Medication-Assisted Treatment 

for Opioid Addiction
 

Facts for Families and Friends
 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

Center for Substance Abuse Treatment 

www.samhsa.gov 
 

 

 

 

 

 

 

“A lot of times family members just think 

that there’s just a ‘say no’ type approach, 

that if you’re not gonna get high, end of 

story, it should be all better, let’s go 

back to life as we knew it. They fail to 

understand that sometimes...we quit being 

the family member that loved ones thought 

we were. We become somebody else.” 

Mike M. 

Has an opioid addiction turned someone you care about into 

“somebody else”? Is there something that can be done to 

help your friend or loved one overcome this addiction? 

Medication-assisted treatment is one way to help those with 

opioid addiction recover their lives. There are three, equally 

important parts to this form of treatment: 

•	Medication 

•	Counseling 

•	Support from family and friends. 

These three parts work together to help people recover. 

Medication-assisted treatment may be helpful to your friend 

or loved one. 

NOTE: Important words often used in treatment are introduced in this booklet in bold type. 

ii 
Opioids are powerful drugs. 

Opioids are drugs that slow down the actions of the body, such 

as breathing and heartbeat. Opioids also affect the brain to 

increase pleasant feelings. They get their name from opium, a 

drug made from the poppy plant. 

People take opioids for medical 

reasons. 

Doctors prescribe opioid medication to treat pain and sometimes for other health problems such as severe coughing. The 

medication comes in a pill, a liquid, or a wafer. It also comes in 

a patch worn on the skin. Examples of prescribed opioid medications include: 

•	Codeine—an ingredient in some cough syrups and in one 

Tylenol® product 

•	Hydrocodone—Vicodin®, Lortab®, or Lorcet® 

•	Oxycodone—Percocet®, OxyContin®, or Percodan® 

•	Hydromorphone—Dilaudid® 

•	Morphine—MSContin®, MSIR®, Avinza®, or Kadian® 

Propoxyphene—Darvocet® or Darvon® 

•	Fentanyl—Duragesic® 

•	Methadone.

1 

1
	 	

People sometimes misuse opioids. 

Opioid medications are sometimes misused to self-medicate or 

to get a good feeling, called a “rush” or “high.” People misuse 

medications by taking their own prescriptions improperly, stealing medications, going to multiple doctors to get extra, or buying them from drug dealers. Sometimes to get high they drink a 

large amount of liquid medicine or crush a lot of pills to ingest, 

snort, or inject. And some people seek a high from heroin, an 

illegal opioid that can be smoked, snorted, or injected. 

Opioids have side effects. 

A person who takes opioids can become tolerant to them. 

This means that more of the drug is needed to obtain its 

effects. It is also possible to become dependent on opioids— 

to feel sick if there are no opioids in the body. This sickness is 

called withdrawal. 

Tolerance and dependence are common side effects of prescribed opioid medication. If tolerance is a problem, doctors 

may adjust the person’s dose or change the medication. People 

who have become dependent on opioid medication but are 

ready to stop taking it can taper off (take less and less) to 

avoid withdrawal. This should be done under a doctor’s care. 

Tolerance and dependence also occur in people who misuse 

medications or take heroin. Over time, such people often begin 

to feel uncomfortable without the opioid. They need to take it 

just to feel normal. 

2 
	 	

	 	

Opioids can be addictive. 

Addiction is a disease that results when the opioid has made 

changes to the brain. A person using medication properly is not 

likely to get addicted, but this sometimes happens. Addiction 

usually occurs through misuse. Some people are at higher risk 

of addiction because of their genes, temperament, or personal 

situation. The signs of addiction are: 

•	Craving—The mind develops an overwhelming desire for 

the drug. 

•	Loss of control—It becomes harder to say no to using 

the drug. Use is compulsive and continues even when it 

causes harm. 

It is not usually possible to taper off an addiction. More help 

is needed because the cravings are so strong and the fear of 

withdrawal is so great. 

Opioid addiction can be treated. 

Opioid addiction is a chronic disease, like heart disease or 

diabetes. A chronic disease is a medical condition for life. 

It cannot be cured, but it can be managed. A person with 

addiction can regain a healthy, productive life. 

