Medication-Assisted Treatment in New Jersey: How Suboxone, Methadone and Vivitrol Work Inside Outpatient Care

✓ Medically reviewed by Dr. David T. Gigliotti, DO, FASAM, Medical Director · Reviewed October 16, 2026

Medication-assisted treatment (MAT) for opioid use disorder means taking one of three FDA-approved medications, methadone, buprenorphine (the active drug in Suboxone) or naltrexone (the monthly shot sold as Vivitrol), alongside counseling. In New Jersey, each one comes through a different door: methadone only from a federally certified opioid treatment program, buprenorphine from any prescriber with a current DEA registration, and naltrexone from any clinic that can prescribe medication. The medication is not the whole program. It sits inside a level of care such as PHP, IOP or OP, where the counseling, the schedule and the medical visits happen.

First, what Ripple is and is not. Ripple Recovery Centers runs outpatient programs in Barrington and Cherry Hill, in Camden County: a partial hospitalization program (PHP), an intensive outpatient program (IOP) and a standard outpatient program (OP). There are no overnight stays and no detox on site. When an assessment points to detox, we arrange placement with trusted medical detox partners first. Physicians at both locations provide medication-assisted treatment, but Ripple is not an opioid treatment program and does not dispense methadone. If someone has stopped breathing or will not wake up, call 911. If you are thinking about suicide, call or text 988.

What is medication-assisted treatment for opioid use disorder?

Opioid use disorder is the medical name for being unable to stop using opioids even when they are causing harm. Three FDA-approved medications treat it, and each works on the brain receptors that opioids use. Methadone is “a long-acting full opioid agonist,” meaning it fully activates those receptors to stop withdrawal and craving (SAMHSA). Buprenorphine is “a high-affinity partial opioid agonist,” so it activates the receptors only partway, enough to stop withdrawal without the full effect (National Academies, 2019). Naltrexone “is not an opioid but rather is a full antagonist,” which means it blocks the receptors so other opioids cannot act on them (National Academies, 2019).

The federal summary of the research is plain: “The science demonstrating the effectiveness of medication for OUD is strong” (SAMHSA TIP 63). Even so, fewer than 1 in 5 people with opioid use disorder are treated with these medications (NIDA). We have sat across from too many people who were told medication was cheating to pretend that gap is an accident.

How do Suboxone, methadone and Vivitrol differ?

Every cell in the table links to the federal page that confirms it. The table does not say which of these Ripple prescribes; that is your physician’s decision after an assessment.

Medication	How it is taken	Where it is dispensed or prescribed	Approved for	Main caution
Methadone	Daily liquid or tablet, by mouth (NIDA)	For opioid use disorder, only a SAMHSA-certified opioid treatment program (OTP) (SAMHSA)	Opioid use disorder	A full opioid and a Schedule II controlled drug; overdose death risk is highest in the first two weeks of treatment (National Academies, 2019)
Buprenorphine (Suboxone, Sublocade)	Daily tablet or film dissolved under the tongue or inside the cheek (MedlinePlus), or a weekly or monthly injection (NIDA)	A doctor’s office, filled at a pharmacy; no federal waiver is required to prescribe it (SAMHSA)	Opioid use disorder	Can be a target for misuse; do not drink alcohol while taking it (MedlinePlus)
Naltrexone (Vivitrol)	Injection into the muscle by a healthcare provider once every 4 weeks (MedlinePlus)	Any practitioner licensed to prescribe medication (SAMHSA)	Opioid use disorder (injection) and alcohol use disorder (pill or injection) (SAMHSA)	You must be off opioids for several days first, and after treatment ends you may be more sensitive to opioids, so a return to use is more dangerous (MedlinePlus)

The naltrexone wait is real: the National Academies report describes needing “at least 4 to 7 days without any opioids” before the first dose (National Academies, 2019), which is why it is usually the hardest medication to start for someone still using fentanyl every day.

