- Table of ContentsPrint
- How Methadone Treatment Works
- Is Methadone Right for Me?
- Viewpoints on Methadone and Sobriety
- Finding Methadone Clinics
- What to Expect When You Visit a Clinic
Methadone, a prescription opioid used in the treatment of opiate addiction, helps to stabilize individuals in recovery by reducing their cravings and withdrawal symptoms so they can fully engage in addiction treatment and therapy. Methadone must be given at specialized methadone clinics.
While there is some controversy among certain recovery groups about using medication in addiction recovery, methadone can be a safe and effective tool in getting clean when used appropriately.
Methadone is a prescription opioid medication primarily used for detoxification and maintenance treatment for people struggling to overcome opioid dependence and addiction.1,2 Methadone is a mainstay of treatment for many opioid-dependent individuals attempting to get clean.
Like other opioid medications, methadone carries some risk ofunwanted side effects, but when used as directed, the substance is considered safe and can be an effective treatment method for opioid addiction.1
How Methadone Treatment Works
When methadone is used in the treatment of opioid-dependent individuals, it is often referred to as methadone maintenance treatment or medication-assisted treatment (MAT).1,2 MAT is a multifaceted treatment approach that:1,3,4,
- Includes the use of an approved medication for detoxification from opioids and for the treatment of opioid addiction.
- Can be provided in varioustreatment settings.
- Is offered throughout the stages of recovery from detox to long-term addiction recovery.
- Can be implemented with methadone, buprenorphine, or naltrexone, all of which are FDA-approved for the management of opioid dependence.
- Involves different stages of treatment including:
- Induction stage—focused on reducing opioid withdrawal.
- Stabilization stage—focused on ending drug-seeking behavior, other opioid use, and cravings.
- Maintenance stage—focused on returning to a normal functioning while receiving medication (without regular adjustments to the dose).
- Typically integrates behavioral therapy to get to the root cause of the drug abuse and establish healthy patterns for long-term recovery.
Methadone is only offered from opioid treatment programs (OTPs) that are certified by the Substance Abuse and Mental Health Services Administration (SAMHSA).1 This helps to ensure that the medication is distributed under safe conditions.
Methadone eliminates the “rush” and the “crash” pattern to break the cycle of addiction.
Like heroin and many prescription pain medications, methadone is an opioid medication.1,2,3,4 The difference is that it is longer-acting; its opioid effects are relatively protracted and less likely to impair the individual’s ability to function as normal. At the same time, the opioid effects methadone will provide will help to alleviate the desire to use other more destructive opioid drugs.
When consumed as part of MAT, methadone works by providing two beneficial effects:1
- Methadone will minimize the painful symptoms of opioid withdrawal.
- Methadone will block the euphoric feelings produced by other opioid substances like heroin and painkillers, reducing cravings and discouraging abuse.
Methadone users are often accused of “simply replacing one addiction with another.”3 However, despite common misconceptions, as part of MAT, methadone is prescribed and dispensed in a supervised and controlled way with an emphasis on safety.3
People that abuse opioids find themselves in a dangerous cycle of seeking an intense “rush,” feeling the “crash” after the short-lived high, and experiencing strong cravings for more of the drug.3 Methadone eliminates the “rush” and the “crash” pattern to break the cycle of addiction, while reducing the cravings that keep people returning to their drug of choice.3 When freed from the compulsion to seek out and use opioids, the individual can commit their time and energy towards activities that contribute to their mental, physical, and social health.
Is Methadone Right for Me?
Methadone is a preferred treatment option for many people. It has a long record of success with over 40 years of use in opioid treatment and is the medication most frequently used in MAT for opioid addiction.2,4
Benefits of methadone include the following:1,2,3,4
- It’s a full opioid agonist. Methadone provides a potent effect that alleviates withdrawal and staves off cravings by powerfully binding to opioid receptors in the brain.
- It is long-lasting. Methadone reduces or eliminates discomfort and drug cravings for up to 36 hours.
- It is safe. When used as directed under supervision, methadone has a strong safety profile. The medication is approved by the FDA for use by pregnant and breastfeeding women.4
Potential Risks and Side Effects
Like other medications, methadone has a variety of side effects that range from mild to serious. A person experiencing serious side effects from methadone should immediately consult with their prescriber. Side effects of methadone include:1,5
- Changes in mood.
- Stomach/chest pain.
- Fast or strong heartbeat.
- Trouble breathing or swallowing.
- Feeling sleepy or very drowsy.
- Confusion or hallucinations.
- Dry mouth.
- Tongue soreness.
- Urination problems.
- Impaired vision.
- Difficulty getting restful sleep.
- Hoarse or scratchy voice.
- Sexual dysfunction and menstrual changes.
- Weight gain.
- Gastrointestinal issues (nausea, vomiting, decreased appetite).
Additional risks and drawbacks of methadone include:1,3
- Potential for abuse. As an opioid, it is possible for a person to use methadone in ways other than prescribed to experience the euphoric effects. This can result in the individual restarting the cycle of addiction that methadone is prescribed to end.
- The long duration of treatment. Methadone will not be a good match for people seeking short-term treatment. The recommended minimum treatment length for methadone is one year.
