WASHINGTON — As research continues to show the effectiveness of medication-assisted addiction treatment, the Trump administration is emphasizing that those medications should be one part of a broader recovery plan—not the entire approach.
In a new letter, the Substance Abuse and Mental Health Services Administration (SAMHSA) said it supports the use of medications such as methadone, buprenorphine and naltrexone, but stressed they should be combined with other forms of care.
“We are equally committed to ensuring that medications are part of the pathway to long-term recovery and sobriety, self-sufficiency, and thriving, not as a default sentence to life-long medication use,” the agency wrote.
The U.S. Food and Drug Administration has approved all three medications for treating opioid use disorder. Research has shown they can reduce opioid use, overdose deaths and recidivism.
However, SAMHSA said many people with opioid use disorder also face challenges related to mental health, housing, legal issues and family stability, which are factors that medication alone cannot address.
“Thus, it is essential that medications are provided as part of a comprehensive approach to treating an individual’s behavioral, physical, and social needs,” the letter states.
The agency also noted there is limited research on the ideal length of treatment. While some patients may require long-term or even lifelong medication, others may benefit from tapering off under medical supervision once stable support systems are in place.
SAMHSA cautioned that arbitrary time limits or abrupt discontinuation can lead to poor outcomes and said decisions about continuing or ending medication should be made on an individual basis, with input from both clinicians and patients.
Under the updated guidance, federal funding should prioritize comprehensive treatment, not medication-only models. Funding can also be used to support individualized tapering and discontinuation of medications.
The policy also calls for increased training for providers on appropriate medication use, including how to safely taper patients and support shared decision-making.
Federal research highlights the effectiveness of these treatments. A 2024 study found methadone reduced the risk of death by 58%, buprenorphine by 52% and naloxone by 30%. Behavioral health services reduced the risk by 75%.
Despite those benefits, the study found that only 4% of participants received medications for opioid use disorder, and just 6% filled a prescription for naloxone.
“At a time when over 100,000 people continue to die each year from overdose, we must prioritize making effective treatments and tools accessible – especially to those who are at the highest risk,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, in 2024.
