Medically Reviewed By

Brittany Kowalski, LCSW, ACS, CCS

Clinical Director, Speranza Behavioral Health · Last clinically reviewed June 2026

What Is Medication-Assisted Treatment (MAT) and How Does It Work?

Despite being the most evidence-supported treatment available for opioid and alcohol use disorders, Medication-Assisted Treatment (MAT) is still surrounded by misconceptions — that it's "trading one addiction for another," that it's a crutch, or that "real recovery" means being medication-free. These misconceptions are not just wrong — they're dangerous, and they prevent people from accessing treatment that could save their lives.

This guide provides a thorough, evidence-based explanation of what MAT is, how each medication works, what the research shows, and what clients can expect when MAT is part of their treatment at Speranza Behavioral Health.

What Is Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) is the use of FDA-approved medications in combination with counseling and behavioral therapies to treat substance use disorders — primarily opioid use disorder (OUD) and alcohol use disorder (AUD). MAT addresses the neurobiological aspects of addiction that willpower, therapy, and motivation alone cannot fully overcome.

MAT is endorsed by:

• The Substance Abuse and Mental Health Services Administration (SAMHSA)
• The National Institute on Drug Abuse (NIDA)
• The American Society of Addiction Medicine (ASAM)
• The World Health Organization (WHO)
• The American Medical Association (AMA)

MAT Medications for Opioid Use Disorder

Buprenorphine (Suboxone, Subutex, Sublocade)

Buprenorphine is a partial opioid agonist — it activates opioid receptors enough to prevent withdrawal and reduce cravings, but with a "ceiling effect" that limits its euphoric potential and significantly lowers overdose risk compared to full agonists like heroin or oxycodone.

Suboxone combines buprenorphine with naloxone (an opioid blocker) to deter misuse — if injected, the naloxone component triggers immediate withdrawal.

How it helps:

• Virtually eliminates opioid withdrawal symptoms
• Dramatically reduces cravings
• Blocks the effects of other opioids (if someone relapses, they feel little to no effect)
• Can be prescribed by a licensed clinician and taken at home
• Reduces overdose mortality by 50–75% when used consistently

Sublocade is a monthly injectable form of buprenorphine — a single injection per month provides consistent therapeutic levels without the daily oral dose.

Methadone

Methadone is a full opioid agonist — it fully activates opioid receptors, eliminating withdrawal and cravings while stabilizing the brain's opioid system. Because of its full agonist properties, methadone for OUD treatment is only dispensed through federally licensed Opioid Treatment Programs (OTPs), where clients receive daily supervised dosing (with take-homes earned over time).

How it helps:

• Highly effective for severe, long-term opioid dependence
• Reduces illicit opioid use by 70–80% in research trials
• Shown to reduce criminal activity, HIV transmission, and overdose mortality
• Provides structure through daily clinic attendance

Naltrexone (Vivitrol)

Naltrexone is an opioid antagonist — it completely blocks opioid receptors, making opioids ineffective. It produces no opioid-like effects itself and has no abuse potential. Vivitrol is a once-monthly injectable formulation.

How it helps:

• Completely removes the reward from opioid use — if someone relapses, there is no high
• Once-monthly injection removes the daily compliance challenge
• Also FDA-approved for alcohol use disorder (reduces cravings significantly)
• Ideal for people who have already detoxed and are fully opioid-free (full detox required before starting)

MAT Medications for Alcohol Use Disorder

Naltrexone (Oral and Vivitrol)

For alcohol use disorder, naltrexone reduces the pleasurable effects of alcohol and significantly reduces cravings. Multiple randomized controlled trials have shown naltrexone reduces heavy drinking days by approximately 25%.

Acamprosate (Campral)

Acamprosate reduces the neurological imbalance that makes early sobriety so uncomfortable. It targets glutamate and GABA systems dysregulated by chronic alcohol use, reducing anxiety, restlessness, and dysphoria in early recovery.

Disulfiram (Antabuse)

Disulfiram creates an unpleasant physical reaction (flushing, nausea, heart palpitations) when alcohol is consumed — serving as a behavioral deterrent. Effectiveness depends heavily on compliance and motivation.

The "Trading One Addiction for Another" Myth

This is the most persistent and most damaging misconception about MAT. The claim is scientifically inaccurate for these reasons:

1. Physical dependence ≠ addiction. Someone taking blood pressure medication every day is physically dependent on it — but that's appropriate medical treatment, not addiction. The same is true of MAT.

2. Addiction is defined by compulsive use despite negative consequences, loss of control, and impaired functioning. A person on stable buprenorphine, holding a job, maintaining relationships, and engaged in therapy is recovering — not addicted.

3. The alternative is worse. The research is unambiguous: people with opioid use disorder who are NOT on MAT die at dramatically higher rates than those who are.

4. Duration is medically appropriate. Just as a person with hypertension may take medication indefinitely, the appropriate duration of MAT is determined by medical need — not by arbitrary time limits or recovery ideology.

What to Expect When Starting MAT at Speranza

At Speranza Behavioral Health, MAT is integrated into our PHP and IOP programs. Here's what the process looks like:

1. Comprehensive Assessment — Medical and psychiatric evaluation to determine appropriate medication, dose, and program level
2. Induction — Starting the medication safely, monitoring for response
3. Stabilization — Finding the therapeutic dose that eliminates withdrawal, cravings, and physiological instability
4. Maintenance — Continuing at therapeutic dose while engaged in therapy, building recovery skills and stability
5. Tapering (if appropriate) — If and when clinically indicated, a slow, medically supervised taper guided by the client's readiness and stability

MAT in Woodbury, NJ

Speranza Behavioral Health provides integrated MAT as part of our PHP and IOP programs in Woodbury, NJ — serving all of South Jersey. Insurance typically covers MAT.

Call (866) 814-0126 for a same-day confidential assessment.

Related Reading:

• Fentanyl Addiction: Signs, Dangers, and Treatment in NJ
• How Long Does Alcohol Detox Take?
• PHP vs. IOP: What's the Difference?

About the Author

Brittany Kowalski

Brittany Kowalski is a licensed clinical social worker (LCSW) and behavioral health advocate at Speranza Behavioral Health in Woodbury, NJ. With over a decade of experience in addiction recovery and mental health treatment, she specializes in dual diagnosis care, trauma-informed therapy, and evidence-based outpatient programs serving South Jersey communities.