Medication-Assisted Treatment Statistics 2026: Success Rates by Medication, the Treatment Gap, and New England Data

Medication-assisted treatment is the most studied intervention in addiction medicine, and one of the most misunderstood. Most pages promising "MAT statistics" recycle numbers from 2022 or earlier, or make effectiveness claims without citing a study. This page does the opposite: every number below is dated, comes from a primary source, and links to where you can verify it.

Three things stand out in the current data. Medication works, by every outcome that matters most. Very few of the people who could benefit actually receive it. And for the first time in a decade, the national overdose curve is bending in the right direction, with New Hampshire and Massachusetts bending faster than the country as a whole.

Key numbers at a glance

• 4.8 million Americans aged 12 or older had a past-year opioid use disorder in 2024, about 1.7 percent of the population (SAMHSA, 2024 NSDUH, released July 2025).
• Only 17.0 percent of them, roughly 818,000 people, received medication for opioid use disorder in the past year (SAMHSA, 2024 NSDUH).
• 27.9 million Americans had a past-year alcohol use disorder in 2024, and just 2.5 percent (697,000 people) received medication for it (SAMHSA, 2024 NSDUH).
• All-cause mortality during methadone treatment was 11.3 deaths per 1,000 person-years versus 36.1 out of treatment; for buprenorphine, 4.3 versus 9.5 (Sordo et al., BMJ, 2017).
• Among 40,885 people with opioid use disorder, treatment with buprenorphine or methadone was the only pathway associated with reduced overdose: 76 percent lower at 3 months and 59 percent lower at 12 months (Wakeman et al., JAMA Network Open, 2020).
• U.S. drug overdose deaths fell to an estimated 69,973 in 2025, down almost 14 percent from 81,313 in 2024 and the third straight annual decline (CDC NCHS, May 2026 release).
• New Hampshire drug overdose deaths fell about 34 percent in 2024 (430 to 282) and Massachusetts fell about 33 percent (2,380 to 1,598), both faster than the roughly 24 percent national decline (CDC provisional counts, 12 months ending December, accessed July 2026).
• 59.4 percent of U.S. substance use treatment facilities provided medications for opioid use disorder in 2023, and 46.2 percent provided medications for alcohol use disorder (SAMHSA, N-SUMHSS 2023).
• 41 percent of Veterans Health Administration patients diagnosed with opioid use disorder received medication for it in fiscal year 2017, up from 33 percent in 2012 (Finlay et al., Journal of Addiction Medicine, 2021).
• After the buprenorphine prescribing waiver was eliminated in January 2023, the number of prescribers jumped by roughly 1,900 in a single month and reached 53,635 by December 2023, but the number of patients filling prescriptions changed little (NEJM, 2024).

What medication-assisted treatment means in 2026

Medication-assisted treatment (MAT) is the use of FDA-approved medications, typically combined with counseling and behavioral therapies, to treat substance use disorders. The terminology is shifting: federal agencies increasingly say MOUD, medications for opioid use disorder, and MAUD, medications for alcohol use disorder, to emphasize that the medication is treatment in its own right rather than an "assist." You will see all three terms in the sources cited on this page, and they describe the same evidence base (SAMHSA, Substance Use Treatment Options, 2025).

The FDA-approved medications

For opioid use disorder, three medications are approved:

• Methadone, a full opioid agonist dispensed through federally certified opioid treatment programs (OTPs).
• Buprenorphine, a partial agonist available by prescription in office-based settings, alone or combined with naloxone in products such as Suboxone. Our guide to Suboxone explains how it works in more detail.
• Naltrexone, an opioid antagonist available as a daily pill or a monthly extended-release injection (Vivitrol). See our naltrexone guide for the full picture.

For alcohol use disorder, the FDA has approved naltrexone (oral and injectable), acamprosate, and disulfiram (NIAAA, Core Resource on Alcohol, 2022).

How many people actually receive medication: the treatment gap

The single most important MAT statistic is how few eligible people get it. The 2024 National Survey on Drug Use and Health (NSDUH), released in July 2025, found that 4.8 million Americans aged 12 or older had an opioid use disorder in the past year. Of them, 17.0 percent, about 818,000 people, received medication for opioid use disorder in that year (SAMHSA, 2024). The National Institute on Drug Abuse states the same finding more bluntly: fewer than 1 in 5 people with opioid use disorder are treated with these medications (NIDA, 2025).

