What you’ll learn
This guide breaks down the three main medications used to treat opioid addiction, Suboxone, methadone, and naltrexone, so you can better understand how they work, who they’re for, and what to expect
Recovery isn’t a straight line. It twists. It hesitates. Sometimes it even loops back on itself. But one of the most important choices along the way is deciding how to treat opioid addiction. This decision (which you have the power to make) can change everything.
The science is clear: opioid use disorder is a medical condition, not a moral failure. And just like any other chronic illness, treatment works best when you tailor it to the individual.
That’s where medication-assisted treatment (MAT) comes in. Medications like Suboxone, methadone, and naltrexone don’t offer a quick fix, but they can offer stability. They quiet the noise of withdrawal, reduce cravings, and give people the space to heal. The right one depends on your history, your needs, and where you are in the process.
This guide is here to help you understand the differences between these medications for opioid use disorder (OUD) and MAT. It’s not meant to steer you toward one path, but to empower you to take that next step with the support of a medical provider who truly listens.
So let’s start with the basics: what exactly is MAT, and why is it such a powerful tool in recovery?
What is medication-assisted treatment (MAT)?
Medication-assisted treatment is a medical approach to treating opioid use disorder, combining FDA-approved medications with counseling or behavioral therapy to support long-term recovery from opioid addiction. MAT is more than just easing withdrawal symptoms. It focuses on giving people a real shot at lasting recovery by combining medications with behavioral support.
The medications used in MAT help by reducing cravings and easing withdrawal symptoms (which are often the most immediate barriers to recovery).
At the same time, therapy addresses the emotional and psychological challenges that often accompany addiction (like trauma, anxiety, or depression). Together, this two-part approach gives people like you or your loved ones a stronger foundation for long-term success.
Access to MAT and these medications makes a huge difference. Consider this: In Baltimore, Maryland, one of the U.S. cities hit hardest by the heroin epidemic, researchers tracked overdose deaths over a 15-year period. As access to methadone and buprenorphine treatment nearly quadrupled, heroin overdose deaths dropped by more than 60% from 1999 to 2009.
A big takeaway? The decline was especially strong after buprenorphine became widely available. In other words, fewer people died when people got access to treatment. That brings us to the three main medications used in MAT, each with its own approach, strengths, and considerations.
Currently, three medications are approved to treat opioid use disorder:
- Buprenorphine, often prescribed as Suboxone (buprenorphine/naloxone)
- Methadone, a long-established treatment option
- Naltrexone, available as a pill or long-acting injection
Each one works differently. And that matters. No two people’s experiences with opioids are exactly the same.
It’s also worth repeating: these treatments aren’t just “legal substitutes.” They’re evidence-based medications that help normalize brain chemistry. Most people on MAT don’t feel high; they feel like their in control again. They can show up for work, for family, for themselves.
When you take it as prescribed and combine it with counseling or peer support, MAT is one of the most effective ways to support recovery from opioid use disorder.
Let’s take a closer look at each option: starting with Suboxone.
How Suboxone works: stability with flexibility
Suboxone contains two active ingredients, and both serve a purpose:
- Buprenorphine gently activates opioid receptors, enough to reduce opioid withdrawal symptoms and cravings
- Naloxone blocks opioids and discourages misuse, especially if the medication is taken in a way it’s not intended
Taken under the tongue as a film or tablet, Suboxone works quietly in the background. It doesn’t produce the kind of high that causes instability. It just levels things out. For many, it’s the first time in a long time they’ve felt like themselves. Not sick. Just present.
One of the biggest advantages? Access.
Unlike methadone, which requires daily visits to a licensed clinic, Suboxone can be prescribed through a doctor’s office, or even via telehealth. QuickMD, for example, offers same-day appointments and prescriptions sent directly to your local pharmacy.
Suboxone may be a good fit if you:
- Have mild to moderate opioid dependence
- Need a flexible treatment plan that fits around work or family life
- Want to avoid daily clinic visits
- Are ready to start treatment sooner rather than later
But while Suboxone offers flexibility, when you start it really does matter.
Timing Matters on Suboxone
There’s one catch: when you start Suboxone matters. If you take it too soon after your last opioid use, it can trigger precipitated withdrawal (a rapid, more intense version of withdrawal).
That’s why working with a provider who knows how to guide you through that first dose is so important. Timing, support, and education make all the difference. For those who need more structure and support, methadone might be the better fit.
