A 34-year-old man with a 6-year history of severe opioid use disorder involving intravenous heroin presents to a community health clinic requesting medication treatment. He has had three prior treatment episodes: two with buprenorphine/naloxone that he discontinued each time within 2 months due to persistent cravings and relapse, and one 21-day inpatient detoxification followed by relapse within one week. He currently uses heroin daily. What is the most appropriate medication treatment recommendation?