Where do you get each medication in New Jersey?

Methadone for opioid use disorder “can only be dispensed through a SAMHSA certified OTP” (SAMHSA). New Jersey’s addiction services directory lists these programs by county (NJ DMHAS treatment directory). Under the federal rule that took effect April 2, 2024, “patients may be eligible for unsupervised, take-home doses of methadone upon entry into treatment” based on the provider’s judgment, and the old requirement of one year of opioid addiction before admission was removed (Federal Register, 2024).

Buprenorphine is the medication that moved out of the clinic and into ordinary medicine. SAMHSA says it “can be prescribed or dispensed in physician offices” (SAMHSA). Since January 2023, Section 1262 of the Consolidated Appropriations Act “removes the federal requirement for practitioners to submit a Notice of Intent (have a waiver)” to prescribe it (SAMHSA). Any practitioner with a current DEA registration that includes Schedule III authority may now prescribe it where state law allows (AAAP), so a family doctor, a psychiatrist, a nurse practitioner or the physician at an outpatient program can write the prescription, and you fill it at a pharmacy. The DEA has also extended telehealth prescribing, including by audio-only visit for opioid use disorder medications, through December 31, 2026 (DEA, December 2025).

Naltrexone is the simplest door. It “can be prescribed and administered by any practitioner licensed to prescribe medications” (SAMHSA). No special program and no daily visit, though the opioid-free period above applies.

Figure: three medications, three doors. Where each FDA-approved medication for opioid use disorder is prescribed in New Jersey, and where all three lead.Sources: SAMHSA methadone, buprenorphine and naltrexone pages; SAMHSA MAT Act page; DEA December 31, 2025 release; National Academies 2019; NIDA.

At Ripple, that means this: we do not run an opioid treatment program, so methadone is not dispensed at either location. If an assessment points to methadone, we say so and help you connect with a certified program through ReachNJ or the state directory. Physicians at both of our locations provide medication-assisted treatment within our outpatient programs, and which medication fits is their call after they have examined you.

Does MAT work?

Yes, and the strongest evidence is about staying alive. In a study of 17,568 Massachusetts adults who survived an opioid overdose, opioid overdose deaths over the following year were 59 percent lower for people receiving methadone and 38 percent lower for people receiving buprenorphine, compared with people on no medication (NIH, 2018). That study could not draw conclusions about naltrexone because too few people were taking it.

A review of 19 cohorts following 122,885 people on methadone found “all cause mortality rates were 11.3 and 36.1 per 1000 person years in and out of methadone treatment,” and 4.3 and 9.5 in and out of buprenorphine treatment (BMJ, 2017). The National Academies summed up the agonist medications as being associated with “an estimated mortality reduction of approximately 50 percent among people with OUD” (National Academies, 2019).

Two honest limits. These are observational studies, so the findings are associations, not proof of cause. And “discontinuation rates are high across all medications, and most discontinuation occurs early after starting treatment” (National Academies, 2019). That is why the medication needs a program around it.

What does New Jersey do differently?

New Jersey has written some of this into law, which matters when the barrier is paperwork rather than medicine.

On April 1, 2019, New Jersey Medicaid stopped requiring prior authorization for medication-assisted treatment, so a prescription can be filled without waiting for insurer approval (NJ Department of Human Services, 2019). Governor Murphy signed that policy into law as A4744 on July 15, 2019 (NJ Department of Human Services, 2019). The statute, P.L.2019, c.163, requires that methadone, buprenorphine, naltrexone and buprenorphine-naloxone benefits for people on Medicaid or in state-funded addiction services “shall be provided without the imposition of any prior authorization requirements” (P.L.2019, c.163). Commercial plans are a separate question, which is why our admissions team confirms your benefits before you start.