How methadone works: structured support for deep-rooted recovery
Methadone has been used to treat opioid addiction for decades. And there’s a reason it’s still around. It works, especially for people dealing with long-term or severe opioid use.
Methadone is what’s called a full opioid agonist. That means it fully activates the brain’s opioid receptors but does so in a slow, steady way. The result? Relief from withdrawal symptoms and cravings without highs and lows from drugs like heroin or fentanyl.
But methadone isn’t a take-home option right away. It’s administered through licensed opioid treatment programs (OTPs), usually requiring daily visits to start.
Methadone may be a strong option for those who:
- Have a long history of opioid use
- Struggle with high tolerance or multiple failed attempts at recovery
- Need daily accountability
- Prefer or benefit from in-person care
What to expect with methadone treatment
The process begins with an evaluation at a licensed clinic. Doses are adjusted over time to find the right balance; enough to stabilize, not sedate. Eventually, some patients earn the ability to take doses home, depending on stability and progress.
But it’s important to know: methadone carries a higher risk of overdose if misused, and tapering off methadone can be more gradual and complex than with other medications.
Another challenge? Access. In some rural or underserved areas, methadone clinics are limited, creating barriers for people who would otherwise benefit.
QuickMD does not prescribe methadone, but can help guide you to appropriate local treatment if it’s a better fit.
Then there’s naltrexone: a completely different approach for people who have already detoxed and want to stay opioid-free.
How naltrexone works: a no-opioid path to prevention
Naltrexone works differently from Suboxone and methadone. It doesn’t activate opioid receptors at all. Instead, it blocks them entirely. Picture a locked door. If you take opioids while naltrexone is active, they simply can’t reach the receptor. No high. No reinforcement. No reward.
This makes naltrexone especially helpful for relapse prevention, not withdrawal management. It’s not designed to reduce cravings or ease physical symptoms. Instead, it acts as a chemical safeguard, helping people stay opioid-free once they’ve completed detox.
There are two forms:
- A daily pill, which requires consistency and commitment
- A monthly injection (brand name Vivitrol), which removes the need for daily decision-making
Naltrexone may be a good fit for those who:
- Are already fully detoxed (opioid-free for 7-10 days)
- Are highly motivated to stay abstinent
- Have a strong support system
- Want or need a non-opioid treatment option
A different kind of challenge with naltrexone
The biggest hurdle with naltrexone is getting started. You need to be entirely off opioids before the first dose, or else it can cause precipitated withdrawal: that sudden, severe reaction that can be painful and dangerous. For some, making it through that detox period can be the most challenging part of treatment.
A study from a large toxicology hospital in Tehran looked at over 130 patients who took naltrexone while still opioid-dependent. Nearly all experienced severe agitation (96%), and many also had nausea, vomiting, diarrhea, abdominal pain, and changes in consciousness. These reactions often began within minutes of taking the medication.
Importantly, most patients recovered with medical support, and the study found that the dose of naltrexone didn’t matter as much as whether opioids were still in the system.
In other words, even small doses can cause strong reactions if the timing isn’t right.
For many, naltrexone offers peace of mind. It’s discreet. There’s no risk of misuse or dependence. And it acts as a chemical safety net during vulnerable moments.
As always, a healthcare provider can help you figure out if this path makes sense for where you are in your journey. Still not sure which direction to go? Here’s how these medications compare side by side.
Suboxone vs methadone vs naltrexone: which is right for you?
If you’re wondering which medication is “best,” the honest answer is: it depends.
What works for one person may not be the right fit for someone else. Your history, health, environment, and personal goals all shape that decision.
Here’s a simplified breakdown to help guide the conversation with your provider:
| Feature | Suboxone | Methadone | Naltrexone |
| How it works | Partial activation of opioid receptors + opioid blocker | Full activation of opioid receptors | Fully blocks opioid receptors |
| How you take it | Daily film or tablet under the tongue | Liquid, taken at a clinic (often daily at first) | Daily pill or monthly injection |
| Where it’s available | Doctor’s office or telehealth (like QuickMD) | Licensed opioid treatment programs (OTPs) | Doctor’s office or telehealth |
| Detox required before starting | Yes – usually 12-24 hours after last opioid use | No detox needed before starting | Yes – must be opioid-free for 7-10 days |
| Risk of misuse | Low to moderate | Higher if misused or unsupervised | Very low |
| Best for | Mild to moderate opioid use; need for flexibility | Severe dependence; need for structure | Post-detox, motivated for abstinence |
| If stopped suddenly | Possible withdrawal; tapering recommended | Difficult withdrawal; gradual taper needed | No withdrawal symptoms |
This isn’t a checklist to fill out on your own. It’s a starting point for a conversation. Your provider will also consider things like mental health conditions, past relapses, access to clinics, insurance coverage, and your support system.
