What Is Medication-Assisted Treatment (MAT)? How It Works, Medications and Cost

Medication-assisted treatment (MAT) combines FDA-approved medications with counseling to treat opioid and alcohol use disorders. Here's how MAT works, how methadone, buprenorphine and naltrexone compare, what insurance covers and how to find a provider.

Medication-assisted treatment, or MAT, uses FDA-approved medications along with counseling and support to treat substance use disorders. It is most often used for opioid use disorder, and it is also an option for alcohol use disorder. You may also see it called MOUD, which stands for medications for opioid use disorder.

MAT is one of the most effective treatments for opioid addiction. According to the New York State Office of Addiction Services and Supports, methadone and buprenorphine treatment reduce overdose deaths by up to 50%. Waypoint lists more than 7,900 programs that offer MAT, in all 50 states and Washington, DC.

If you or someone you love is in danger right now, call or text 988, or call 911.

How medication-assisted treatment works

Opioids change how the brain responds to pain, stress and reward. When someone stops using them, withdrawal and cravings can be intense, and that is often when people return to use. MAT medications work on the same brain systems to ease withdrawal, reduce cravings, or block the effects of opioids.

The medication is only part of the plan. Most MAT programs also include:

Counseling or therapy, individually, in groups, or both
Regular check-ins with a prescriber to adjust the dose
Recovery support, such as peer support, case management or help with housing and work

MAT is not "trading one drug for another." When taken as prescribed, these medications let people stabilize, think clearly and function day to day. The National Academies of Sciences, Engineering, and Medicine concluded that medications for opioid use disorder save lives.

Medications for opioid use disorder

There are three FDA-approved medications for opioid use disorder: methadone, buprenorphine and naltrexone.

Methadone

Methadone is a long-acting medication that prevents withdrawal and reduces cravings. It is taken by mouth once a day.

Where you get it: Only through a certified opioid treatment program (OTP), sometimes called a methadone clinic.
How often you go: At first, most people visit the clinic daily. Under federal rules updated in 2024, patients can receive take-home doses as early as the first week of treatment under certain conditions.
Good fit for: People with long-term or heavy opioid use, or who have tried other options without success.

Buprenorphine (Suboxone and others)

Buprenorphine eases withdrawal and cravings with a lower risk of overdose than full opioids. It is often combined with naloxone (the combination is sold as Suboxone and as generics). It comes as a film or tablet that dissolves under the tongue, or as a monthly injection.

Where you get it: From an opioid treatment program, or from a doctor, nurse practitioner or other prescriber in a regular office or by telehealth.
What changed: Prescribers used to need a special federal waiver (the "X-waiver") to prescribe buprenorphine for addiction. That requirement was eliminated in 2023, so any clinician with the right DEA registration can now prescribe it.
Good fit for: People who want treatment through a regular doctor's office and fewer clinic visits.

Naltrexone (Vivitrol)

Naltrexone blocks the effects of opioids and reduces cravings. For opioid use disorder it is given as a monthly injection (Vivitrol).

Where you get it: From any prescriber who can give the injection.
Important: You must be fully through opioid withdrawal before starting, usually 7 to 10 days without opioids. Starting too early can cause sudden withdrawal.
Good fit for: People who have already completed detox and want a non-opioid medication.

Comparing the three

| | Methadone | Buprenorphine | Naltrexone | |---|---|---|---| | How it works | Fully activates opioid receptors | Partly activates opioid receptors | Blocks opioid receptors | | How it's taken | Daily liquid or tablet | Daily film or tablet, or monthly shot | Monthly shot | | Where to get it | Opioid treatment program only | OTP, doctor's office or telehealth | Any prescriber | | Need to stop opioids first? | No | Mild withdrawal usually needed | Yes, about 7 to 10 days |

The best medication is the one that works for you and that you can stick with. Your prescriber will help you choose, and you can switch if your first option isn't a good fit.

