Understanding FDA-Approved Medications for Opioid and Alcohol Recovery
If you or someone you love is struggling with an opioid use disorder or severe alcohol dependence, the cycle of craving and withdrawal can feel impossible to break. Willpower alone is rarely enough when brain chemistry has been fundamentally altered. Fortunately, modern medicine offers a proven path forward. Medication-Assisted Treatment (MAT) has become the gold standard, evidence-based approach to managing these conditions. Which significantly reduces the risk of overdose and supporting long-term recovery.
The state of Tennessee has made significant strides in expanding access to MAT, recognizing its vital role in combating the local opioid epidemic. However, navigating the different types of medications, understanding how they work, and knowing the specific regulations in Tennessee can be overwhelming. At Nashville Treatment Solutions, we want to ensure our community understands their options. This guide details the FDA-approved medications used in MAT and how we integrate them into our comprehensive outpatient programs.
What Is Medication-Assisted Treatment and How Does It Work?
Medication-Assisted Treatment is a “whole-patient” approach that combines FDA-approved medications with counseling and behavioral therapies. The medications work to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the abused drug.
When combined with our clinical therapies at Nashville Treatment Solutions, MAT provides a stable foundation, allowing individuals to focus on the psychological work of recovery in our Partial Hospitalization (PHP) or Intensive Outpatient (IOP) programs without being distracted by severe physical sickness.
Buprenorphine (Suboxone, Subutex)
Buprenorphine is a partial opioid agonist. This means it binds to the same opioid receptors in the brain as drugs like heroin or fentanyl, but only partially activates them. It produces enough of an effect to stop withdrawal symptoms and cravings, but it has a “ceiling effect.” This means it does not produce the intense high or dangerous respiratory depression of full opioids.
- How it is used: It is most commonly prescribed as Suboxone, which combines buprenorphine with naloxone (an opioid blocker) to deter misuse.
- Tennessee Regulations & Flexibility: Unlike methadone, which must be dispensed daily at a specialized clinic, buprenorphine can be prescribed in an office-based setting by physicians who have obtained a specific DEA waiver. This makes it highly flexible. At Nashville Treatment Solutions, our medical staff can manage your buprenorphine prescription while you attend our standard or outpatient rehab programs, allowing you greater freedom to work and live a normal life.
Naltrexone (Vivitrol)
Naltrexone represents a fundamentally different approach. It is a full opioid antagonist. It does not activate the opioid receptors at all; instead, it completely blocks them. If a person taking naltrexone attempts to use opioids, they will not feel the effects.
- How it is used: It is often administered as Vivitrol, a once-monthly extended-release injection.
- Dual Benefit: Naltrexone is unique because it is FDA-approved to treat both opioid use disorder and alcohol use disorder (by reducing the rewarding effects and cravings associated with drinking).
- The Catch: A patient must be completely detoxed and free of opioids for 7 to 14 days before starting naltrexone; otherwise, it will precipitate immediate and severe withdrawal. It is ideal for highly motivated individuals stepping down from residential care.
Methadone
Methadone was the first FDA-approved medication for opioid use disorder. It is a full synthetic opioid agonist. Because it is long-acting, methadone occupies the opioid receptors for 24 to 36 hours. This prevents withdrawal and reducing cravings without causing the rapid highs and lows of short-acting street drugs.
- Tennessee Regulations: In Tennessee, methadone is strictly regulated and can only be dispensed through federally licensed Opioid Treatment Programs (OTPs), commonly known as methadone clinics. Patients typically must visit the clinic daily to receive their dose.
- Who it helps: Methadone is often highly effective for individuals with severe, long-standing opioid addictions who have not had success with buprenorphine, or individuals requiring highly structured, daily oversight. While NTS does not dispense methadone directly, we coordinate with local OTPs to ensure our clients can receive their medication while participating in our therapeutic programming.
The Mandatory Counseling Component
Federal regulations—and best clinical practices—require that MAT programs provide simultaneous behavioral health treatment. Tennessee law also mandates that all MAT programs provide or coordinate counseling services. Medication alone is not recovery; it is stabilization.
At Nashville Treatment Solutions, we exceed minimum requirements by providing comprehensive on-site therapies. When you utilize MAT with us, you are also engaging in individual therapy to address root causes, group therapy for peer support, and family counseling. This holistic integration ensures that while the medication heals the brain chemistry, the therapy heals the mind and behavior.
Find the Right Medication Pathway for You
Choosing the right MAT medication is a complex medical decision that depends on your addiction history, lifestyle, and goals. You do not have to figure this out alone.
Our medical and psychiatric team is ready to evaluate your needs and build a personalized treatment plan. Contact our admissions team at Nashville Treatment Solutions today to learn more about our MAT services and start your journey toward a stable, substance-free life.
Frequently Asked Questions About the Types of Approved MAT in Tennessee
Is MAT just trading one addiction for another?
No. This is a dangerous stigma. Addiction is characterized by compulsive use, loss of control, and negative consequences. MAT medications stabilize the brain, allowing individuals to function normally, hold jobs, and repair relationships without the destructive behaviors of active addiction.
Can I switch between different MAT medications once I start?
Yes, under medical supervision. If one medication is not effectively managing your cravings or fits poorly with your lifestyle, our medical team can safely transition you to an alternative MAT option.
How long will I need to be on MAT?
Duration varies widely. Some individuals use MAT for a few months to stabilize early recovery, while others remain on maintenance doses for years or even a lifetime. The decision to taper off MAT should always be made collaboratively with your physician based on your clinical stability.
Sources
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). Medications for Substance Use Disorders. Retrieved from: https://www.samhsa.gov/medications-substance-use-disorders. Accessed on February 25, 2026.
- Dydyk, A. M., et al. (2021). Medication assisted treatment for opioid use disorder. StatPearls.
- Wakeman, S. E., et al. (2023). Association of medication-assisted therapy and risk of drug overdose-related hospitalization. JAMA Network Open.