The gap is wider than the opioid picture alone suggests. Across all substances, 48.4 million people aged 12 or older had a substance use disorder in 2024, and the survey classified 52.6 million people as needing substance use treatment; only 19.3 percent of those who needed treatment, 10.2 million people, received any form of it. Among people who actually had a substance use disorder in the past year, 12.3 percent received treatment. Even severity does not close the gap: among people with a severe substance use disorder, only 27.9 percent received treatment in 2024 (SAMHSA, 2024 NSDUH).

On the supply side, SAMHSA's facility census shows movement in the right direction. In 2023, 59.4 percent of the nation's 14,620 substance use treatment facilities provided medications for opioid use disorder, up from 57.0 percent in 2022, and 46.2 percent provided medications for alcohol use disorder (N-SUMHSS 2023 annual report, published 2024). Treatment for opioid addiction that combines medication with counseling is the standard of care described across these federal sources, and it is the model used in outpatient opioid addiction treatment programs.

A note on comparability: NSDUH redesigned its methodology in 2021, and the 2024 report itself cautions that current estimates should not be casually trended against pre-2021 figures. Older statistics still circulating on the web, such as the frequently copied claim that 612,750 people received opioid MAT, describe the world of 2019 and earlier and should be retired.

Does medication-assisted treatment work: the headline evidence

For a chronic, relapsing condition, the outcomes that matter most are staying alive, staying out of the hospital, and staying in care. On all three, the evidence for methadone and buprenorphine is unusually strong and unusually consistent.

Mortality. The landmark pooled analysis is Sordo et al. in the BMJ (2017), covering 19 cohorts and more than 138,000 people. All-cause mortality was 11.3 deaths per 1,000 person-years during methadone treatment versus 36.1 out of treatment, roughly a two-thirds difference. For buprenorphine it was 4.3 versus 9.5. Overdose-specific mortality showed the same pattern: 2.6 versus 12.7 per 1,000 person-years for methadone.

Overdose after a near miss. A Massachusetts cohort study of 17,568 adults who survived an opioid overdose found that methadone treatment was associated with a 53 percent reduction in all-cause mortality (adjusted hazard ratio 0.47) and a 59 percent reduction in opioid-related mortality in the following year, while buprenorphine was associated with reductions of 37 and 38 percent respectively (Larochelle et al., Annals of Internal Medicine, 2018).

Against every alternative. The most cited comparative study, Wakeman et al. in JAMA Network Open (2020), followed 40,885 insured adults with opioid use disorder across six treatment pathways: no treatment, inpatient detoxification or residential care, intensive behavioral health, buprenorphine or methadone, naltrexone, and nonintensive behavioral health. Only the buprenorphine or methadone pathway was associated with reduced overdose, 76 percent lower during 3-month follow-up (adjusted hazard ratio 0.24) and 59 percent lower during 12-month follow-up (0.41). It was also the only pathway associated with fewer serious opioid-related acute care episodes. Notably, only 12.5 percent of that study population received buprenorphine or methadone, while 59.3 percent received nonintensive behavioral health alone.

Retention. Cochrane's systematic reviews found methadone significantly better than non-medication approaches at keeping people in treatment and suppressing heroin use (Mattick et al., 2009), and buprenorphine better than placebo at retaining patients at every dose studied (Mattick et al., 2014).

Success rates by medication

No ranking page in this topic aggregates medication-by-medication outcomes with citations, so here is that table. Each cell names its study and year.

The practical summary from the X:BOT trial (Lee et al., Lancet, 2018) is worth spelling out. In the full intention-to-treat population, 24-week relapse was higher with extended-release naltrexone (65 percent) than buprenorphine-naloxone (57 percent), but nearly all of that difference came from people who could not complete naltrexone's opioid-free induction. Among successfully inducted patients, the two medications performed comparably. Both agonist medications remain more protective against death in observational data, which is why the choice of medication is a genuinely clinical decision rather than a ranking exercise.

