Opioid maintenance treatment (OMT) has been developed within drug dependency treatment in Finland over the last 20 years. This study, based on interviews with 15 stakeholders and content analysis of 174 newspaper texts, draws on Boltanski and Thévenot's theory of justification to explore ways in which OMT has been justified and identifies the main actors contributing to its development. Multiple factors, involving different actors, have influenced the development process, reflecting the ethos of contemporary Finnish welfare and health policy. Currently, the main justifications for choosing OMT treatment seem to emerge from a neoliberal frame of understanding.