Medication for addiction treatment: what it is and whether it works

This page is general information, not medical advice. Do Not Lose Hope does not provide treatment or crisis help. Talk with a doctor before you start or stop any medicine.

Is medicine for addiction just trading one drug for another?

No. This is the most common worry, and federal health officials answer it directly. SAMHSA, the U.S. agency for substance use treatment, says these medicines are evidence based and "do not just substitute one drug for another" (SAMHSA, checked October 21, 2026).

Here is the difference. Addiction drives cravings and withdrawal that take over a person's life. These medicines calm the cravings and withdrawal at a steady, prescribed dose. That gives the brain and body a chance to settle, so the person can work, parent, sleep and get counseling.

SAMHSA says medicine plus counseling has been shown to:

• improve survival
• keep more people in treatment
• cut illegal opioid use and related crime
• help people get and keep jobs
• improve birth outcomes for pregnant women with a substance use disorder

It can also lower the risk of HIV and hepatitis C by reducing relapse (SAMHSA).

We know some families and recovery groups still see medicine as "not really clean." That belief keeps people from care that works. A person taking a prescribed medicine as directed is in treatment.

What medicines treat opioid addiction?

The FDA has approved three main medicines for opioid use disorder: methadone, buprenorphine and naltrexone (SAMHSA). SAMHSA says they are safe for long term use, from months to a lifetime, and that you should talk to your doctor before stopping.

Methadone. A long acting medicine taken daily, as a liquid, powder or tablet. For opioid addiction, it can only be given through a SAMHSA certified opioid treatment program (OTP, sometimes called a methadone clinic). At first you go in to take your dose. Once you are stable, the program may let you take some doses at home. These programs must also offer counseling. SAMHSA cites a recommended minimum of 12 months of treatment, and some people need it long term (SAMHSA, Methadone, checked October 21, 2026).

Buprenorphine. Often combined with naloxone in one product. It can be prescribed in a regular doctor's office, which makes it easier to get than methadone. Its effects are weaker than full opioids, which makes it safer in an overdose and less likely to be misused. To start, a person usually must go 12 to 24 hours without opioids and be in early withdrawal. Treatment length is set for each person and can be indefinite (SAMHSA, Buprenorphine, checked October 21, 2026).

Naltrexone. A monthly shot (extended release) approved for both opioid and alcohol use disorder. It blocks the effects of opioids rather than acting like one (SAMHSA).

Safety basics from SAMHSA:

• Never take more than prescribed, and never share your medicine.
• Do not drink alcohol or use sedatives with methadone or buprenorphine. Mixing can cause overdose or death.
• Lock medicine away from children. Liquid methadone can look like juice.
• Call 911 if someone took too much or you suspect an overdose.

Pregnant? SAMHSA says women who are pregnant or breastfeeding can safely take methadone, and that it does not cause birth defects. Withdrawal during pregnancy can be risky. Some babies may have withdrawal after birth, so talk with your doctor (SAMHSA, Methadone).

What medicines treat alcohol addiction?

The most common are acamprosate, disulfiram and naltrexone. They do not cure the disorder. SAMHSA says they work best for people who are also in a treatment program (SAMHSA).

If you have been drinking heavily for a long time, do not quit suddenly on your own. Stopping suddenly can bring painful, even life threatening, withdrawal (NIAAA). Ask a doctor or call your county line first. Your county can arrange a safe detox.

Is counseling required?

SAMHSA describes medicine plus counseling as the "whole patient" approach. But in California's county drug treatment system, DHCS says a provider must give you the medicine even if you decline counseling (DHCS BHIN 21-024, checked October 21, 2026). Counseling is still strongly encouraged, and many people find it helps.

Can a treatment program turn me away because I take medicine?

No, not for that reason alone. A licensed California alcohol or drug recovery or treatment facility may not deny you admission based only on a valid prescription for an FDA approved addiction medicine (Health and Safety Code 11834.26(d), checked October 21, 2026). It also must keep at least two doses of naloxone on site.

