People call us asking whether they should be on medication for their addiction. That is usually the wrong question.
The better question, and the one medication-assisted treatment in Berlin, NJ at South Jersey Recovery Program is built around, is which medication, paired with what, for how long.
What Medication Assisted Treatment Actually Is
Medication assisted treatment, or MAT, is not one drug. It is a category. It means an FDA-approved medication prescribed alongside counseling to treat opioid use disorder or alcohol use disorder.
Notice the two conditions named. There is no FDA-approved medication for cocaine, methamphetamine, cannabis, or benzodiazepine use disorder.
If someone offers you a pill for those, they are treating a symptom such as sleep or anxiety, not the addiction itself. Nicotine has its own approved medications. Everything below is about opioids and alcohol.
Within those two conditions there are five medications, and they do different jobs.
| Medication | Treats | What it does | How it is taken |
|---|---|---|---|
| Buprenorphine (Suboxone, Zubsolv, Sublocade, Brixadi) | Opioid use disorder | Partial activation of opioid receptors. Stops withdrawal and craving with a ceiling on respiratory depression | Daily film or tablet under the tongue, or a weekly or monthly injection |
| Methadone | Opioid use disorder | Full activation of opioid receptors at a steady, controlled dose | Oral liquid or tablet, dispensed through a federally certified opioid treatment program; take-home doses are allowed as a patient stabilizes |
| Naltrexone (oral, or Vivitrol injection) | Opioid or alcohol use disorder | Blocks opioid receptors, so ordinary doses of opioids do not produce the usual effect; alcohol produces less reward | Daily tablet or monthly injection |
| Acamprosate | Alcohol use disorder | Calms the glutamate overactivity that drives post-acute withdrawal | Tablets, three times daily |
| Disulfiram | Alcohol use disorder | Causes a severe reaction if you drink: flushing, vomiting, racing heart, and in severe cases collapse, seizures, or death | Daily tablet |
Four of those can be prescribed in an office-based outpatient setting. One cannot.
Methadone is dispensed only through a federally certified opioid treatment program, and South Jersey Recovery Program is not one. If methadone is the right medication for you, we will say so and help you find a program, and our therapy can run alongside it.
Why the Medication Works
Opioid addiction is not a failure of willpower. It is a receptor problem.
Repeated opioid use changes the brain’s reward and stress circuits. When the drug stops, those circuits do not quietly reset.
They produce withdrawal, then weeks or months of craving, low mood, and poor sleep that clinicians call post-acute withdrawal. Trying to sit through counseling in that state is like trying to read in a burning building.
How the opioid medications work
Buprenorphine occupies the same receptors heroin and fentanyl do, but only partially. The withdrawal stops. The craving fades.
Because it is a partial agonist, pushing the dose higher does not keep pushing breathing lower the way a full opioid does. That ceiling is why buprenorphine overdose is rare in people who take it as prescribed.
Naltrexone does the opposite. It sits on the receptor and blocks it, so ordinary doses of opioids do not produce the usual effect.
That blockade is surmountable. The FDA label warns that trying to override it with large amounts of opioids can cause fatal overdose, and that risk also rises at the end of a dosing interval, after a missed injection, or after stopping naltrexone, because tolerance is gone by then.
There is a timing catch as well. You must be fully withdrawn before the first dose, usually seven to ten days after short-acting opioids, or naltrexone will throw you into abrupt withdrawal. Your prescriber decides when it is safe.
How the alcohol medications work
For alcohol, the mechanism is different but the logic is the same.
- Naltrexone reduces the reward drinking delivers.
- Acamprosate steadies a nervous system that heavy drinking left overexcited.
- Disulfiram removes the option by making drinking dangerous. The reaction can be severe and, per the FDA label, occasionally fatal, so it is prescribed only with your full knowledge and only when you are not intoxicated.
Medication takes withdrawal and craving off the table. Everything else in treatment happens on that table.
What MAT Looks Like at South Jersey Recovery Program
MAT here is part of an outpatient program, not a prescription you pick up and leave with.
The first visit is an assessment. A clinician takes your substance use history, medical history, current medications, and mental health history, because the third of those often decides the plan. You will be asked what you have tried before and what happened.
A urine drug screen is generally part of it. That is not a test you can fail. It tells the prescriber what is actually in your system, which matters when fentanyl is involved.
From there, three decisions get made together:
- Which medication, if any, based on the substance, your history, and what you can realistically take every day.
- Which level of care. Medication can be paired with partial care five days a week, our intensive outpatient program three to five days a week, or standard outpatient sessions as you stabilize.
- Which therapy. Individual therapy and group therapy for everyone. Trauma therapy when trauma sits underneath the use. Dual diagnosis treatment when depression, anxiety, or PTSD is part of the picture, which it usually is.
The prescriber and the therapists work from one plan. Doses get adjusted at follow-up visits. As you stabilize, the level of care steps down while the medication generally continues.
Who prescribes Suboxone, Sublocade and Vivitrol at South Jersey Recovery Program?
Our medical staff prescribe on site in Berlin, NJ, as part of your treatment plan, and clinical staff are on site Monday to Friday, 8:30 a.m. to 4:30 p.m.
Buprenorphine is available as a daily film or tablet (Suboxone) or as the monthly Sublocade injection; naltrexone as a daily tablet or the monthly Vivitrol injection.
