives, tranquilizers or other drugs that slow breathing while on buprenorphine or methadone. Mixing them can lead to overdose or death.
How Long Treatment Lasts and Staying Safe
There is no set end date. SAMHSA says buprenorphine treatment is tailored to each person and in some cases can be indefinite. For methadone, SAMHSA points to NIDA’s guidance that treatment should last at least 12 months, and some people need long-term maintenance. If you decide to stop, do it gradually with your prescriber.
Overdose risk rises when tolerance drops. SAMHSA warns that after stopping naltrexone, taking the same or even smaller doses of opioids than before can be life-threatening. The same is true after any break from opioids, including after detox or jail. Keep naloxone on hand and make sure someone close to you knows how to use it.
Paying for MOUD and Finding a Program
Most coverage includes these medicines. Medicare Part B covers methadone, buprenorphine and naltrexone in a doctor’s office or through an opioid treatment program. At an enrolled OTP you pay no copayments, though the Part B deductible applies. SAMHSA lists 9,569 facilities that accept Medicaid. The Medicaid rehab guide and the insurance coverage guide explain what plans must cover, and the Can I Pay for Treatment? checker shows options by coverage and state. If you have no insurance, see free and low-cost rehab.
To find a program:
- Ask your primary care provider whether they prescribe buprenorphine or naltrexone.
- Search the treatment finder by ZIP and filter by medication, or browse treatment by state.
- Call SAMHSA’s National Helpline at 1-800-662-4357, free and confidential, 24 hours a day.
Medication can be combined with outpatient rehab or a residential program. The levels of care tool compares them. If you’re supporting a family member, the guide on how to help someone with addiction covers how to raise the subject.
Frequently Asked Questions
Can I Get Medication for Opioid Use Disorder Without Going to Rehab?
Yes. Buprenorphine can be prescribed in a regular doctor's office or by telehealth, and naltrexone can be prescribed by any licensed prescriber. You don't need to enter a residential program first. Methadone is the exception: for opioid use disorder it comes only from a certified opioid treatment program.
Do I Have to Go to Counseling to Get MOUD?
Counseling is strongly encouraged, but federal rules no longer make medication depend on it. SAMHSA says medication should not be made contingent on counseling, and opioid treatment programs cannot deny you methadone or buprenorphine because you decline counseling.
Is Lofexidine a Treatment for Opioid Use Disorder?
Lofexidine (Lucemyra) is FDA-approved to ease opioid withdrawal symptoms. NIDA notes it is not used for long-term treatment of opioid use disorder. It can help during detox, but it doesn't replace buprenorphine, methadone or naltrexone.
Can Teenagers Get Medication for Opioid Use Disorder?
Some can. SAMHSA says naltrexone isn't recommended for anyone younger than 18. The 2024 federal rule removed the old requirement that people under 18 show two failed treatment attempts before entering an opioid treatment program. See the guide to treatment for teens for programs that serve young people.
Should I Carry Naloxone if I'm Taking MOUD?
It's a good idea. SAMHSA warns that people who stop naltrexone can overdose on doses they used to tolerate, and mixing buprenorphine or methadone with alcohol or sedatives can cause overdose. Keep naloxone at home and tell the people close to you where it is.
Does Medicare Cover Methadone and Buprenorphine?
Yes. Medicare Part B covers methadone, buprenorphine and naltrexone when you get them in a doctor's office or through an enrolled opioid treatment program. At an enrolled program you pay no copayments, though the Part B deductible applies.
More on Medication Treatment
- Methadone ClinicsHow certified opioid treatment programs work
- Suboxone DoctorsWho can prescribe buprenorphine and where to find it
- Naloxone (Narcan)Over-the-counter naloxone and how to respond to an overdose
- DetoxWhat medical detox involves, how long it takes and where to find it
- Inpatient RehabHow residential treatment works, short and long-term programs
- Outpatient RehabTreatment while you live at home, and who it suits
This guide explains treatment options in plain language from official sources. It isn't medical advice; a clinician can assess what care fits your situation.
Sources
- SAMHSA: Buprenorphine
- SAMHSA: Methadone
- SAMHSA: Naltrexone
- NIDA: Medications for Opioid Use Disorder
- FDA: Information About Medications for Opioid Use Disorder
- CDC: Treatment of Opioid Use Disorder
- Medicare.gov: Opioid Use Disorder Treatment Services
- SAMHSA: 42 CFR Part 8 Final Rule for Patients
- SAMHSA FindTreatment.gov listing data, checked October 2026