3 
 

 

 

Most people cannot just walk away from addiction. They need 

help to change addictive behavior into nonaddictive, healthful 

patterns. They can get this help with treatment—with the care 

of doctors and substance abuse treatment providers. 

Treatment helps people stop using the problem drug. It helps 

them get through withdrawal and cope with cravings. Treatment 

also helps them move away from other harmful behaviors, such 

as drinking alcohol or abusing other drugs. 

Just as important, treatment helps people address life issues 

they might have that are tied to the addiction, such as feelings 

of low self-worth, a bad situation at work or home, or spending time with people who use drugs. In short, treatment helps 

people move into healthy, addiction-free lifestyles—into a way 

of living referred to as recovery. 

Treatment may include medication. 

Medication-assisted treatment is treatment for addiction 

that includes the use of medication along with counseling and 

other support. Treatment that includes medication is often the 

best choice for opioid addiction. 

44 
 

 

 

 

 

If a person is addicted, medication allows him or her to regain 

a normal state of mind, free of drug-induced highs and lows. It 

frees the person from thinking all the time about the drug. It 

can reduce problems of withdrawal and craving. These changes 

can give the person the chance to focus on the lifestyle changes 

that lead back to healthy living. 

Taking medication for opioid addiction is like taking medication 

to control heart disease or diabetes. It is NOT the same as 

substituting one addictive drug for another. Used properly, the 

medication does NOT create a new addiction. It helps people 

manage their addiction so that the benefits of recovery can 

be maintained. 

There are three main choices for 

medication. 

The most common medications used in treatment of opioid 

addiction are methadone and buprenorphine. Sometimes 

another medication, called naltrexone, is used. Cost varies for 

the different medications. This may need to be taken into 

account when considering treatment options. 

Methadone and buprenorphine trick the brain into thinking it 

is still getting the problem opioid. The person taking the medication feels normal, not high, and withdrawal does not occur. 

Methadone and buprenorphine also reduce cravings. 

Naltrexone helps overcome addiction in a different way. It 

blocks the effect of opioid drugs. This takes away the feeling 

of getting high if the problem drug is used again. This feature 

makes naltrexone a good choice to prevent relapse (falling 

back into problem drug use). 

All of these medications have the same positive effect: they 

reduce problem addiction behavior. 

5
All three medications come in pill form. Methadone also comes 

as a liquid and a wafer. Methadone is taken daily. The other two 

medications are taken daily at first. After time, buprenorphine 

is taken daily or every other day, and doses of naltrexone are 

taken up to 3 days apart. 

Methadone to treat addiction is dispensed only at specially 

licensed treatment centers. Buprenorphine and naltrexone are 

dispensed at treatment centers or prescribed by doctors. A 

doctor must have special approval to prescribe buprenorphine. 

Some people go to the treatment center or doctor’s office 

every time they need to take their medication. People who are 

stable in recovery may be prescribed a supply of medication to 

take at home. 

Medication is matched to the person. 

When a person decides to try medication-assisted treatment, 

the first step is to meet with a doctor or other medical staff 

member. This first meeting is called an assessment. The 

person is asked questions such as: 

•	How long have you been taking the opioid drug? 

•	Are you taking any other drugs? 

6 
 

 

 

•	Do you drink alcohol? 

•	What are your drug-taking and drinking habits and patterns? 

•	Have you been in treatment before? 

•	Do you have other health problems? 

•	Are you taking any medicines? 

•	Have you ever had reactions to medicines? 

•	Are you pregnant? 

•	Do you have any special needs? 

•	What are your goals for recovery? 

•	Do you have family or friends to support you through treatment? 

During this meeting, the person learns about treatment choices, 

rules that must be followed to stay in treatment, and what to 

expect next. 

A physical exam also is part of the assessment. This exam finds out 

about the person’s general health. It also checks for diseases that 

are common to people who have been abusing drugs. The exam 

often includes a drug test. This is usually a check of urine or saliva. 

After the assessment, the doctor or substance abuse treatment 

provider discusses treatment choices with the person, who 

may choose to include family or friends in the discussion. 

The person agrees to a treatment plan. This covers: 

•	The goals for treatment 

•	The decision on which medication to use and the dose level 

to start 

•	The schedule for visits to the treatment center 

•	The plan for counseling 

7 
 

 

 

 

•	Other steps to take, such as attending a support group 

•	How success toward goals will be measured. 

