Buprenorphine and methadone are considered the “gold standard” of addiction treatment, helping to mitigate withdrawal symptoms, suppress cravings, and facilitate recovery for people with opioid use disorder. Yet access to these medications is mired in red tape. Methadone is available exclusively at fixed-site clinics that almost all patients are required to attend daily to receive their dose, often waiting in line for hours to receive the medication that allows them to function. While buprenorphine is less controlled and can be prescribed by any medical provider, pharmacies will sometimes avoid stocking this lifesaving medication, and many providers choose not to prescribe.

Policies that constrain access to MAT are based on misguided stigma, not evidence. The fact is that MAT is an incredibly effective treatment, one with a higher success rate at treating opioid use disorder than almost any other medication at treating any other condition. Because MAT operates on the same receptors as opioid agonists like heroin, fentanyl, and oxycodone, people who use MAT experience a 62% reduction in fatal overdose risk. Adherence to MAT is also significantly higher than other treatment modalities. MAT doesn’t just save lives—it also gives people the long-term stability they need to rebuild while recovering from a substance use disorder.

The evidence is clear: we need expanded access to MAT now. Less than 20% of Americans with substance use disorder have ever accessed treatment, in part because of the cost barriers and the shame and stigma around divulging substance use. Policies that increase MAT access include requiring all pharmacies to stock buprenorphine, ensuring that no person is denied medication at the counter due to stigma; enhanced flexibility for MAT teleprescribing; and loosening the stringent rules around methadone dosing that waste hours of patients’ time. And we need more research into groundbreaking treatment options, like long-acting injectables and “MAT for methamphetamine,” where providers prescribe antidepressants with stimulating effects to mitigate withdrawal from and cravings for street stimulants. 

Investments in low-barrier MAT can foster recovery, reduce overdose, and encourage connections to care. Now is the time to push for evidence-based solutions like MAT that meet people where they are and give them a foundation to thrive.