Medications for Opioid Use Disorder (MOUD) are safe, FDA-approved treatments that significantly reduce overdose deaths, ease withdrawal, and help people sustain recovery. Despite strong evidence behind them, many people never access MOUD because of stigma, misinformation, or not knowing where to start. This page is here to change that.
What Is MOUD?
MOUD refers to three FDA-approved medications used to treat opioid use disorder (OUD). Each works differently, and each is a valid path to recovery. None of them is a substitute for “real” recovery — they are recovery.
Methadone
Methadone is a long-acting medication that has been used to treat opioid use disorder for more than 50 years. It works by activating the same brain receptors that opioids affect, but much more slowly and for much longer — relieving withdrawal and cravings without producing a high. Because methadone for OUD is a controlled substance, it must be dispensed through a federally certified Opioid Treatment Program (OTP), also called a methadone clinic. Patients typically go to the clinic daily, at least at first, to receive their dose.
Buprenorphine (Suboxone, Subutex, Sublocade, Zubsolv)
Buprenorphine is a partial opioid agonist — it activates opioid receptors, but only partially, which means it curbs cravings and withdrawal without producing a full opioid effect. It also has a “ceiling effect” that makes it much harder to overdose on than other opioids. It is commonly prescribed as a combination tablet with naloxone (brand name Suboxone) to discourage misuse.
Important news: As of 2023, the federal X-Waiver requirement was eliminated. This means that any DEA-licensed prescriber — including primary care doctors, nurse practitioners, and telehealth providers — can now prescribe buprenorphine for OUD. No special training or waiver is required. This is a major access improvement. Buprenorphine is also available as a monthly injection (Sublocade) for those who prefer not to take a daily medication.
Naltrexone (Vivitrol)
Naltrexone works differently from methadone and buprenorphine — instead of activating opioid receptors, it blocks them entirely. If someone on naltrexone uses opioids, they will feel no effect. It is not an opioid and has no abuse potential. However, a person must be fully detoxed from opioids (typically 7–10 days opioid-free) before starting naltrexone, or they will go into immediate withdrawal. It is available as a monthly injection (Vivitrol), which removes the daily pill burden. Naltrexone can be prescribed by any licensed physician, nurse practitioner, or physician assistant without any special certification.
Why MOUD Works: Key Facts
- An estimated 5.7 million people in the U.S. had opioid use disorder in 2023 — yet fewer than 1 in 5 are treated with MOUD medications.
- People treated with methadone or buprenorphine are significantly less likely to die or experience an overdose than those who do not receive medication.
- MOUD reduces risky behaviors associated with HIV and hepatitis C transmission.
- MOUD is safe and effective during pregnancy and breastfeeding and is the standard of care recommended by major medical organizations.
- The vast majority of recent overdose deaths involve illicitly manufactured fentanyl, often present in other drugs without the user’s knowledge. MOUD is one of the most effective tools we have to prevent these deaths.
Sources: National Institute on Drug Abuse (NIDA), updated March 2025. Read the full NIDA research report.
Getting Treatment: Where to Start
Call or text SAMHSA’s free helpline: 1-800-662-4357 (1-800-662-HELP) — free, confidential, 24/7, available in English and Spanish. They can refer you to local treatment, support groups, and community organizations. No insurance required.
FindTreatment.gov — the official federal treatment locator. Search by ZIP code to find substance use treatment facilities near you. You can filter by medication type, insurance accepted, and other services.
SAMHSA Medications for Substance Use Disorders — SAMHSA’s main MOUD hub with information about each medication, provider resources, and links to the most current guidance.
What’s Changed Recently
The X-Waiver is gone (2023). Before 2023, doctors who wanted to prescribe buprenorphine for opioid use disorder had to obtain a special federal waiver — a process that kept MOUD out of mainstream medicine for decades. The Consolidated Appropriations Act of 2023 eliminated this requirement entirely. Any DEA-licensed prescriber can now prescribe buprenorphine for OUD. This means your primary care doctor, OB-GYN, urgent care provider, or telehealth prescriber may now be able to help you — you no longer have to find a specialist.
Telehealth buprenorphine is here to stay. Rules established during the COVID-19 pandemic — and later made permanent — allow buprenorphine for OUD to be initiated and maintained entirely via video visit in many cases. This is a significant access improvement for people in rural areas or those with transportation and childcare barriers.
Note: Methadone for OUD treatment still requires a federally certified Opioid Treatment Program (OTP/methadone clinic). That has not changed.
Support for People on MOUD
Many traditional 12-step and abstinence-based communities do not fully welcome people on MOUD medications. If that’s been your experience, you are not alone — and there are communities built specifically for you.
Medication-Assisted Recovery Anonymous (MARA) International — A judgment-free community of people in medication-assisted recovery. Offers meetings and peer support for those whose recovery path isn’t accepted in traditional abstinence-only spaces.
Recovery Research Institute — Evidence-based, research-backed information about addiction and recovery written accessibly for general audiences. A great resource for patients, families, and anyone who wants straight answers grounded in science.
Faces & Voices of Recovery — The nation’s leading recovery advocacy organization, working to reduce stigma and expand peer support for all paths to recovery — including MOUD.
For Providers
ASAM National Practice Guideline — The American Society of Addiction Medicine’s authoritative clinical guideline for the treatment of opioid use disorder, covering all three FDA-approved MOUD medications.
Harm Reduction & Safety
National Harm Reduction Coalition — Overdose Prevention — Resources on naloxone access, syringe programs, and harm reduction strategies. MOUD is part of a broader continuum of care, and harm reduction meets people wherever they are.
Never Use Alone — If you use drugs alone, call first: 1-800-484-3731. A peer-staffed line where someone stays on with you and alerts emergency services if you become unresponsive. Free, 24/7, judgment-free.
Pittsburgh’s Local MOUD Resource
With generous funding from the Life Unites Us campaign, the Pittsburgh Recovery Walk supported the creation of a zine titled “Using Medication for Opioid Use Disorder? A Guide to Surviving and Thriving in the Pittsburgh Area.”
This guide was put together by a group of people who live in and around Pittsburgh. Some of us have personal experience with MOUD. All of us have been personally affected by addiction in some way, and we have all struggled with judgment and stigma. All of us agreed that the stigma of MOUD creates an additional burden for people who are trying to stay alive and get better. We think it’s time for a change.
The guide is available to view and download below (published June 2023). If the cost of printing is out of reach, or if you want to connect with the authors for any reason, please email moud.pgh@gmail.com.
A Guide to Surviving and Thriving in the Pittsburgh Area Download PDF