The plan describes what happens if it is not followed. The 

person may be asked to sign a form showing that he or she 

agrees to follow the plan. 

Medication is introduced carefully. 

Methadone can be safely taken at the start of recovery. Buprenorphine can be taken once withdrawal has begun. Naltrexone 

cannot be taken until opioids are completely out of the body, 

usually 7 to 10 days after withdrawal begins. Taking buprenorphine 

or naltrexone too soon can make withdrawal worse. 

Medical staff members meet with the person a few hours after the 

first dose is taken and regularly for a week or two. These meetings 

are to make sure the medication is working, that side effects are 

not too uncomfortable, and that the person is taking medication 

exactly as told. Following directions is important, because taking 

the medication improperly can lead to overdose or death. 

88 
WitHdrAWAL	SyMPtOMS	

•	Yawning and other 

sleep problems 

•	Sweating more than 

normal
 

•	Anxiety or nervousness 

•	Muscle aches and pains
 

•	Stomach pain, nausea, 

or vomiting
 

•	Diarrhea 

•	Weakness 

If the medication is not working as expected, the doctor may 

adjust the dose up or down or prescribe a different medication. 

The person may feel some symptoms similar to withdrawal as 

adjustments are made. 

Methadone and buprenorphine can cause drowsiness at first. 

For this reason, a person starting on either medication should 

not drive or perform other high-risk tasks, to avoid accidents. 

If drowsiness continues to be a problem, the doctor may adjust 

dose levels. 

The right medication has been found when the person feels 

normal, has minor or no side effects, does not feel withdrawal, 

and has cravings under control. 

Medication can be taken safely for years. 

People can safely take treatment medication as long as needed— 

for months, a year, several years, even for life. Sometimes 

people feel that they no longer need the medication and would 

like to stop taking it. Use of methadone and buprenorphine 

must be stopped gradually to prevent withdrawal. Stopping 

naltrexone does not cause withdrawal. Plans to stop taking a 

medication should ALWAYS be discussed with a doctor. 

9 

9
 

 

 

Counseling can help. 

Many people on medication-assisted treatment benefit from 

counseling—from the opportunity to talk with a professional 

either one-on-one or in a group with others in treatment. 

Through counseling, people learn about the disease of addiction. 

They also learn why the addiction occurred, the problems it has 

caused, and what they need to change to overcome those problems. 

Counseling can provide encouragement and motivation to stick to 

treatment. It can teach coping skills and how to prevent relapse. 

And, it can help people learn how to make healthy decisions, 

handle setbacks and stress, and move forward with their lives. 

In group counseling, people connect with others in treatment 

and make new friends who don’t use drugs. They can get these 

benefits from support groups, too. These are informal meet

ings of people facing similar challenges. 

Family and friends are important, too. 

It is very hard to go through recovery alone. Support from 

family and friends is very important. Love and encouragement can 

help a person make the decision to enter treatment and stick with it. 

Family and friends can provide help in practical ways—for 

example, by offering rides to treatment, a safe place to live, or 

help finding work. Family and friends also can help the person 

in recovery avoid or overcome setbacks. 

Some treatment programs offer counseling for loved ones. 

­

They do this because being close to a person with addiction can 

be very hard and can cause pain and anger or feelings of shame 

and hopelessness. 

10 
 

Counseling is a useful way for family and friends to learn more 

about the person’s situation, how to help, and how to handle 

the problems their loved one’s addiction has caused them, too. 

It is a safe place to express feelings and to find out what help is 

available for them. 

There are support groups, too, that are just for family and 

friends. These are safe places to share information and encourage others who have loved ones who are dealing with addiction. 

Many people overcome opioid addiction and regain normal, 

healthy lives. One way they do this is with medication-assisted 

treatment. Medication, counseling, and support: together they 

can help your loved one or your friend. 

“Recovery is work. It’s a lifetime of work

with the biggest payoff.” 

Tim S. 

11 
12

WArningS

•	Medications kept at home must be locked in a safe place. If 

children take them by mistake, they can overdose or die. 

This is especially true for methadone, because it often comes 

as a colored liquid. Children can mistake it for a soft drink. 

•	All three medications have side effects in some people, such as

upset stomach and sleep problems. These are usually minor. 

