Sustained five-year recovery as a primary measure of substance use disorder (SUD) outcomes can reshape both treatment outcome research and clinical practice. In this context, the definition of recovery is that of the Betty Ford Institute Consensus Panel, including no use of alcohol, marijuana or other drugs of abuse. The use of medications as prescribed in medication assisted treatment (MAT) is fully compatible with recovery. Physician health programs serve as a model of chronic disease management for SUDs, including opioid use disorders. Use of the five-year recovery standard will encourage all treatment programs to focus their attention on long-term patient outcomes.