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Recovery is being used as a conceptual fulcrum for the redesign of addiction treatment and related support services in the United States. Efforts by policy, research, and clinical leaders to define recovery and calls for assertive models of long-term recovery management raise critical questions about how recovery-focused systems transformation efforts will affect the pharmacotherapeutic treatment of opioid addiction and the status of patients participating in such treatment. This paper highlights recent work advocating a recovery-oriented approach to medication-assisted treatment.