As you explore your options, it’s also important to clear up some common myths that often get in the way of recovery.
Common misconceptions about addiction treatment
Even with years of research backing medication-assisted treatment, myths still hold power. These false beliefs can delay recovery or discourage someone from reaching out. Let’s clear a few of them up.
“Aren’t you just trading one addiction for another?”
No. Addiction is about loss of control, harmful consequences, and the inability to stop using. Medications like Suboxone and methadone (when prescribed and monitored) don’t create that uncertain day-to-day experience. They bring stability. People can go to work, care for loved ones, and start building again.
“Shouldn’t you just tough it out and quit everything?”
In theory, sure. But for many people, going “cold turkey” isn’t just painful, it’s unsafe. Withdrawal can be severe, and the brain changes caused by long-term opioid use don’t reverse overnight. MAT doesn’t weaken willpower; it gives people a fighting chance.
“You’re supposed to be off these meds in a few weeks, right?”
There’s no set timeline. Some people taper. Others stay on longer, or indefinitely (this is actually a smart move for prolonged recovery on Suboxone in particular). Recovery is about function and well-being, not hitting some imaginary finish line.
No matter where you stand, the right provider can help you navigate treatment safely and with confidence.
Why working with a provider matters
Starting treatment on your own, without medical guidance, can be risky. Not just physically, but emotionally. Withdrawal symptoms, medication timing, and unexpected reactions. These are best handled with support.
Here’s what a good provider can help with:
- Assessing your history and treatment goals
- Recommending the right medication and dose
- Helping you avoid precipitated withdrawal
- Monitoring for side effects and adjusting as needed
- Connecting you with therapy, support groups, or other services
Most importantly, a provider gives you someone in your corner, someone who knows how to navigate the process and won’t judge you for where you’ve been.
That’s where QuickMD shines.
Starting Suboxone treatment with QuickMD
For many, the hardest part of recovery is just getting started. Finding a clinic. Clearing your schedule. Navigating the system. It can feel like too much when you’re already overwhelmed.
That’s where QuickMD helps make things easier.
QuickMD connects you with licensed providers who understand addiction treatment and who can prescribe Suboxone safely, quickly, and privately.
No long waitlists. No clinic lines. Just a video visit from wherever you are.
Here’s what the process looks like:
- Book an appointment online, often for the same day
- Meet one-on-one with a provider via secure video chat
- Get a personalized evaluation and prescription if Suboxone is appropriate
- Pick up your medication at your local pharmacy
- Stay connected through regular follow-ups and support
This model works exceptionally well if you:
- Want to start treatment right away
- Prefer the privacy of home-based care
- Have limited access to clinics or transportation
- Need flexible, judgment-free support
QuickMD providers are trained to help with timing your first dose, guide you through side effects, and adjust your plan as needed. Most importantly, they’ll meet you where you are and walk with you toward where you want to be.
A quick note about your treatment options
QuickMD specializes in prescribing Suboxone (buprenorphine/naloxone) for opioid use disorder through fast, private telehealth visits. However, we don’t prescribe methadone or naltrexone.
If another medication might be a better fit for you, we’ll help guide you in the right direction. The SAMHSA Treatment Locator is a great place to start
No matter which path you choose, what matters is finding care that works for you. Recovery looks different for everyone, but you don’t have to do it alone.
Frequently asked questions (FAQs)
Can I switch from methadone to Suboxone?
Yes, but it requires careful planning. Methadone needs to be tapered to a lower dose before switching to Suboxone to avoid precipitated withdrawal. Your provider will help you time this safely and adjust your treatment based on how your body responds.
What if I’ve tried treatment before and relapsed?
You’re not alone, and you’re not disqualified. Relapse is part of many people’s recovery journey. MAT is designed to support long-term healing, and you can absolutely start again. A provider can help you restart safely, without shame or judgment.
Is it safe to start Suboxone if I still have opioids in my system?
Not quite. Starting Suboxone too soon after using opioids can trigger precipitated withdrawal, a sudden, intense version of withdrawal symptoms. That’s why timing is so important. A QuickMD provider will assess when it’s safe to start and guide you through those first critical hours.
