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Medication treatment for opioid use disorder in New York City
New York City has the densest network of medication-based opioid use disorder (OUD) care in the country, spanning licensed opioid treatment programs (OTPs) across all five boroughs, office-based prescribers, hospital systems, and statewide telehealth options. The medications used are methadone, buprenorphine (including Suboxone and the extended-release injection Sublocade), and naltrexone (including the monthly Vivitrol injection). The clinic listings above this page show specific providers; the rest of this page is local context to help you decide what to call about.
What care looks like, and where you get it
Three FDA-approved medications treat opioid use disorder, and the setting depends on which one you and a clinician choose. Methadone for OUD is dispensed only through OASAS-certified opioid treatment programs, not at retail pharmacies. Buprenorphine, including Suboxone, can be prescribed in a doctor’s office, a hospital clinic, or an OTP, and filled at a pharmacy; an extended-release injection (Sublocade) is given monthly by a clinician. Naltrexone, including the Vivitrol injection, is prescribed in office settings, but you have to be off opioids for a set time before the first dose so it doesn’t trigger withdrawal. Since 2023, any provider with a standard DEA registration can prescribe buprenorphine for OUD, which has expanded where you can get it in the city, including in primary care and many hospital outpatient clinics. You can compare how methadone and Suboxone work before you call, or read more about what an OTP actually does.
Starting treatment in NYC
Most programs in the city will assess you the day you walk in or the next business day, and many will start medication at that first visit. Methadone induction happens inside an OTP under nursing supervision. Buprenorphine can be started in an emergency department, an office, or by telehealth; if you have been using fentanyl, the timing of the first buprenorphine dose matters because starting too soon can set off severe, sudden symptoms (precipitated withdrawal), so a clinician will plan the start with you. New York’s MATTERS network was built specifically to move people from an emergency department or other front-door setting into outpatient buprenorphine within days, and it now covers hospitals, OB-GYN offices, correctional facilities, and community clinics across the state. The OASAS HOPEline (1-877-846-7369) is staffed 24/7 if you want help finding a starting point, and the state treatment locator is at FindAddictionTreatment.ny.gov. Read more about starting methadone when you have been using fentanyl.
Take-home doses, telehealth, and what changed
Federal rules updated by SAMHSA in 2024 expanded take-home methadone (up to a 28-day supply for patients who are stable in treatment), permitted telehealth to start treatment, and removed the older rule that required a year of opioid addiction before OTP admission. Take-home eligibility is decided by the program based on clinical stability. As of June 2026, buprenorphine can be started by telehealth, including by phone in many cases, without a prior in-person visit; the broader telehealth flexibilities run through December 31, 2026 and DEA is finalizing permanent rules, so a provider can tell you what is current when you call. New York funds mobile medication units that bring methadone and buprenorphine directly into underserved areas, with additional units coming through the FY2026 state budget. Continuing or transferring care matters as much as starting it, so see why staying on your dose without gaps protects the work you have already done.
Paying for treatment
New York Medicaid (NYRx for the pharmacy benefit, with managed care for medical services) covers all three FDA-approved medications for opioid use disorder, and the 2024 Consolidated Appropriations Act made that coverage requirement permanent nationwide. OTP services in New York are also exempt from Medicaid’s Recipient Restriction Program, so a member who is restricted to a single primary care provider can still receive methadone or buprenorphine at an OTP without prior approval. Most private insurance plans sold in the state cover buprenorphine and naltrexone; methadone coverage in commercial plans is less consistent and worth confirming with the clinic. Many OASAS-certified programs offer sliding-scale fees or accept the state’s Substance Use Disorder block grant for people who are uninsured, and the state’s opioid settlement fund has paid to expand low-cost integrated outpatient and OTP sites.
The overdose picture in NYC, and why it matters for treatment
Drug overdose deaths in New York City fell from 3,046 in 2023 to 2,192 in 2024, a 28% decline and the largest single-year drop the city has recorded, according to the NYC Department of Health and Mental Hygiene (DOHMH, 2025). Fentanyl was present in 73% of overdose deaths in 2024, and xylazine, a non-opioid veterinary sedative that does not respond to naloxone, was detected in 21%. The decline has not been even: rates of overdose death remain highest in parts of the Bronx, Upper Manhattan, and Central Brooklyn, and among Black and Latino New Yorkers in those neighborhoods. Treatment with methadone or buprenorphine is the single intervention shown to cut the risk of opioid overdose death by roughly half (NIDA, SAMHSA), which is why getting on and staying on medication is the strongest move a person can make against an unpredictable drug supply. For more on what’s driving the local picture, read about opioid addiction and how it’s treated.
