MAT (Medication-Assisted Treatment) for Opioid Use Disorder: What You Need to Know

Medication-assisted treatment, usually shortened to MAT, has become one of the most evidence-supported approaches to opioid use disorder, and also one of the most misunderstood. There’s a persistent belief in some circles that using medication to treat addiction is just replacing one drug with another, or that it’s a crutch rather than real recovery.

The clinical evidence says otherwise. Here’s what MAT actually is and what the research shows.

What MAT Is

Medication-assisted treatment is the use of FDA-approved medications, combined with counseling and behavioral therapies, to treat substance use disorders. The medications are one component of treatment, not a substitute for it.

For opioid use disorder specifically, three medications are FDA-approved.

Buprenorphine, often prescribed as Suboxone (which combines buprenorphine with naloxone), is a partial opioid agonist. It activates the same receptors as opioids but to a much lesser degree, reducing cravings and withdrawal symptoms without producing the euphoric high of full opioids. It can be prescribed by certified physicians and taken at home.

Methadone is a full opioid agonist that also reduces cravings and withdrawal. For opioid use disorder, it’s dispensed through federally certified opioid treatment programs, typically in daily clinic visits. It has the longest track record of any MAT medication and a well-established evidence base.

Naltrexone, often known by the brand name Vivitrol as a monthly injectable, is an opioid antagonist. It blocks opioid receptors entirely, so that if someone uses an opioid while taking it, they feel no effect. Naltrexone has no opioid activity, which makes it appropriate for people who want a non-opioid option. It requires being fully through withdrawal before starting.

What the Research Actually Shows

The evidence base for MAT for opioid use disorder is substantial.

Studies consistently show that people treated with buprenorphine or methadone have significantly lower rates of return to opioid use, lower rates of overdose, lower rates of infectious disease transmission, and higher rates of remaining in treatment compared to those who receive counseling or behavioral treatment alone.

A 2019 study in JAMA Psychiatry found that patients receiving buprenorphine or methadone had roughly half the overdose mortality of those receiving no medication. The evidence for methadone’s effectiveness has been building for decades.

Naltrexone has a strong evidence base for people who are able to complete detox and adhere to the medication. The injectable Vivitrol formulation was developed specifically to address the adherence challenges of the oral form.

Addressing the “Replacing One Drug with Another” Concern

Buprenorphine and methadone do activate opioid receptors. That’s part of how they work. They stabilize the opioid receptor system that chronic opioid use has disrupted. But using them for opioid use disorder is not the same as using opioids to get high. The experience is different, with no euphoria at therapeutic doses. The function is different, stabilization rather than intoxication. And the outcomes are different: reduced overdose risk, sustained recovery, a functional life.

Consider the parallel with blood pressure medication. A person takes it every day to manage a chronic condition. That’s appropriate medical management, not a sign that the underlying condition isn’t being treated. Opioid use disorder is a chronic brain disorder, and MAT is appropriate medical management for some people. The evidence supports it.

Dismissing MAT on principle, or steering people away from a treatment that the evidence shows saves lives, causes real harm.

MAT at Skypoint Virginia

Skypoint Virginia provides medication-assisted treatment as part of our integrated approach to opioid use disorder. Medications are prescribed and monitored by our clinical team, and MAT is combined with counseling and behavioral therapy, because the medication addresses the neurobiological component of opioid use disorder while therapy addresses the behavioral, psychological, and social dimensions.

Virginia Medicaid covers MAT, including the medications and the associated counseling.

Frequently Asked Questions

Is MAT considered “real” recovery?

Yes. The clinical community, SAMHSA, and the major addiction medicine organizations are clear: MAT combined with counseling is a fully legitimate evidence-based treatment for opioid use disorder. The stigma around it reflects outdated ideas about addiction, not the science.

How long do people stay on MAT?

It varies significantly by person. Some people stabilize and taper over months. Others benefit from long-term maintenance, sometimes years, and the evidence supports that approach for people who are stable and functional on medication. The right duration is a clinical decision, not a predetermined timeline.

Can I be on MAT and participate in 12-step programs?

Some 12-step groups are more accepting of MAT than others, and individual meetings vary. This is worth discussing with a counselor. Many people in MAT participate successfully in 12-step communities; others find alternative peer support groups a better fit.

Does Virginia Medicaid cover MAT?

Yes. Virginia Medicaid covers FDA-approved medications for opioid use disorder and associated counseling. Call 804-552-6985 to verify your specific plan’s coverage.

What if I’ve tried MAT before and stopped?

Previous MAT experience is useful clinical information. Understanding why it stopped, whether by choice or circumstance, helps inform what approach makes sense this time. Call us and we’ll talk through it.

If you or someone you love is dealing with opioid use disorder and you want to understand what MAT involves, whether it’s appropriate, and what coverage you have, we’re glad to talk it through. Call us at 804-552-6985 or contact our admissions team. The call is confidential, with no pressure to commit to anything.

Your Journey, Our Commitment.

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