•	People on any of these medications should be checked by a

doctor for liver problems. 

•	People on any of these medications should talk to their doc

tor before stopping or starting any other medications. 

•	Women should let their substance abuse treatment provider

know if they are pregnant or breast-feeding. Only metha

done is recommended for these women. 

•	Be aware of the signs of methadone overdose:

- Trouble breathing or shallow breathing

- Extreme tiredness or sleepiness

- Blurred vision

- Inability to think, talk, or walk normally

- Feeling faint, dizzy, or confused.

Anyone on methadone who has these symptoms should get 

medical attention immediately. NOTE: Overdose is less likely 

with buprenorphine and unlikely with naltrexone. However, to 

avoid problems, any medication for opioid addiction should be 

taken exactly as the doctor prescribes. 

•	People on any of these medications should NOT use other

opioid medications or illegal drugs. They should NOT drink 

alcohol or take sedatives, tranquilizers, or other drugs that slow 

breathing. Taking any of these substances in large amounts along 

with the treatment medication can lead to overdose or death. 

­

­

12 
		

	 	 	

	 	 	 	 	 	 	

	 	

	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	

	 	

Addiction

WHAt’S	true And WHAt’S	nOt

Addiction is a disease. It cannot be cured, but it can 

be treated with medication, counseling, and support 

from family and friends. Addiction is NOT a sign of 

weakness. It is NOT TRUE that all anybody needs to 

kick addiction is to “be strong.” 

the goal of medication-assisted treatment is to

recover from addiction. It does NOT replace one 

addictive drug with another. It provides a safe, controlled level of medication to overcome the use of a 

problem opioid. 

A substance abuse treatment provider must

obtain informed consent (agreement in writing)

before sharing information about patients.

There are two exceptions to this privacy rule: (1) if it 

appears that patients may harm themselves or others 

and (2) if patients have been ordered into treatment 

by the courts. To learn more about privacy rights, talk 

to a substance abuse treatment provider. 

recovery is possible. But it takes work. After treatment is finished, everything is NOT automatically fine 

again. Recovery takes commitment every day, through 

treatment and beyond. 

the Facts

13 

13
oals

g

goal 1: Withdraw from the problem opioid.

This stage is also called detoxification or detox. 

_____ Stop taking the opioid drug. 

_____ Work with the doctor to select a medication. 

_____ Reflect on whether use of alcohol or other drugs is 

interfering with recovery. 

_____ Receive medical treatment to improve overall health. 

_____ Begin counseling to improve health, behavior, and 

coping skills. 

goal 2: Begin recovery.

_____ Work with the doctor to adjust the medication and 

dose as needed. 

_____ Replace unhealthy behaviors with healthy behaviors. 

For example, join a support group, find a new hobby, 

or look for a job. 

_____ Work to improve or repair relationships. 

_____ Learn to recognize and avoid triggers (places or 

activities that cause drug cravings to come back). 

_____ Learn how to avoid relapse. 

gOALS	FOr	reCOvery

A	gOAL	FOr ALL	StAgeS:

Many people in treatment relapse one or more times before 

getting better and remaining drug free. Each relapse is a setback, but it does not mean failure. People who relapse can 

continue with treatment and achieve full recovery. 

A person can prevent relapse by staying away from triggers, 

for example, by avoiding former drug-use hangouts and staying 

away from friends who use drugs. 

Another way to prevent relapse is to guard against impatience 

or overconfidence. A person who makes these statements (or 

14 
goals

in MediCAtiOn-ASSiSted	treAtMent

_____ Learn to take medication at home (if permitted by 

program, State, and Federal rules). 

_____ Get random drug tests. 

goal 3: Stay in recovery.

_____ Keep a normal routine. For example, work or go to 

school, go to support groups or counseling, build 

relationships, and have fun. 

_____ Schedule regular visits with the doctor to check dose 

levels and to get refills. 

_____ Continue to avoid triggers and relapse. 

_____ Get random drug tests. 

goal 4: Live addiction free.

_____ Keep strong habits of healthy behavior. 

_____ Check in with the doctor or substance abuse treatment 

provider every 1 to 3 months. 

_____ Continue to draw strength from family, friends, and 

support groups. 