"The honest success metric for a chronic condition is not thirty days of abstinence, it is whether the person is still engaged in care and rebuilding a life. In the first ninety days on medication I am watching retention above everything: is the dose right, are cravings quieting down, is the person sleeping, showing up, and starting to trust the process."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

What a MAT success rate actually means

When a page advertises a single "MAT success rate," ask what was measured. The literature uses at least three different yardsticks:

• Retention measures whether a person is still in treatment at a defined point, commonly 3, 6, or 12 months. This is the standard trial endpoint because staying in treatment is what predicts reduced mortality (BMJ, 2017).
• Completion comes from administrative datasets such as SAMHSA's Treatment Episode Data Set, which tracks discharges from treatment episodes. Completion makes sense for a time-limited program, but for maintenance medication it is the wrong frame: leaving methadone or buprenorphine treatment is associated with a sharp rise in mortality, not a graduation (BMJ, 2017).
• Abstinence at a snapshot in time is the measure most quoted and least informative for a chronic condition. NSDUH itself notes that people receiving medication may no longer meet disorder criteria precisely because the medication is working (SAMHSA, 2024 NSDUH).

These definitions explain why survey and registry numbers disagree: NSDUH counts self-reported medication receipt, TEDS counts facility-reported treatment episodes, and trials count randomized participants. Any page quoting a single unsourced success percentage is measuring something it has not defined.

MAT and the 2024 to 2025 overdose decline

The overdose curve turned in 2024, hard. CDC provisional data show 80,860 drug overdose deaths reported in the 12 months ending December 2024, down about 24 percent from 106,881 in the 12 months ending December 2023 (CDC VSRR provisional counts, accessed July 2026), a decline CDC announced as unprecedented in the fentanyl era (CDC newsroom, 2025).

The decline continued. NCHS reported an estimated 69,973 overdose deaths in 2025, down almost 14 percent from 81,313 in 2024 and the third consecutive annual decrease; opioid-involved deaths fell from an estimated 55,296 in 2024 to 44,564 in 2025 (NCHS, May 2026). The most recent provisional 12-month window, ending January 2026, stands near 68,000 reported deaths (CDC VSRR, accessed July 2026).

How much of this is medication? CDC does not assign percentage shares to causes, and honest analysis should not either. The agency's stated contributing factors include widespread data-driven naloxone distribution, better access to evidence-based treatment for substance use disorders, shifts in the illicit drug supply, and sustained prevention investment (CDC, 2025). Expanded access to buprenorphine and methadone sits squarely in that second factor. What the data support saying is this: the first sustained national overdose decline in a decade coincided with the largest expansion of medication access in the history of U.S. addiction treatment.

Medication for alcohol use disorder: the forgotten half

Nearly every page about MAT statistics is opioid-only. That ignores the substance with the largest treatment population: 27.9 million Americans had a past-year alcohol use disorder in 2024 (SAMHSA, 2024 NSDUH).

The medications work. A 2023 meta-analysis in JAMA covering 118 trials and more than 20,000 participants found that acamprosate prevented a return to any drinking with a number needed to treat of 11, and oral naltrexone at 50 mg per day did so with a number needed to treat of 18; for preventing a return to heavy drinking, oral naltrexone's number needed to treat was 11 (McPheeters et al., JAMA, 2023). For comparison, those figures are in the range of widely prescribed medications for depression and cardiovascular prevention.

The usage numbers are startling by contrast. Only 2.5 percent of people with a past-year alcohol use disorder, about 697,000 of 27.9 million, received any medication for it in 2024 (SAMHSA, 2024 NSDUH). NIAAA's clinical core resource cites an even lower figure from prescription data, noting these medications are "vastly underused" and were prescribed to only 1.6 percent of adults with past-year AUD in a 2021 analysis (NIAAA, 2022). By either measure, medication for alcohol use disorder is the most underused evidence-based tool in addiction care, which is why comprehensive alcohol addiction treatment programs routinely evaluate whether naltrexone or acamprosate belongs in a care plan.

New Hampshire and Massachusetts: the two-state MAT picture

No national statistics page covers the states Clear Steps Recovery serves, so we compiled the data. Every cell is sourced and dated.

