Medication Assisted Treatment is NOT replacing one addiction for another. With all due respect, It is ignorance such this that that has created the stigma associated with persons suffering from opioid dependence from seeking out treatment in the form of medications such as Subtext or Methadone. These medications have pharmacokinetic profiles that differ from heroin, morphine, hydromorphone, oxycodone and almost every abused illicit opioid. These medications have half-lives of >24 hours which in turn allows once daily dosing. When former opioid addicts begin to become stabilized on these medications, their brains also begin to heal. Pharmacological therapy with methadone, buprenorphine w/naltrexone, buprenorphine or other medications directly offsets or reverses some of the brain changes associated with addiction, greatly enhancing the effectiveness of behavioral therapies. Although researchers do not yet know everything about how these medications work, it is clear that they are all truly active treatments, rather than simply substitutes for the addictive opioids. Both methadone and buprenorphine are long-acting opioid medications. Unlike morphine, heroin, oxycodone, and other addictive opioids that remain in the brain and body for only a short time, methadone and buprenorphines' effects last for days. Methadone and buprenorphine causes dependence, but—because of their steadier influence on the mu opioid receptor—they produce minimal tolerance and alleviate craving and compulsive drug use. In addition, methadone and buprenorphine therapy tend to normalize many aspects of the hormonal disruptions found in addicted individuals (Kling et al., 2000; Kreek, 2000; Schluger et al., 2001). For example, it moderates the exaggerated cortisol stress response set off with abuse of opioids with short half-lives, which in turn increases the danger of relapse in stressful situations. In closing, Opioid dependence and addiction are most appropriately understood as chronic medical disorders, like hypertension, schizophrenia, and diabetes. As with those other diseases, a cure for drug addiction is unlikely, and frequent recurrences can be expected; but long-term treatment can limit the disease’s adverse effects and improve the patient’s day-to-day functioning. The mesolimbic reward system appears to be central to the development of the direct clinical consequences of chronic opioid abuse, including tolerance, dependence, and addiction. Other brain areas and neurochemicals, including cortisol, also are relevant to dependence and relapse. Pharmacological interventions for opioid addiction are highly effective; however, given the complex biological, psychological, and social aspects of the disease, they must be accompanied by appropriate psychosocial treatments. Clinician awareness of the neurobiological basis of opioid dependence, and information-sharing with patients, can provide insight into patient behaviors and problems and clarify the rationale for treatment methods and goals. Methadone as well as buprenorphine treatment reduces relapse rates, facilitates behavioral therapy, and enables patients to concentrate on life tasks such as maintaining relationships and holding jobs. Pioneering studies by Dole, Nyswander, and Kreek in 1964 to 1966 established methadone’s efficacy (Dole et al., 1966). And similarly with buprenorphine (when it's pharmacokinetic and pharmacologic profile where revealed and studied with respect to opioid abuse treatment). Patients are generally started on a daily dose of 20 mg to 30 mg, with increases of 5 mg to 10 mg until a dose of 60 mg to 100 mg per day is achieved. The higher doses produce full suppression of opioid craving and, consequently, opioid-free urine tests (Judd et al., 1998). Patients generally stay on methadone for 6 months to 3 years, some much longer. Relapse is common among patients who discontinue methadone after only 2 years or less, and many patients have benefited from lifelong methadone maintenance. Buprenorphine patients are generally started on 2 to 8 mg (sublingually) when they are being seen for the first time. Daily doses can increase to a maximum of 32mg per day after which no further benefit can be obtained due to its' partial agonist profile.