Since January 1, 2026, licensed programs also may not deny admission only because you used or are under the influence, and must have a plan for a return to use that tries to keep you connected to care (DHCS BHIN 26-006, checked October 21, 2026). See Your rights in a drug or alcohol treatment program.

In county Drug Medi-Cal programs, every provider must offer medicine directly or have a working referral to it. Opioid treatment programs must offer methadone, buprenorphine, naltrexone, naloxone and disulfiram (DHCS BHIN 21-024).

Where do I start in California?

1. Call your county access line. San Mateo County Behavioral Health and Recovery Services offers detox, outpatient, residential and medication assisted treatment. Consultation, assessment and referral are free, and the county says no one is turned away for lack of funds (San Mateo County Health, checked October 21, 2026). Santa Clara County's 24/7 call center screens and refers people with Medi-Cal, Medicare or no insurance.
2. Or ask your own doctor or clinic about buprenorphine.
3. Or go to an emergency room in a crisis. CA Bridge is a California program working to make addiction care, including medication, available 24/7 in hospital emergency departments (CA Bridge, checked October 21, 2026).

You can call a county line for someone you are worried about (San Mateo County BHRS). For a step by step guide, see How to find drug and alcohol treatment for an adult.

How do I pay for it?

• Full scope Medi-Cal covers medication treatment through county drug programs and opioid treatment programs (DHCS BHIN 21-024).
• Starting January 1, 2027, Medi-Cal members with unsatisfactory immigration status move to Fee for Service, and county substance use services continue (DHCS, checked October 21, 2026).
• Adults 19 and older without a qualifying status can no longer newly enroll in full Medi-Cal since January 1, 2026. Adults with DACA can still newly apply (DHCS). See Medi-Cal for adults in 2026.
• No insurance: San Mateo County says its treatment uses a sliding fee scale and no one is turned away for lack of funds (San Mateo County Health). County pages do not say whether every medication program serves people without full Medi-Cal, or what it costs, so ask both when you call.
• Private insurance: California's state regulated plans must cover medically necessary substance use treatment. Problems? Call the DMHC Help Center at 1-888-466-2219 (DMHC).

If care is denied, see How to complain or appeal when Medi-Cal mental health or addiction care is denied.

Is it safe if I am an immigrant?

Treatment records have extra federal privacy protection. Under 42 CFR Part 2, substance use treatment records generally cannot be used to investigate or prosecute you without your written consent or a court order. A subpoena alone is not enough (HHS, checked October 19, 2026).

For people applying for a green card, the CDC instructs civil surgeons that methadone or buprenorphine used for opioid remission is not treated as a controlled substance for the medical exam (CDC, checked October 19, 2026). Drug use and addiction can still raise immigration questions. Read Is it safe to get help for drug or alcohol use if I am an immigrant? and talk to an immigration lawyer before a green card medical exam.

Questions to ask about medication treatment

Questions people ask

How long will I be on it? It depends on you. SAMHSA says these medicines are safe from months to a lifetime. Never stop suddenly without your prescriber.

Will I feel high? Taken as prescribed, buprenorphine's effects are weaker than full opioids, and naltrexone blocks opioid effects. Methadone doses are tailored and adjusted by the program.

Can my family member start before they are "ready" to quit everything? Yes. California programs may not turn someone away only for recent use, and medicine can help a person get stable first.

Is naloxone the same as treatment? No. Naloxone reverses an overdose in an emergency. Keep it on hand if anyone you love uses opioids.

Who can help

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• San Mateo County BHRS Access Call Center: 1 (800) 686-0101, 24/7, TTY 711.
• Santa Clara County Behavioral Health Call Center: (800) 704-0900, 24/7.
• Other California counties: DHCS county access lines.
• DHCS statewide referral line: (800) 879-2772.
• SAMHSA National Helpline: 1-800-662-4357.
• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org.

Recovery is possible, and medicine is one of the strongest tools we have. Asking for it is a brave first step.