To provide the most accurate and helpful information, I've put together the top 15 frequently asked questions about methadone treatment. These FAQs address common concerns and are from a review of patient questions, social media discussions, and current research. Also, you'll find a comprehensive, searchable directory of methadone clinics throughout the United States. My goal is to make this page a definitive resource for anyone seeking methadone treatment. I would love to hear your feedback and suggestions.
Frequently Asked Questions About Methadone Treatment You Need To Know
What is methadone and how does it work?
Methadone is a synthetic opioid medication invented in 1937 as a replacement for morphine which was in short supply. Like naturally occurring opiates such as morphine, codeine, thebaine, and oripavine, it binds and activates the opioid receptors in the brain and spinal cord. However, methadone is longer-acting and is more potent than the naturally occurring opiates. This means that it can produce the same effects with less amounts.
What is in methadone?
The main ingredient in methadone is methadone hydrochloride. This is a synthetic opioid medication. Methadone hydrochloride is a full opioid agonist which means it completely activates the opioid receptor and the more you give, the more response you get. In addition to methadone hydrochloride, methadone medication may contain other inactive ingredients. These can vary depending on the specific formulation (liquid, tablet, or dispersible tablet). These other ingredients might include things like fillers, flavorings, or preservatives. However, methadone hydrochloride is the key ingredient. Used in a methadone maintenance programs, it is often found as a liquid.
What is methadone used for?
Methadone is primarily used as a medication to treat opioid use disorder, which is sometimes referred to as opioid addiction. It is considered the most effective treatment for opioid addiction. People who take methadone as part of an opioid treatment program do so to stop abusing other opioids, such as heroin, fentanyl, or prescription pain relievers. Methadone helps by reducing cravings for these drugs. It also relieves the uncomfortable withdrawal symptoms that occur when someone stops taking opioids. When included as part of a comprehensive treatment plan, often called Medication-Assisted Treatment (MAT), methadone treatment can help individuals overcome opioid addiction and improve their quality of life. It is often considered safe and effective for long-term use to help people stay in recovery.
Methadone is also used in pain management because of its very long half-life; this means that 1 dose may last 8-12 hours for pain relief.
What are the benefits of MAT with methadone?
Earlier, I said that methadone was considered the most effective treatment for opioid addiction. The reason why we know this is because of numerous medical studies showing the following benefits of using methadone over other methods:
Benefit | Description |
Improved survival rates | Reduces the risk of overdose and death associated with opioid use. |
Reduced overdose risk | Helps prevent overdoses by blocking the effects of other opioids. |
Increased treatment retention | Improves the likelihood of staying in treatment and completing the program. |
Reduced opioid use | Decreases the frequency and intensity of opioid cravings and use. |
Reduced criminal activity | Lowers the risk of engaging in criminal behavior to obtain opioids. |
Improved employment | Increases the ability to find and maintain stable employment. |
Improved birth outcomes | Reduces the risk of complications for pregnant women with OUD and their babies. |
Reduced risk of infectious diseases | Decreases the risk of contracting HIV or hepatitis B or C through intravenous drug use. |
What is a methadone Clinic?
A methadone clinic is a specialized healthcare facility that provides methadone maintenance treatment or methadone detoxification to individuals with opioid use disorder. These clinics are certified opioid treatment programs that are typically regulated by the state and federal government. They are staffed by doctors, nurses, and counselors who are trained in addiction treatment. At a methadone clinic, patients receive a daily dosage of methadone, which helps manage their withdrawal symptoms and reduce opioid cravings. Along with dispensing medication, these clinics also offer counseling, therapy, and other support services as part of a complete treatment plan. The goal is to help people stop using harmful opioids and achieve a healthier lifestyle.
Don't forget. On this page, you have the ability to search and find a methadone treatment program near you. The directory is updated weekly.
How much does methadone treatment cost, and is it covered by insurance?
Many insurance plans, including Medicaid and Medicare, do cover methadone treatment for opioid use disorder. However, coverage details can vary, so it's essential to check with your insurance provider to understand your specific benefits and any out-of-pocket costs you may have. Some clinics may also offer assistance treatment costs through grants or sliding scale payments.
Is MAT with methadone just replacing one addiction with another?
This is a common concern, but it's important to understand that MAT is not simply exchanging one addiction for another. When used as prescribed, methadone helps stabilize brain chemistry, reduces cravings, and prevents withdrawal symptoms without causing the harmful effects of illicit opioid use. This allows individuals to focus on therapy and other aspects of their recovery. As mentioned before, people using methadone for MAT statistically do better than those addicted to opiates.
Unfortunately, there is a stigma associated with MAT. Some people mistakenly believe that taking medication for opioid addiction is not true recovery. However, I would challenge those individuals. Is taking blood pressure or diabetes medicine replacing bad lifestyle habits such as eating too much and not exercising? Addiction is no different than any other chronic disease other than people's attitude towards the patients.
