Medication-Assisted Treatment (MAT): What It Is, How It Works

Buprenorphine (Suboxone, Subutex, Sublocade)

A partial mu-opioid receptor agonist. At appropriate doses, it suppresses opioid withdrawal and craving and blocks the effect of additional opioids. Because it is a partial agonist, the respiratory depression risk is much lower than with full agonists like methadone or heroin; the dose-response curve flattens out.

Buprenorphine is The Archangel Centers' primary MAT option for opioid use disorder.

• Suboxone: buprenorphine combined with naloxone, taken sublingually (under the tongue) once daily. The naloxone deters injection misuse. The most widely used form.
• Subutex: buprenorphine alone, used in specific clinical situations (pregnancy, naloxone allergy).
• Sublocade: monthly injectable buprenorphine. Removes the daily medication ritual and supports long-term retention.

Naltrexone / Vivitrol

An opioid antagonist. Blocks the effect of opioids entirely. Requires a period of opioid abstinence before initiation (typically 7 to 10 days), or precipitated withdrawal will occur. Available as oral naltrexone (daily) or extended-release injection (Vivitrol, monthly).

Vivitrol is the option most often used at The Archangel Centers for clients who choose an antagonist approach after a sufficient opioid-free period, often after detox or an inpatient stay.

Methadone (referred out)

A full mu-opioid receptor agonist with decades of evidence for opioid use disorder. Dispensed only through federally licensed opioid treatment programs (OTPs), with daily dosing at the clinic for most patients. Methadone is not in our formulary; clients who need methadone are referred to a federally licensed OTP in their region. Methadone is a legitimate, evidence-based treatment, simply not one we deliver.

Myth: "MAT is trading one addiction for another."

The most common misperception, often repeated even in recovery communities. MAT medications, used as prescribed, do not produce the cycle of impairment, craving, and harm that defines an addiction. They restore function. Buprenorphine at therapeutic doses does not produce a "high" in opioid-dependent users. Naltrexone has no abuse potential at all. The American Society of Addiction Medicine, the American Medical Association, and SAMHSA all explicitly recommend MAT as the standard of care.

Myth: "Real recovery means medication-free."

Many people in long-term recovery use MAT for years or indefinitely and consider themselves fully recovered. Decisions about discontinuation are made carefully with the medical provider; for many, longer is safer.

Myth: "If I take MAT, I will be high all the time."

Buprenorphine at therapeutic maintenance doses does not produce impairment. People on MAT work, drive, parent, and live ordinary lives.

Myth: "MAT undermines 12-step recovery."

12-step communities vary in their stance on MAT. The official position of most major 12-step organizations is that MAT is a personal medical matter, not a barrier to membership. Many people in 12-step recovery are on MAT.

Myth: "I should be able to do it without medication."

There is no moral hierarchy of recovery paths. The most consistent finding in opioid use disorder treatment is that MAT-supported recovery produces dramatically better outcomes than abstinence-only approaches, including a substantial reduction in overdose deaths. Choosing the path that works is not a moral failure.