New Jersey also treats naloxone, the overdose reversal drug, as something nobody should have to argue for. A 2021 law requires New Jersey-regulated health plans, Medicaid and NJ FamilyCare, and the State Health Benefits Program to cover opioid antidotes “without the imposition of any prior authorization or other utilization management requirements” (P.L.2021, c.157). The state’s Naloxone365 program lets anyone 14 or older “request and obtain naloxone at participating pharmacies for free without having to provide a name or reason,” and those pharmacies gave out 66,007 two-dose kits in the program’s first year (NJ Department of Human Services, 2024). As of August 2025, more than 650 pharmacies take part (NJ Department of Health, 2025).

For finding care, the state runs ReachNJ at 1-844-732-2465, where a trained specialist gives “a referral to a local treatment provider or other supportive services,” regardless of insurance or ability to pay (ReachNJ). The number behind all of this: more than 2,800 New Jersey residents died of an overdose in 2023, an 11 percent decline from the year before (NJ Department of Health, 2025).

How does medication fit inside PHP, IOP and OP?

Medication handles the receptors. It does not handle the job you are afraid of losing or the Tuesday night when everyone you know is using. That is what the program is for, and the research agrees: NIDA notes that behavioral approaches such as cognitive behavioral therapy work well “especially when applied in concert with medications” (NIDA).

A partial hospitalization program is the most structured level, with programming 6 hours a day. An intensive outpatient program is fewer hours on fewer days, built so work and family can continue. Outpatient treatment is the lightest touch. At every level, medication is prescribed and monitored by the physician, and the counseling, groups and check-ins are where the rest of the work happens. The level of care changes as you do; the medication decision is made separately, on medical grounds, and can continue across levels, as our guide to choosing between PHP, IOP and OP explains.

Three practical notes. If withdrawal would be dangerous or unmanageable at home, detox placement comes first; our article on what detox placement means explains that handoff. If you take benzodiazepines, say so at the assessment: the FDA advised in September 2017 that buprenorphine and methadone “should not be withheld from patients taking benzodiazepines,” because the risk of untreated opioid addiction can outweigh the risk of combining them under medical management (FDA). And if fentanyl is what you are using, read our pages on fentanyl addiction and opioid addiction before your first appointment.

Ripple works with many major insurance plans. Coverage depends on your plan, and our admissions team confirms your benefits before you start. Verify your insurance

Where we stand

We will say this plainly, because most people who come through our doors have heard the opposite. Medication for opioid use disorder is treatment, not a crutch. Treatment with methadone or buprenorphine is associated with a roughly 50 percent lower death rate among people with opioid use disorder (National Academies, 2019), and no counseling-only approach has evidence like that. A program that refuses medication on principle is not being strict. It is behind the evidence, and the federal government has said so for years (SAMHSA TIP 63).

Second, nobody but your prescriber should set the date you stop. The four weeks after leaving methadone or buprenorphine carry a high risk of death (BMJ, 2017). A sponsor, a judge or a sober house rule that says “off everything by Christmas” is making a medical decision without a license, and we have watched that end badly.

Third, medication without a program is a prescription, not treatment. Most people who stop their medication stop early (National Academies, 2019). The groups, the individual sessions and the regular contact with a physician carry someone through the month when the medication alone is not enough. We built outpatient programs around that fact.

At Ripple

Ripple Recovery Centers provides partial hospitalization, intensive outpatient and outpatient treatment at two Camden County locations: 630 Clements Bridge Road in Barrington and 103 East Gate Drive in Cherry Hill. Both are licensed by the State of New Jersey. There are no overnight stays. When an assessment shows that detox is needed first, we arrange placement with trusted medical detox partners before outpatient care begins.

Physicians at both locations provide medication-assisted treatment as part of our programs. Which medication fits, and whether one fits at all, is decided by the physician after an assessment. PHP runs 6 hours a day; IOP and OP are built around work and family schedules. We treat opioid, fentanyl, alcohol, benzodiazepine and cocaine use disorders. Our medication-assisted treatment program page explains how the medical side of care works here. Start admissions or Verify your insurance.

