While not without its disadvantages, narcotic replacement therapy has been shown to improve the success rate of those in recovery.

Over the last several decades, the use of narcotics, or opioids, has increased dramatically ― as has the prevalence of opioid use disorder and opioid-related deaths. In fact, according to the Centers for Disease Control and Prevention (CDC), 75% of all fatal drug overdoses in 2021 involved opioids.

When someone is dependent on opioids or has opioid use disorder, treatment can be a long, difficult process. However, doctors have used narcotic replacement therapy for decades as an effective treatment for opioid dependence and opioid use disorder.

Below, we’ll take a look at what narcotic replacement therapy is, how successful it is at treating opioid dependence, and how to find opioid use disorder treatment near you.

Narcotic replacement therapy is a treatment for opioid dependency that uses synthetic opioids to reduce cravings and prevent relapse. Narcotic replacement therapy is also known as opioid replacement therapy, opioid substitution therapy, or opioid agonist therapy.

Although there are technically four different FDA-approved medications for treating opioid use disorder, the three most common include:

  • Buprenorphine, a partial opioid agonist that relieves cravings and withdrawal symptoms without causing euphoria.
  • Methadone, an opioid agonist that acts more slowly but strongly to reduce cravings and opioid withdrawal symptoms.
  • Naltrexone, an opioid antagonist that prevents the activation of opioid receptors and, in turn, the “high” that opioids cause.

Each of these medications works differently in the body, but the goal of opioid replacement therapy is to reduce addiction and dependence. There are two steps to this process.

First, the detoxification phase of treatment involves using these medications to reduce withdrawal symptoms. It can take anywhere from a few weeks to upward of six months with gradual dosage changes for someone to detox during this phase.

After a successful detox, the maintenance phase involves taking maintenance dosages of these medications. Over time, this can help reduce or even eliminate opioid use disorder and, ultimately, improve someone’s overall functioning and quality of life.

Narcotic replacement therapy is one of the most widely used and effective forms of treatment for opioid use disorder.

One large study from 2020 compared the effectiveness of six different treatment options for people with opioid use disorder ― including treatment with buprenorphine or methadone.

Results of the study, which included over 40,800 participants, found that only treatment with buprenorphine or methadone led to a decreased risk of overdose after 3- and 12-month follow-up periods. Treatment with buprenorphine or methadone was also associated with less acute care needs during the follow-up periods.

Because of the nature of opioid use disorder and the medications used for narcotic replacement therapy, there are some benefits and risks to this treatment.


Opioid replacement therapy can be extremely beneficial for people who undergo and complete treatment. According to a Research Report from the National Institute on Drug Abuse, some of the benefits of using opioid replacement medications for treatment are that they:

  • reduce overall opioid use
  • decrease the symptoms of opioid use disorder
  • lower the risk of people with the disorder transmitting other infectious diseases
  • reduce illegal behavior associated with opioid use

People who undergo narcotic replacement therapy are also more likely to remain in treatment than other treatment approaches. Because of this, this treatment can help reduce the chance of overdose death and additional disease transmission and infection, among other benefits.


While narcotic replacement therapy can be an effective treatment approach for opioid use disorder and dependence, there are some risks. One early review published in 2012 found that the most common safety concerns associated with treatment were:

  • potential for overdose
  • potential for misuse
  • chance of side effects, like liver and heart problems

Another possible disadvantage of narcotic replacement therapy is that it can sometimes be difficult for people to access these treatment programs. And for people who do have access to treatment, they don’t always stick with it.

For example, one study from 2019 found that only around 56% of those undergoing opioid agonist therapy completed treatment. Among those who didn’t complete treatment, 23.3% of participants voluntarily dropped out of treatment early.

If you or someone you love is considering taking the first step toward treatment for opioid use, some resources can help. Here are a few resources to help you access treatment programs near you:

If you’ve already started discussing treatment with your doctor or therapist, they can also help recommend treatment options in your area.

Opioid use disorder affects millions of people in the United States, but many people with this disorder find it difficult to get the right treatment. Narcotic, or opioid, replacement therapy can be an effective way to reduce opioid dependence and treat the symptoms of withdrawal.

If you’ve noticed that opioid use is negatively affecting your life, consider reaching out to a doctor or other mental health professional for help. With the right treatment, you can recover and take your life back from this disorder.