Prescriptions are coordinated with your pharmacy and any outside provider, and doses are reviewed at follow-up visits inside partial care, IOP or outpatient. You do not need to be enrolled in a separate clinic to get the medication, and you do not need to pick one before the assessment.
Is Medication Assisted Treatment Right for You?
For moderate to severe opioid use disorder, medication is the standard of care. That is not our opinion. A 2017 meta-analysis in the BMJ (Sordo et al., BMJ 2017;357:j1550, PMID 28446428) pooled cohort studies of more than 120,000 people and found that all-cause mortality roughly halved while people were on methadone or buprenorphine compared with time off it.
The American Society of Addiction Medicine’s National Practice Guideline for the Treatment of Opioid Use Disorder, in its 2020 focused update, treats medication as the default for opioid use disorder rather than a fallback.
For alcohol, the medications help a smaller share of people, but they are badly underused. The National Institute on Alcohol Abuse and Alcoholism calls them “vastly underused” and reports that they are prescribed to roughly 2 percent of adults with past-year alcohol use disorder.
| MAT makes sense when | MAT is a less clear fit when |
|---|---|
| Opioid use disorder of any severity, especially with fentanyl exposure | The substance is cocaine, methamphetamine, cannabis, or benzodiazepines, where no approved medication exists |
| Alcohol use disorder with strong cravings or repeated relapse | Mild alcohol use disorder where counseling alone has not yet been tried |
| Previous treatment episodes without medication that ended in relapse | A medical condition or medication that interacts with the drug in question |
| Leaving detox, jail, or a residential program, when tolerance has dropped | You cannot commit to taking a daily medication and a monthly injection is not an option |
Severity is judged against the DSM-5-TR’s eleven criteria: two or three met is mild, four or five is moderate, six or more is severe. Where you fall generally shapes which medication and which level of care.
What We Do Not Offer
MAT gets confused with detox more than any other part of treatment, so this is worth being blunt about.
South Jersey Recovery Program is an outpatient provider. We do not run a medically supervised detox. We do not have beds, overnight staff, or residential housing.
For opioids, that is usually fine. Buprenorphine can be started as an outpatient once you are in early withdrawal, and many people begin it without ever entering a detox facility.
For alcohol and benzodiazepines, it is often not fine. Withdrawal from either can cause seizures, and severe alcohol withdrawal can progress to delirium tremens, which is a medical emergency.
If you drink heavily every day, or take benzodiazepines daily, you generally need a medical detox before outpatient treatment can safely begin. We will tell you that at the assessment, help you arrange it, and start with you when it is done.
Detox handles the withdrawal. What happens after it is the part we do.
Why the Risk Spikes After Time Away From Opioids
Tolerance to opioids drops within days. After a detox, a jail stay, or a residential program, a dose that was routine a month ago can stop your breathing.
With fentanyl now in most of New Jersey’s illicit opioid supply, often alongside xylazine, the same dealer and the same amount on a different Tuesday can be fatal.
This is the strongest argument for starting medication before you leave a higher level of care, not after. Buprenorphine or naltrexone in place on discharge day is what makes those first weeks survivable.
If someone is unresponsive or breathing slowly after using, call 911 first, then give naloxone. If there is no response after two to three minutes, give a second dose in the other nostril and keep going until help arrives. Stay with the person.
Naloxone does not reverse xylazine, medetomidine, alcohol, or benzodiazepines, so give it even if you are not sure what was used and follow the dispatcher’s instructions.
Naloxone reverses an opioid overdose. It does not treat an addiction.
Narcan nasal spray has been sold over the counter since 2023. Ask us where to get it and how to use it.
Dependence Is Not Addiction
The objection we hear most is that MAT trades one addiction for another.
It does not. Someone on a stable dose of buprenorphine is physically dependent, the way a person on blood pressure medication is dependent. What they do not have is compulsive use, escalation, and a life organized around finding the next dose. They are not overdosing. They are at work.
Addiction is a pattern of behavior. Dependence is a fact of pharmacology. Confusing the two has kept a lot of people off a medication that would have kept them alive.
How Long Does MAT Last?
As long as it is helping.
Some people take buprenorphine for a year. Some take it for many years.
Tapering off on a schedule someone else set, whether a family member or a court or a sense that you should be “done,” is one of the most common ways people relapse. The decision to taper belongs with you and your prescriber, and it should be slow.
Naltrexone and acamprosate for alcohol are typically continued for months, and longer if urges return when they stop. Duration is a decision you make with the prescriber.
Verify any of this against your own situation with the prescriber. Medications, interactions, and insurance coverage change.
The bottom line
MAT is a category of medications, not one drug, and on this page it means opioids and alcohol.
For opioid use disorder, medication is the standard of care, and time on it is associated with roughly half the death rate or less.
We offer MAT in Berlin, NJ as part of outpatient treatment. Medication is prescribed on site, and we coordinate with your outside providers and pharmacy. We do not detox, and we do not dispense methadone. We will tell you which you need.
Call (856) 788-6914 or contact us online. The consultation is confidential, and you can verify your insurance on the same call.
Medication does not replace the work. It is what makes the work survivable, and medication-assisted treatment in Berlin, NJ at South Jersey Recovery Program is where that work starts.