Sources: overdose deaths from CDC VSRR provisional counts (reported counts, accessed July 2026; 2025 figures remain provisional); treatment capacity and client counts from the SAMHSA 2023 N-SUMHSS state profiles (facility census, clients in treatment on March 31, 2023). Official state surveillance lives at NH DHHS drug overdose surveillance and the Massachusetts DPH current opioid statistics hub, which publish finalized state-specific series, including MA's opioid-specific death counts, on their own schedules.

Two patterns in this table deserve attention. First, both states outpaced the national decline in 2024 and kept falling in 2025, with Massachusetts sustaining a much steeper second-year drop. Second, the two states deliver medication differently: New Hampshire's MOUD caseload is weighted toward office-based buprenorphine (about 62 percent of its 7,346 counted MOUD clients were at non-OTP facilities), while Massachusetts splits nearly evenly between OTP-based methadone and office-based care among its 38,681 counted clients (SAMHSA, N-SUMHSS 2023). For someone seeking care, this means the realistic entry point in New Hampshire is usually a buprenorphine prescriber or outpatient program rather than a methadone clinic.

"Across southern New Hampshire and the Boston metro, the prescription itself is rarely the bottleneck anymore; for most patients a same-week buprenorphine start is a realistic goal. What still gets people stuck is everything around the medication: transportation, insurance churn, and the handoff between levels of care. The state curves are encouraging, but they describe averages, not the person sitting in front of you."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

Veterans and medication-assisted treatment

Veterans carry a disproportionate share of the conditions that lead to opioid use disorder, including chronic pain and post-traumatic stress, and VA research has driven much of what is known about treating them (VA Office of Research and Development, 2025).

Within VA care, medication receipt has climbed but remains incomplete. Among the 53,568 Veterans Health Administration patients diagnosed with opioid use disorder in fiscal year 2017, 41 percent received medication for it, up from 33 percent in fiscal year 2012, with women, older, Black, rural, homeless, and justice-involved veterans all less likely to receive it than their counterparts (Finlay et al., Journal of Addiction Medicine, 2021). That 41 percent is more than double the 17 percent receipt rate in the general population (SAMHSA, 2024 NSDUH), a credit to VA system efforts, and still means most veterans with opioid use disorder in that cohort went without the medication most likely to keep them alive.

Veterans in New Hampshire and Massachusetts can access MAT through VA facilities or through VA Community Care partners in their own communities. Clear Steps Recovery is an approved VA Community Care provider, and our veterans rehab program coordinates directly with VA referrals.

Dual diagnosis: MAT when mental health conditions co-occur

Medication for a substance use disorder rarely happens in isolation. In 2024, 21.2 million American adults had both a mental illness and a substance use disorder in the same year; that is roughly one third of the 61.5 million adults with any mental illness and nearly half of the 46.3 million adults with a substance use disorder (SAMHSA, 2024 NSDUH). NIDA's research on co-occurring disorders documents why: shared risk factors, self-medication, and overlapping brain changes make each condition a risk factor for the other (NIDA, Co-Occurring Disorders and Health Conditions, 2024).

For MAT outcomes, the practical implication is that untreated depression, anxiety, or PTSD undermines retention, the very metric that predicts survival. That is why NIDA reports that integrated care, the same team addressing both conditions at the same time, leads to better health outcomes than treating them separately, and why quality outpatient MAT includes psychiatric assessment and therapy alongside the prescription (NIDA, 2024).

The 2023 and 2024 rule changes behind the access statistics

Two federal policy shifts are quietly rewriting MAT access statistics, and no competing statistics page covers either one.

January 2023: the X-waiver disappears. Section 1262 of the Consolidated Appropriations Act of 2023, known as the MAT Act, removed the federal requirement for practitioners to hold a special DATA 2000 waiver to prescribe buprenorphine for opioid use disorder (SAMHSA, statutes and regulations, 2024). Any prescriber with standard DEA registration can now treat opioid use disorder with buprenorphine. Early data show what changed and what did not: prescriber counts jumped by roughly 1,900 in January 2023 alone and reached 53,635 by December 2023, yet the number of patients actually filling buprenorphine prescriptions changed little, with about 5,245 additional new initiations in the first month (NEJM, 2024). Removing the legal barrier was necessary but not sufficient; stigma, reimbursement, and clinical comfort still constrain real-world prescribing.

