For decades, addiction treatment has been surrounded by myths, stigma, and misinformation. Few topics spark more debate than medications used to treat opioid addiction. Are they replacing one drug with another? Do they actually work? Can someone taking Suboxone still be considered sober?

These are some of the internet's most searched questions, and they're exactly what addiction medicine physician Dr. Steven Klein tackles in this episode of Recoverable. Drawing on both his medical expertise and his own lived experience in recovery, Dr. Klein explains why opioid use disorder should be treated like any other serious medical condition, with evidence-based care instead of judgment.

Throughout the conversation, he challenges long-held misconceptions, explains how medications save lives, and reminds listeners that recovery isn't about taking shortcuts. It's about giving people the best chance to reclaim their health, their relationships, and their future.

Here are the biggest questions the episode answers.

1. What Are Medications for Opioid Use Disorder (MOUD)?

MOUD are proven medical treatments, not a last resort.

One of the first misconceptions Dr. Klein addresses is the terminology itself. Many people still use the phrase "medication assisted treatment," or MAT, but today's medical community increasingly uses MOUD, which stands for medications for opioid use disorder. The shift may seem small, but it reflects an important change in how addiction is viewed.

Rather than treating medication as simply an "assist," MOUD recognizes these medications as legitimate medical treatments for a serious disease. Dr. Klein emphasizes that medication is only one piece of recovery. Therapy, peer support, counseling, family involvement, and long-term care all remain essential parts of successful treatment.

What medications are used to treat opioid use disorder?

Dr. Klein explains that there are three primary FDA-approved medications used today:

• Buprenorphine (Suboxone)
• Methadone
• Naltrexone

Each works differently, but all have one shared purpose, reducing overdose deaths and helping people regain stability.

Naltrexone blocks opioid receptors entirely, preventing opioids from producing their usual effects. Buprenorphine partially activates those receptors, reducing withdrawal symptoms and cravings without producing the same dangerous respiratory depression seen with opioids like heroin or fentanyl. Methadone, another effective option, remains widely used through specialized treatment programs.

2. Do Medications for Opioid Use Disorder Actually Work?

The evidence is overwhelming.

If there is one message Dr. Klein returns to repeatedly, it's this, the science is no longer up for debate.

The medications used to treat opioid addiction are among the most effective treatments in all of medicine. Buprenorphine dramatically reduces opioid cravings, lowers overdose risk, and keeps more people engaged in treatment than attempting recovery without medication.

One statistic especially stands out.

Dr. Klein explains that buprenorphine has a Number Needed to Treat (NNT) of roughly 2 to 3. In practical terms, for every two or three people who receive the medication, one experiences a meaningful clinical benefit. Compared to many common medications used across healthcare, those are extraordinary results.

Is the goal simply abstinence?

The answer is more nuanced than many people expect.

Dr. Klein explains that the first goal of treatment isn't simply checking a box labeled "abstinence." The first priority is preventing overdose and saving lives. From there, treatment helps people regain agency, reconnect with family, return to work, and begin addressing the deeper causes of addiction.

He describes agency as the ability to once again make decisions that align with your own values instead of decisions driven by withdrawal or cravings. That shift often marks the beginning of lasting recovery.

3. Is Taking Suboxone Just Replacing One Addiction With Another?

This is one of the biggest myths in addiction treatment.

Few questions generate more controversy online than whether someone taking Suboxone is "really sober."

Dr. Klein doesn't hesitate with his answer.

He believes this stigma keeps people from receiving life-saving treatment. While buprenorphine is technically an opioid, it behaves very differently than heroin or fentanyl. It activates opioid receptors only partially, significantly reducing cravings while making overdose far less likely. More importantly, it allows people to rebuild their lives instead of constantly chasing drugs.

He also points out that no one questions insulin for diabetes or chemotherapy for cancer. Yet addiction medicine is often judged by an entirely different standard because addiction itself remains deeply stigmatized.

Can someone on MOUD still be considered sober?

According to Dr. Klein, absolutely.

He rejects the idea that using evidence-based medication somehow invalidates recovery. Instead, he argues that accepting medical treatment often demonstrates enormous courage.

One of the most memorable moments comes when he connects medication with the first step in recovery.

Accepting help through medication can itself be an acknowledgment that you cannot overcome the disease entirely on your own.

Rather than weakening recovery, medication often creates the stability needed for therapy, relationships, spiritual growth, and lasting behavioral change. It's a tool, not a shortcut.

He continues by describing his patients as "heroic" and "incredibly courageous" for seeking treatment and using every available tool to survive a life-threatening illness.

4. Is Medication Alone Enough to Treat Opioid Addiction?

Medication treats the symptoms, recovery treats the person.

One of the most powerful distinctions Dr. Klein makes is between treating opioid use and treating addiction itself.

Medications like buprenorphine and naltrexone are incredibly effective at reducing cravings, preventing overdose, and helping people stabilize. But addiction rarely begins with the substance. It begins with something much deeper.

As Dr. Klein puts it, "Drugs and alcohol are not the answer, but they make us forget the question."

It's a simple statement that captures the heart of recovery. Drugs temporarily numb emotional pain, trauma, shame, anxiety, or disconnection, but they don't resolve those underlying issues. Once someone is medically stable, the real work begins.

Why do people develop addiction in the first place?

While every person's story is different, Dr. Klein says many addictions share a common thread, disconnection.

Sometimes that disconnection comes from trauma. Sometimes it comes from loneliness, identity struggles, grief, or emotional pain. Other times it's a gradual separation from ourselves, our families, or our sense of purpose.

He explains that addiction often flourishes in the space between who we truly are and who we believe we have to be. Healing means reconnecting those pieces.

That's why therapy, peer support, family involvement, and long-term recovery programs remain essential. Medication creates the stability to do that deeper work, it doesn't replace it.

5. Why Don't More People Use Medications That Save Lives?

Stigma is still one of the biggest barriers.

Despite decades of research proving their effectiveness, medications for opioid use disorder remain underused.

The biggest reason isn't that they don't work.

It's stigma.

Dr. Klein explains that many patients arrive already convinced they'll never take medications like Suboxone because they've heard they're "cheating," "not really sober," or simply replacing one addiction with another. Those beliefs often come from misunderstanding rather than science.

He compares refusing addiction medication because of stigma to refusing chemotherapy for cancer. Both involve serious illnesses. Both have evidence-based treatments. Yet addiction continues to be judged differently because society still treats it as a moral failing instead of a medical condition.

Are injectable medications changing recovery?

One of the most exciting developments discussed in the episode is the growing use of monthly injectable buprenorphine.

Instead of taking medication every day, patients can receive one injection each month. That dramatically simplifies treatment while improving adherence and reducing the daily reminders associated with addiction.

Dr. Klein believes injectables also help shift a patient's identity.

Rather than waking up every morning focused on medication, people are free to focus on rebuilding their lives. Recovery becomes less about managing a prescription and more about reconnecting with family, work, community, and purpose.

What should someone do if they're considering medication?

Dr. Klein's advice is compassionate and practical.

First, recognize the courage it has already taken to reach the point of asking for help. Then connect with a medical professional trained in addiction medicine who can explain every available treatment option.

Whether treatment begins in an outpatient clinic, a residential treatment center, or through a primary care physician, the important thing is simply taking that first step.

He reminds listeners that opioid use disorder is a life-threatening disease, not a character flaw. Like any serious illness, it deserves evidence-based care delivered without shame.

Come back next Thursday, July 2nd, for Part Two of our conversation with Dr. Klein!