What happens if I miss a dose of methadone?
In many cases, if you miss a single dose, you may be able to take it as soon as you remember, as long as it's within a certain timeframe. However, if several hours have passed or if you have missed multiple doses, your clinic may advise you to wait until your next scheduled dose or come in for an evaluation. Never take more methadone than prescribed to make up for a missed dose, as this can increase the risk of side effects or overdose. Each methadone program will have its own specific guidelines for missed doses, so it's always best to follow the instructions provided by your treatment team.
What are the potential side effects of methadone?
When prescribed under the supervision of a treatment provider, methadone is safe and effective. However, like any medication, methadone may have side effects. These can include:
Nausea
Constipation
Drowsiness
Restlessness
Headache
Insomnia
Agitation
Disorientation
It's crucial to discuss any concerns about side effects with your doctor. They can help manage side effects and adjust your dosage as needed.
Patients on methadone must be aware of the potential for negative interactions between methadone and other substances, including alcohol and opioids. You should notify your treatment team of any prescription medications, over-the-counter drugs, or other substances you are taking before starting methadone.
When is methadone Taken?
A typical methadone dose is usually taken once a day. When used in an opioid treatment program, the patient will receive methadone at about the same time each day. The exact time to take methadone can vary slightly depending on the treatment center and the individual's needs. In some individuals, a split-dose typically twice per day may be prescribed.
It's important to take methadone as directed by the treatment plan. Taking it consistently helps maintain a stable level of the medication in the body, which is important for managing withdrawal symptoms and reducing cravings for other opioids like heroin. Some people may use methadone for a short time (detoxification) to overcome an opioid addiction, while others take methadone long-term (maintenance) as part of their recovery.
How long will I need to be on methadone treatment?
While most guidelines say that the duration of methadone treatment varies depending on individual needs and progress, the truth is that opioid addiction and opioid dependence is a chronic disease. Opioid addiction changes the brain and the changes might be permanent; we don't know for sure. There is no evidence to support the idea that stopping MAT is beneficial. In fact, research shows that the longer durations of MAT, the better the long-term outcomes.
So after 26 years of treatment thousands of patients, I've learned a few things from my most successful patients who have avoid relapse. I tell my patients to focus on fixing their lives. Fix their employments, their relationships, their health, etc. After all of these things are fixed and optimized, then tapering off of methadone can be considered.
Can I take methadone if I am pregnant?
Methadone is remarkable in helping women stay sober from illicit opioids. Methadone is considered a safe and effective treatment option for pregnant women with OUD. The American College of Obstetricians and Gynecologists (ACOG) recommends MAT for pregnant women with opioid disorders. It can help reduce the risk of complications for both the mother and the baby. While some babies may experience neonatal abstinence syndrome (NAS) after birth, this is typically mild and manageable with appropriate medical care. Women can also continue to take methadone while breastfeeding.
Will I need therapy in addition to methadone?
Yes, counseling and behavioral therapies are essential components of MAT. In fact, certified methadone treatment programs require some form of counseling. Quite often, most patients will have other substance use disorders in addition to opioid addiction. While methadone helps manage the physical aspects of addiction, therapy addresses the underlying causes of addiction, helps you develop coping skills, provides strategies to prevent relapse, and help with other substance abuse.
Can I become addicted to methadone?
While methadone can cause physical dependence, this is not the same as addiction. Physical dependence means that your body has adapted to the presence of the medication, and you may experience withdrawal symptoms if you stop taking it abruptly. Addiction, on the other hand, is characterized by compulsive drug use despite negative consequences. When used as prescribed in MAT, methadone helps manage withdrawal symptoms and cravings, allowing individuals to regain control of their lives without the harmful behaviors associated with addiction.
What is a methadone treatment dose for opioid use disorder?
The right dose varies from person to person, depending on many factors like opioid use history, opioid tolerance, and metabolism. When starting treatment, doses typically begin low—around 10 to 50 milligrams—to prevent side effects, impairment like drowsiness or slowed breathing. In the US, the law as of 2024 allows for no more than 50 milligrams the first day of treatment. From there, the dose may be adjusted gradually until it prevents withdrawal symptoms and cravings. The first few weeks of methadone treatment are the highest risks for accidental overdose. Therefore, most treatment programs will titrate the dose very slowly.
For many people, maintenance doses range from 60 to 120 milligrams per day, though some may need more or less. However, with the spread of fentanyl abuse, maintenance doses for fentanyl users can range much higher-around 120 to 240 milligrams.
About the author:
Dr. Harold Pierre is a board-certified anesthesiologist, board certified addiction medicine specialist, and a concierge addiction doctor with over 26 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.
*Disclaimer: This blog post is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your doctor or other qualified health provider with any questions you may have regarding your health or a medical condition before making any changes.
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