Harm reduction in NYC, including free naloxone
New York City runs an unusually dense overdose-prevention infrastructure that exists alongside treatment, not in place of it. OnPoint NYC operates the country’s first two officially recognized overdose prevention centers, in East Harlem and Washington Heights, and the city’s Relay program sends a peer Wellness Advocate to the bedside of someone who has survived an overdose in any of 16 partnering hospital emergency departments, with follow-up for up to 90 days. Naloxone (the medication that reverses an opioid overdose, sold as Narcan) is available over the counter, free at hundreds of community sites through DOHMH’s Opioid Overdose Prevention Programs, and at 24/7 public health vending machines around the city; New York’s statewide pharmacy standing order also lets any pharmacy dispense it without an individual prescription, and the state’s N-CAP program can cover up to $40 of an insurance copay. New York’s Good Samaritan Law protects people who call 911 during an overdose from arrest for low-level drug possession. If a return to use happens, the right step is to get back to treatment quickly; here is what to know about overdose risk on and after methadone.
Pregnancy, reentry, and other situations that need a tailored start
Several New Yorkers come to treatment under circumstances that need a specific kind of program. For pregnant patients, methadone and buprenorphine are the recommended standard of care during pregnancy, and OASAS-certified programs prioritize pregnant patients for admission; perinatal-experienced teams at New York City’s large hospital systems coordinate medication, prenatal care, and planning for the newborn so families stay together, with neonatal opioid withdrawal syndrome (NOWS) managed in the hospital after delivery. For people leaving incarceration, NYC Health + Hospitals/Correctional Health Services operates the Key Extended Entry Program (KEEP) at Rikers Island, the country’s oldest and largest jail-based opioid treatment program, which has provided methadone since 1987 and now offers all three FDA-approved medications and a warm handoff to a community OTP at release. Family members supporting someone through any of these situations can read how to help a loved one start medication treatment, or, for pregnancy specifically, more on methadone during pregnancy.
Frequently asked questions
Do I have to go to a clinic every day?
At the start of methadone treatment, yes, dosing happens at the OTP. As you stabilize, federal rules updated in 2024 allow programs to grant take-home doses on a graduated schedule, up to a 28-day supply for patients who are stable. Buprenorphine and naltrexone are prescribed in office settings and don’t require daily visits.
Can I start treatment by telehealth in New York?
You can start buprenorphine by telehealth, including by phone in many cases, under federal flexibilities current through December 31, 2026. Methadone can be initiated using audio-visual telehealth within an OTP under SAMHSA rules; pharmacy-dispensed methadone for OUD is not available under current federal law. Confirm what’s current with the clinic when you call.
What if I’ve been using fentanyl and I’m worried about starting Suboxone?
Starting buprenorphine too soon after fentanyl can cause sudden, severe symptoms (precipitated withdrawal). Clinicians experienced with fentanyl use have approaches to time the first dose carefully, including microdosing and inpatient or close-monitoring options. Tell the intake nurse what you have been using and how recently; that information shapes the plan.
Will my insurance cover this?
New York Medicaid covers all three FDA-approved medications for opioid use disorder, including methadone in OTPs, buprenorphine through the NYRx pharmacy benefit, and naltrexone. Most private plans sold in New York cover buprenorphine and naltrexone; methadone coverage in commercial plans is less consistent, and sliding-scale fees are common at OASAS-certified programs.
How long do people stay on medication?
There is no set timeline. Many people stay on methadone or buprenorphine for years and do best with long-term treatment; others taper later under clinical supervision. Long-term medication is real treatment, not an unfinished step. Read more on how long methadone treatment lasts.
Sources and disclosures
Last reviewed June 2026.
Sources used on this page:
- SAMHSA, Medications for Substance Use Disorders (federal MOUD framework and the 2024 revision of 42 CFR Part 8).
- Federal Register, Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities (2026).
- DEA press release, December 31, 2025 on telemedicine extension and the buprenorphine final rule.
- NYC DOHMH, Epi Data Brief No. 150, Unintentional Drug Poisoning (Overdose) Deaths in NYC, 2024 (October 2025).
- NYS Office of Addiction Services and Supports (OASAS), Opioid Use Disorder.
- NYS Department of Health, Standing Order for Naloxone in Pharmacies.
- NYC DOHMH, Relay program expansion announcement, February 2026.
- Office of the Governor, statement on 2024 overdose decline and MATTERS network.
- NYC Health + Hospitals, Correctional Health Services (KEEP program).
Methadone Centers is not a treatment provider. The directory is for informational purposes and does not constitute medical advice. Speak with a licensed clinician about whether medication treatment is right for you. Calls to the helpline displayed on this site may be answered by a paid sponsor; we do not receive payment for any specific clinic referral.