Getting to Ripple from Camden County and South Jersey

Our Barrington location at 630 Clements Bridge Road sits between the White Horse Pike (Route 30) and I-295, a short drive from Haddon Heights, Runnemede, Bellmawr, Gloucester City and Camden. Our Cherry Hill location at 103 East Gate Drive is off Marlton Pike East (Route 70), just east of I-295, convenient to Haddonfield, Collingswood, Voorhees, Pennsauken, Maple Shade and Marlton. Philadelphia residents reach either office over the Ben Franklin or Walt Whitman Bridge.

Camden County recorded 206 suspected drug overdose deaths in 2024, down from 327 in 2023, a 37 percent drop the county called historic (Camden County, 2025). The state’s tracker counted 83 suspected overdose deaths in Camden County in the first four months of 2024 alone, out of 702 statewide (NJ CARES). ReachNJ at 1-844-732-2465 can point you to any licensed program in South Jersey, including opioid treatment programs if methadone is the right fit.

Frequently asked questions

Do I have to go to a methadone clinic to get MAT in New Jersey?

No. Only methadone requires a federally certified opioid treatment program (SAMHSA). Buprenorphine can be prescribed by any practitioner with a current DEA registration and filled at a pharmacy, and naltrexone by any licensed prescriber. Many people in New Jersey get MAT through an outpatient program or a doctor’s office without ever visiting a methadone clinic.

Can a regular doctor prescribe Suboxone in New Jersey?

Yes. Since January 2023, the federal waiver that used to be required is gone; SAMHSA says the change “removes the federal requirement for practitioners to submit a Notice of Intent” before prescribing buprenorphine (SAMHSA). A primary care doctor, psychiatrist or nurse practitioner with a DEA registration can prescribe it. The physicians in Ripple’s outpatient programs make that decision after an assessment.

Does New Jersey Medicaid require prior authorization for MAT?

No. NJ Medicaid dropped prior authorization for medication-assisted treatment on April 1, 2019, and P.L.2019, c.163 put that into state law for Medicaid and state-funded services (P.L.2019, c.163). Commercial plans are not covered by that law, so rules vary by plan. Our admissions team confirms your benefits before you start.

Is MAT just replacing one addiction with another?

No. Naltrexone “is not addictive or sedating, and does not result in physical dependence,” and buprenorphine “relieves drug cravings without producing the high or dangerous side effects of other opioids” (NIDA). Addiction means continued use despite harm. Taking a prescribed medication on schedule, under medical supervision, so you can work and parent and sleep, is the opposite of that.

How long do people stay on MAT?

There is no fixed length, and anyone who gives you one without examining you is guessing. The risk of death is high in the four weeks after stopping methadone or buprenorphine (BMJ, 2017), so any taper is planned with the prescriber, slowly, when life is stable. Some people take medication for months, some for years. The level of care around it changes on its own timeline.

Can I start Vivitrol if I am still using opioids?

Not right away. Naltrexone blocks opioid receptors, so starting it while opioids are still in your system causes sudden withdrawal. The National Academies report describes needing at least 4 to 7 days with no opioids first (National Academies, 2019). That is one reason the physician may suggest a different medication, or detox placement first, depending on what you are using and how much.

Can I keep working while on MAT in an outpatient program?

Usually, yes. IOP and OP are built around work schedules, and buprenorphine and naltrexone do not require daily clinic visits. Our article on keeping your job during outpatient treatment covers how people manage it. Methadone programs often require daily dosing visits early on, though the 2024 federal rule allows take-home doses sooner based on the provider’s judgment (Federal Register, 2024).

Where can I get naloxone for free in New Jersey?

Any participating Naloxone365 pharmacy will give a two-dose nasal spray kit to anyone 14 or older, free, with no name, reason or prescription required (NJ Department of Human Services, 2024). More than 650 pharmacies statewide take part (NJ Department of Health, 2025). If you or someone in your house uses opioids, keep a kit at home.

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