Medications for alcohol use disorder

MAT also helps people cut back on or stop drinking. According to SAMHSA, the FDA-approved options include:

Naltrexone, as a daily pill or monthly injection, which reduces cravings and the "reward" from drinking
Acamprosate, a daily pill that helps ease the discomfort of staying sober after you stop drinking
Disulfiram, a daily pill that causes unpleasant symptoms if you drink

Many people with alcohol use disorder never hear about these options. If you are trying to stop drinking, ask your doctor whether one of them could help.

Who MAT is a good fit for

MAT may be a good fit if you:

Have been diagnosed with, or think you may have, opioid or alcohol use disorder
Have tried to stop on your own and had strong cravings or withdrawal
Have had an overdose or are at high risk of one
Are leaving detox, residential treatment, a hospital or jail, when overdose risk is especially high
Want treatment that fits around work, school or family

MAT can be part of any level of care, from weekly outpatient visits to intensive outpatient, partial hospitalization or residential treatment. Our guide to treatment levels of care explains how they fit together.

If you are pregnant, talk to a provider right away. Methadone and buprenorphine are both used during pregnancy, and stopping opioids suddenly can be risky for you and the baby.

How long does MAT last?

There is no set end date. Some people take medication for months, and many take it for years. Research and federal guidance treat MAT like care for other long-term conditions: you stay on the medication as long as it helps. Stopping should be a decision you make with your prescriber, not a deadline set by a program or a family member.

What MAT costs and what insurance covers

Cost depends on the medication, how often you visit and your coverage. The good news is that coverage has grown a lot in recent years.

Medicaid: Every state's Medicaid program must cover all FDA-approved medications for opioid use disorder, along with related counseling. That requirement was made permanent in 2024.
Medicare: Medicare covers medications for opioid use disorder, including methadone, buprenorphine and naltrexone, along with counseling and treatment services through opioid treatment programs and other providers.
Private insurance: Most plans cover MAT. Federal parity law requires coverage for addiction treatment on terms comparable to medical care, but prior authorization and copays vary. Our guide to insurance and rehab explains what to ask.
No insurance: Many opioid treatment programs and community health centers offer sliding scale fees or state-funded care. Call your state's addiction services agency or the SAMHSA National Helpline at 1-800-662-4357 (free, confidential and available 24/7).

Questions to ask a MAT provider

Before you start, it helps to ask:

Which medications do you offer, and can I switch if one isn't working?
How often will I need to come in? Do you offer telehealth visits?
Is counseling included, and is it required?
Do you take my insurance or Medicaid plan? What will I pay out of pocket?
How soon can I start? Do you offer same-day or next-day starts?
Do you provide naloxone (Narcan) to patients and families?

How to find MAT near you

You can search Waypoint for programs that offer medication-assisted treatment, then narrow results by location, insurance, telehealth and programs for specific groups. Waypoint lists more than 1,500 opioid treatment programs, which are the clinics that can provide methadone, and thousands more programs that offer buprenorphine, naltrexone or other MAT. You can also browse all services to compare levels of care.

Not sure where to start? Our free self-assessment guide can help you think through what kind of care you need.

Frequently asked questions

Is MAT just replacing one addiction with another?

No. Addiction involves compulsive use despite harm. MAT medications, taken as prescribed, are steady, controlled doses that reduce cravings and withdrawal so people can work, parent and rebuild their lives. Physical dependence on a medication is not the same as addiction.

Can I get Suboxone online?

Often, yes. Since the X-waiver was eliminated, many prescribers offer buprenorphine through telehealth. Rules for prescribing controlled medications by telehealth can change, so confirm the program's current process.

Do I have to go to a methadone clinic every day?

Usually at first, but not forever. Many patients earn take-home doses over time, and federal rules now allow take-homes earlier in treatment for patients who meet certain conditions.

Can I do MAT while living in sober housing?

Many recovery residences welcome residents on MAT, but not all do. Ask before you move in. Our guide to choosing a recovery residence covers what to look for.

Is MAT safe during pregnancy?

Methadone and buprenorphine are commonly used to treat opioid use disorder during pregnancy. Talk to a prescriber as soon as possible rather than stopping on your own.

This article is for general information and is not medical advice. Talk with a licensed provider about which treatment is right for you.