- The impact on infants. Although methadone is safe for pregnant mothers, the substance imparts a risk to the babies at the time of birth.Babies may experience uncomfortable withdrawal symptoms that begin a few days after birth and last for up to one month.
While methadone is safe when used appropriately, abusing it can lead to an overdose. The same characteristics that make methadone a good choice for MAT (strength and duration of action) increase the risk of fatal overdose when the medication is used in a reckless manner. Symptoms of overdose include:2,5
- Markedly constricted pupils (aka pinpoint, or pinprick pupils).
- Profound sedation/intermittent loss of consciousness.
- Cold or damp skin.
- Limp/flaccid muscles.
- Slowed, shallow, or stopped breathing.
Taking more methadone than prescribed, using it too frequently, or combining it with other substances can result in overdose.1,5 Only use methadone as directed.
Viewpoints on Methadone and Sobriety
It is important to remember that there is no one set path to recovery.
Support groups that are organized and led by peers are great ways to reinforce and extend the benefits of MAT.3 Some groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have strict “abstinence-only” policies that do not support the use of medications in recovery.6 Individual meetings may have different policies and procedures, however, so don’t hesitate to ask about your local organization’s viewpoints on MAT. Never go with a program that doesn’t feel right to you. If you know that MAT is in your best interest, find a group that supports your choice to get treatment in this manner.
Support groups that welcome members utilizing medication-assisted treatment include:6
- Rational Recovery.
- SMART Recovery.
- Women for Sobriety, Inc.
- Secular Organizations for Sobriety.
Additionally, Methadone Anonymous is a 12-step group for those addicted to opioids and other drugs who are engaging (or have engaged) in methadone maintenance treatment. This group firmly believes in methadone as a therapeutic tool in addiction recovery.
With differing opinions and recommendations, it is important to remember that there is no one set path to recovery.3 Whatever treatment method helps you to overcome your addiction is the right treatment method.
Finding Methadone Clinics
What is a methadone clinic? A methadone clinic is a licensed opioid treatment center that specializes in MAT with methadone.1 There are many ways to find methadone clinics like:
- Calling your insurance company.
- Researching available options online.
- Contacting a local mental health orsubstance abuse treatment facility.
- Speaking to an addiction specialist.
- Clicking on theOpioid Treatment Program Directory on SAMHSA’s website.
If you undergo supervised detoxification at the onset of your opioid addiction treatment, the detox program should refer you to an appropriate methadone clinic to continue treatment.7
When looking for a clinic, read reviews about the methadone clinic and ask plenty of questions like:
- How often do I have to come to the center?
- What is the average duration of treatment?
- What other services and programs are offered at the clinic?
- What if I am sick or must miss a day?
Remember that one person’s experience with a methadone clinic will not be shared by all patients. Explore different options to find one that seems to meet your own unique needs.
What Does Methadone Treatment Cost?
Cost will vary not only on personal factors like insurance benefits but also on:8
- Location of the clinic.
- Duration of the treatment.
- Amenities, programs, and services.
- Staff expertise and availability.
Based on data compiled across a sampling of methadone clinics, the average cost of a single treatment cycle is about $7,400 and lasts for 87 weeks.8 Other sources place the average cost of one year of treatment from a methadone clinic at about $4,700.3
When you contact the center or receive your referral, ask specifically about the cost of treatment, insurance coverage, and alternatives to reduce the expenses. Clinics might offer sliding scales or separate programs to lower the costs for people in need.
What to Expect When You Visit a Clinic
Each methadone clinic will be slightly different, but there will be many similarities regarding the staffing profile, physical spaces, and the routine. Reputable methadone clinics will have:9
- Doctors to complete an assessment, prescribe the substance, and participate in treatment planning.
- Nurses to dispense and observe the consumption of methadone. Since the medication frequently is given as a liquid, they will hand the individual a small cup and watch them drink the solution.
- Counselors to offer behavioral therapy (which helps to end illicit substance use, maintain sobriety, and improve overall well-being).
After you are given a dose of methadone from a nurse, you will be observed in a post-dosing supervision room for about 20 minutes in order to ensure you don’t leave with methadone and that you don’t suffer any severe side effects.9
Methadone maintenance therapy will not be the best choice for every recovering addict, but it can be a lifesaving treatment for those suffering from crippling opioid addictions.
- Substance Abuse and Mental Health Services Administration. (2015).Methadone.
- Drug Enforcement Administration. (2014).Methadone.
- National Institute on Drug Abuse. (2012).Principles of Drug Addiction Treatment: A Research-Based Guide.
- Substance Abuse and Mental Health Services Administration. (2005).Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs.
- U.S. National Library of Medicine: MedlinePlus. (2016).Methadone.
- Substance Abuse and Mental Health Services Administration. (2011).Medication-Assisted Treatment for Opioid Addiction.
- Substance Abuse and Mental Health Services Administration. (2015).Detoxification and Substance Abuse Treatment.
- French, M. T., Popovici, I., & Tapsell, L. (2008). The Economic Costs of Substance Abuse Treatment: Updated Estimates and Cost Bands for Program Assessment and Reimbursement. Journal of Substance Abuse Treatment, 35(4), 462–469.
- World Health Organization. (2009).Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.