Training FM residents to offer medication-assisted treatment (MAT) for opiate use disorders is not a simple task. As opposed to simply buying some new medical devices for the clinic and training residents to use it, instead MAT training requires systematic changes in work-flow, billing, and scheduling. It can require systemic change in mission, vision, and even personnel. Certainly, it requires the interpersonal skills necessary to get buy-in from administrators, faculty, staff, and residents in order to adopt this training as part of the curriculum. In this presentation we share our story of success in becoming one of the only providers of MAT in our area, emphasizing the strengths and weaknesses of our approach. We share research that supports the need to train for MAT in residency, and we provide specific tips that participants can take home to use in their training location to aid in their MAT training efforts.