Medication treatment for opiate addiction
Buprenorphine, methadone and naltrexone in plain words: what they do, how long people take them and what they cost.
Find treatment near youUpdated October 2026. Sources are linked on this page.
The short answer
- What it is
- A daily or monthly medicine that stops withdrawal and cravings, usually alongside counseling.
- How long
- Often a year or more. Longer is linked to better results, and there is no set end date.
- What it costs
- Often little or nothing with Medicaid. With private insurance, a copay. Without insurance, clinics may charge on a sliding scale.
The three medications
| Buprenorphine | Methadone | Naltrexone | |
|---|---|---|---|
| How you take it | A film or tablet under the tongue, or a monthly shot | A daily liquid dose | A monthly shot |
| Where you get it | A doctor’s office, clinic or telehealth visit | A licensed opioid treatment program | Any prescriber |
| Good to know | You can start once withdrawal has begun | Dosed at the clinic, with take-home doses over time | You must be opioid-free for 7 to 10 days first |
All three are approved by the FDA for opioid use disorder. Buprenorphine and methadone ease withdrawal and cravings by acting on the same receptors opioids do, without the high when taken as prescribed. Naltrexone works differently: it blocks opioids from having an effect at all.
None of them is the “right” one for everybody. The best choice depends on what you have been using, how long, what is available near you and what fits your life. A prescriber can help you weigh them.
What the evidence says
Public findings, each linked to its source.
- 59% fewer
opioid overdose deaths in the year after an overdose among people who received methadone, and 38% fewer with buprenorphine. Source: National Institutes of Health
- 7 in 10
adults who have ever had a substance use problem say they are in recovery. Source: SAMHSA
What the first weeks look like
First visit
Health history and a plan.
First dose
Withdrawal eases within hours.
Finding your dose
Adjusted over days or weeks.
Staying steady
Regular check-ins and support.
The first visit is mostly talking: what you have been taking, your health, and what you want from treatment. With buprenorphine, you usually wait until withdrawal has started before the first dose, because taking it too early can make you feel worse. Most people feel relief within a few hours.
The dose is then adjusted until cravings and withdrawal stay quiet through the day. After that, visits space out. Many programs add counseling or peer support, which helps but is not required to start medication.
What it costs
With no insurance
Sliding-scale clinics and state-funded programs can help.
See your options: With no insuranceFind medication treatment in your state
Real, licensed facilities from public records. No paid placements.
Questions people ask us
Is this just trading one drug for another?
No. Taken as prescribed, buprenorphine and methadone do not produce a high. They hold withdrawal and cravings steady so a person can work, parent and think clearly, and they sharply lower the risk of overdose.
Will I be on it forever?
Not necessarily. Some people taper off after a year or two and some stay on longer. There is no required end date, and stopping too early raises the risk of relapse and overdose. The decision is yours to make with your prescriber.
Can I work and drive while taking it?
Most people can once their dose is stable. You may feel drowsy in the first days or after a dose change, so check with your prescriber before driving during that time.
Can I start through telehealth?
Often, yes, for buprenorphine. Many clinics can prescribe it after a video or phone visit. Methadone has to be started in person at a licensed opioid treatment program.
Sources
- SAMHSA: Medications for Substance Use Disorders
- NIDA: Medications for Opioid Use Disorder
- NIH: Methadone and buprenorphine reduce risk of death after opioid overdose
- FDA: Information about Medications for Opioid Use Disorder
This page is general information, not medical advice. Talk with a clinician about your own situation.