_____ Continue in counseling for other issues, as needed. 

g oals

AvOid	reLAPSe	And	triggerS

even thinks them) might need to return to an earlier goal 

for recovery: 

“This treatment isn’t working!”
 

“I thought I wasn’t supposed to feel cravings.”
 

“I’m cured! I can control it if I only use with my friends.”
 

“There’s no way I can relapse!”
 

“I can stay away from drugs by myself.”
 

“When I got high, I had so much fun! I never had problems.”
 

15 
	 	 	 	 		

	 	 	

Support groups and information 

•	This is not a complete list. Listing here does not mean that 

the Substance Abuse and Mental Health Services Administra

tion (SAMHSA) endorses any of the organizations. 

•	Some support groups have abstinence-only policies and do 

not look favorably on medication-assisted treatment. The 

programs listed here do not have abstinence-only policies, 

but individual group meetings vary. You may need to try 

several support groups to find the right one. 

•	Some support programs are for people with a substance 

use disorder, and others allow families and friends to attend 

meetings or have separate meetings for them. Check with 

each organization for details. 

•	An Internet-based support group may be your best option 

if no groups meet in your community. Another option is to 

contact Alcoholics Anonymous (AA, http://www.aa.org) to 

find out whether AA meetings in your community are open 

to people in recovery from other substances besides alcohol. 

­

dual recovery Anonymous

 http://www.draonline.org or 913-991-2702 

Lifering

 http://www.unhooked.com or 800-811-4142 

Methadone Anonymous

 http://www.methadoneanonymous.info 

national Alliance of Advocates for Buprenorphine

treatment

 http://www.naabt.org 

national Alliance of Methadone Advocates

 http://www.methadone.org or 212-595-NAMA (6262) 

rational recovery

 http://www.rational.org or 530-621-4374 

1616 
17 

	 	

	 	

Secular Organizations for Sobriety

 http://www.cfiwest.org/sos/index.htm or 323-666-4295 

SMArt	recovery

 http://www.smartrecovery.org or 866-951-5357 

Women for Sobriety,	inc.

 http://www.womenforsobriety.org or 215-536-8026 

Substance abuse treatment facility 

locator 

800-662-HELP (4357) (English and Español) 

800-487-4889 TDD (for hearing impaired) 

http://dasis3.samhsa.gov 

Free booklets 

•	The Facts About Buprenorphine for Treatment of Opioid 

Addiction (SMA) 09-4442 (also in Spanish) 

•	The Facts About Naltrexone for Treatment of Opioid 

Addiction (SMA) 09-4444 (also in Spanish) 

•	Introduction to Methadone (SMA) 06-4123 

•	Faces of Change: An Illustrated Booklet for Consumers 

(SMA) 08-4174 

•	What Is Substance Abuse Treatment? A Booklet for Families 

(SMA) 08-4126 (also in Spanish: (SMA) 08-4098) 

•	Motivación para el Cambio (Spanish only) (SMA) 06-4170 

Electronic access and printed copies 

This publication may be ordered from SAMHSA’s Publications 

Ordering Web page at http://www.store.samhsa.gov. Or, please 

call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and 

Español). The document can be downloaded from the KAP Web 

site at http://www.kap.samhsa.gov. 
“For me, recovery is about creating 

a better life for myself and for 

my family and ultimately for my 

community. Because when I’m better, 

they’re all better.”

Tom C.

ACknOWLedgMentS

This publication was prepared for the Substance Abuse and Mental Health Services 

Administration (SAMHSA) by the Knowledge Application Program (KAP), a Joint Venture 

of The CDM Group, Inc., and JBS International, Inc., under contract number 270-04-

7049, with SAMHSA, U.S. Department of Health and Human Services (HHS). Christina 

Currier served as the Government Project Officer.

All material appearing in this publication is in the public domain and may be reproduced 

or copied without permission from SAMHSA. Citation of the source is appreciated. 

However, this publication may not be reproduced or distributed for a fee without 

specific written authorization from the Office of Communications, SAMHSA, HHS. 

This publication may be ordered from SAMHSA’s Publications Ordering Web page 

at http://www.store.samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 

(1-877-726-4727) (English and Español). The document can be downloaded from 

the KAP Web site at http://www.kap.samhsa.gov.

HHS Publication No. (SMA) 09-4443 

First printed 2009 

Revised 2011