February 2024: methadone rules modernize. SAMHSA's final rule updating 42 CFR Part 8, published February 2, 2024, made permanent the COVID-era flexibilities that had proven safe: take-home methadone doses starting as early as the first week of treatment under defined conditions, screening for buprenorphine initiation by audio-only or audio-visual telehealth, screening for methadone initiation by audio-visual telehealth, elimination of the one-year addiction history requirement for OTP admission, and expansion of interim treatment from 120 to 180 days (SAMHSA, 42 CFR Part 8 table of changes, 2024). The rule also retired the term "detoxification" from the regulation itself in favor of patient-centered language. NIDA-funded research supported the change, finding that expanded take-home dosing was safe and may help people stay in treatment (NIDA, 2025).

Watch these two dates when reading any MAT statistic: numbers collected before 2023 describe a different regulatory world, and the treatment-gap figures above are the first to reflect the new one.

Myths vs data: is MAT trading one addiction for another?

The most damaging sentence in addiction care is "you're just trading one addiction for another." The pharmacology says otherwise. NIDA explains that methadone and buprenorphine, taken as prescribed, occupy the same receptors as other opioids but prevent cravings and withdrawal without producing the euphoric high that drives compulsive use (NIDA, 2025). These medications can produce physical dependence, meaning the body adapts and withdrawal follows abrupt discontinuation. That is a property shared with blood pressure medications, antidepressants, and many other long-term treatments, and it is managed the same way, by tapering under medical supervision rather than stopping suddenly (NIDA, 2025).

Dependence describes a predictable physiological state. Addiction describes compulsive use despite harm. The data on this page show what happens when the two are confused: a treatment associated with roughly two-thirds lower mortality (BMJ, 2017) reaches only 17 percent of the people who need it (SAMHSA, 2024 NSDUH). Stigma is not the only reason for that gap, but it is the one that costs nothing to fix.

"Physiological dependence is a predictable finding we manage every day across medicine; addiction is compulsive use despite harm, and they are not the same thing. A patient who is stable on buprenorphine or methadone is not still sick with addiction, they are being treated for it. What troubles me most about the trading-one-addiction-for-another myth is that it talks people out of the very treatment that would most likely keep them alive."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

What these numbers mean if you are considering MAT

If you or a family member is weighing medication-assisted treatment, the statistics above condense to a few practical points. In the pooled cohort data, death rates during methadone treatment were roughly a third of the rates out of treatment, with a similar pattern for buprenorphine. The best medication is the one you can realistically start and stay on, which is a conversation with a clinician, not a chart. And the access barriers that defined the last decade have genuinely eased: buprenorphine can now be prescribed in ordinary outpatient settings, often starting the same week.

In New Hampshire, Clear Steps Recovery provides outpatient medication-assisted treatment in Londonderry, and in Massachusetts through our Needham MAT program, both combining medication management with counseling and both accepting VA Community Care referrals. If you want a sense of what treatment actually feels like from the inside, our stories from MAT participants are a good place to start. If you are in crisis right now, call or text 988 for immediate support.

Methodology and data notes

This page was compiled in July 2026 from primary sources only: federal surveys and surveillance systems (NSDUH 2024, N-SUMHSS 2023, CDC VSRR provisional overdose counts accessed July 2026), peer-reviewed studies (BMJ, JAMA, JAMA Network Open, Annals of Internal Medicine, the Lancet, Cochrane reviews), and federal agency guidance (SAMHSA, NIDA, NIAAA, VA). Provisional CDC counts are reported deaths and may rise slightly as records are finalized; 2025 and 2026 figures should be treated as provisional. NSDUH estimates from 2021 onward reflect a survey redesign and are not directly comparable to earlier years. Survey-based medication receipt (NSDUH) and facility-based client counts (N-SUMHSS) measure different things and will not match each other. Statistics were verified against their live sources on the review date shown above; no figures were drawn from secondary summaries or other treatment providers. This article is educational and is not medical advice; medication decisions belong with a licensed clinician who knows your history.