Healer or Dealer
How to Consciously Treat Opioid Addictions
by Matthew Felgus, MD
Healer or Dealer is a practical, compassionate roadmap for treating opioid use disorder without losing the person inside the diagnosis. Drawing on decades in the field, first as a drug counselor, then as a dual-board-certified addiction medicine physician and psychiatrist, Dr. Matthew Felgus shows how to use medication well, when to taper, and how to address the “Big Four” drivers of use: anxiety, depression, trauma, and insomnia.
Treatment that focuses only on prescriptions can keep people stuck; treatment that ignores medication can leave them unsafe. Healer or Dealer argues for a third way: care that blends evidence and humanity, medication when it helps, tapering when it’s time, whole-person care always.
With clarity and humility, Dr. Felgus translates front-line experience into steps families, clinicians, and communities can use. He explains what buprenorphine/Suboxone® actually does; why the lowest effective dose often serves patients best; and how to plan tapering over years, not months, when readiness and stability align. He also shows how to treat substance use and mental health together, because cravings rarely resolve while anxiety, depression, trauma, or insomnia go unaddressed.
The book introduces the Substance Use Continuum as a plain-language framework for assessment and next steps; offers practical ways to distinguish anxiety from withdrawal; and makes space for multiple paths – 12-Step and non-12-Step alike – grounded in respect rather than rigidity. Above all, Healer or Dealer centers the person: their values, pace, and real life.
Written in clear, accessible prose, this is a guide for people who want more than “just meds,” and more than slogans. It is for those looking for care that heals.
Key Takeaways
Medication with meaning When and how to start the various treatment options for opioid misuse so life can stabilize without over-medicating.
Tapering, when it’s time A safety-first, collaborative approach to tapering over years, tied to readiness, skills, and stability.
Treat the “Big Four” Practical strategies for anxiety, depression, trauma, and insomnia so recovery can last.
Clinicians & care teams seeking clear, humane guidance on medications, dual diagnosis, and tapering.
Patients & families who want to understand options and build a plan that fits real life.
Educators, employers & community leaders working to reduce harm and support recovery with practical tools.
Justice, first responders & policy stakeholders aiming for responses that are both safe and human.
About the Author
From Healer Or Dealer
“Medications are one piece of the puzzle of healing, and usually not the most important piece.”
– Matthew Felgus, MD, Healer or Dealer, p. 9
“Intuition does know what one needs in order to heal. It knows when something feels right or it doesn’t – from the foods we eat to the medicines we ingest. We can ignore and shut out its message, or we can take another path towards our freedom.”
“Remember, though, the goal is not simply to get off of opioid replacement medication. The goal is to remain off of opioids. Preparing for this is a process that takes time and work on oneself.”
– Matthew Felgus, MD, Healer or Dealer, p. 181
Bring Dr. Felgus to your conference, grand rounds, or training. Signature talks translate the book’s framework into clinician-ready steps – wise MAT, safe tapering, dual-diagnosis care, and the Substance Use Continuum.
AllOneRising is an independent publisher dedicated to practical, compassionate resources at the intersection of medicine, mental health, and recovery, work that translates evidence into humane action and unites science with soul.
Guided by its mission: Celebrating and upleveling group consciousness by revealing the wisdom of the All; rising to the true nature of connectivity and the knowing that lies within our sacred selves, AllOneRising champions evidence-informed books that honor human dignity, deepen connection, and help communities heal together.