Note: This report was updated in July 2019 to include objections and evidence-based responses that are often raised in correctional justice settings.

Californians struggling with substance use, including opioid use disorder (OUD), should be screened for these illnesses wherever they seek help; those with OUD can be treated immediately and referred for ongoing care. California is building a “no wrong door” health care system, ensuring that medications for addiction treatment are widely available in emergency departments and hospitals, primary care and mental health clinics, jails and prisons, residential treatment programs, and other care settings. The need is urgent, since fentanyl (an extremely potent street drug) is increasingly responsible for overdose deaths for users of opioids and stimulants; fentanyl overdose deaths have more than quadrupled in California between 2014 and 2017.

Medication-assisted treatment (MAT) uses FDA-approved medicines such as buprenorphine (Suboxone), methadone, and naltrexone (Vivitrol), supplemented by behavioral treatment and social supports. Harm-reduction services are employed to keep patients safe until they are ready to seek treatment — services such as dispensing naloxone, an opioid antidote that prevents death from overdose, or providing clean syringes, to prevent HIV and hepatitis C. A medication-first approach allows patients to first be stabilized on medication, and then be brought into the right level of care to fit their needs — therefore decreasing the risk of overdose and relapse.

Despite data showing the success of MAT in treating opioid addiction, objections are still common. MAT for Opioid Use Disorder: Overcoming Objections outlines frequently cited objections and evidence-based responses to each.