Objective: This study explored medication-assisted treatment (MAT), the combined use of medication and psychosocial treatment, as a strategy for reducing violent outcomes in community-based offenders. The primary aims were to (a) examine associations between participant characteristics and treatment adherence, (b) examine associations between treatment adherence and substance use, (c) examine associations between treatment adherence and violent outcomes, and (d) determine whether associations between treatment adherence and violent outcomes may be attributable to reductions in substance use. Method: Baseline interviews were completed with 129 male offenders in community-based treatment prior to their 1st MAT appointment. Follow-up interviews (n = 91) were conducted approximately 90 days later. Results: Participant age was associated with medication adherence. Medication nonadherence was associated with at least occasional alcohol use but not drug use. Conversely, missing several counseling sessions was associated with at least occasional drug use but not alcohol use. Results of multivariable analyses suggested MAT may be effective in reducing violent outcomes, and victimization specifically, through reductions in alcohol use. Conclusion: Findings provide evidence supporting MAT as an intervention for victimization. Continued efforts are needed to explore strategies to promote treatment adherence and reduce violent outcomes in community-based offenders with alcohol and drug use problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)