FAQ - Methadone

Is using methadone substituting one addiction for another?

NO.  Methadone can reduce or eliminate withdrawal symptoms, eliminate cravings and eliminate the euphoric effect of other opioids.  Methadone is administered in a controlled environment by skilled nursing staff.  This allows an individual suffering from opioid addiction to perform daily activities while reducing the risk of overdose, acquiring transmittable diseases such as HIV and Hepatitis and reduces exposure to legal issues surrounding obtaining and using illegal substances.     Methadone-maintained patients are in control of their daily medication and noted improvement is seen in their daily social and family lives. Opioid use disorder is a chronic brain disease that requires medication and treatment.
Methadone pharmacotherapy has been shown to lead to improved overall adjustment, including reductions in:  

psychiatric symptoms  

unemployment  

family or social problems 

Is methadone safe?

YES. Research and clinical study has demonstrated the unequivocal medical safety of long-term methadone; there are no serious adverse effects, no harmful medication interactions, and it is safe for pregnant women.     

Over forty years of research demonstrates the positive effects of methadone on patients health. Patients have significantly reduced risks of infections associated with IV drug abuse, sexual behaviors, and other risky health behaviors. Many methadone-maintained patients begin experiencing increased physical and mental health within days of starting a treatment program. Most medical conditions observed in methadone-maintained patients are either related to their preexisting health conditions, new conditions secondary to their past drug abuse, or normal aging processes and health. A patient’s health actually improves in methadone maintenance treatment.
Methadone maintenance is safe and effective when used with appropriate safeguards and psychosocial services. Maintenance treatment typically leads to reduction or cessation of illicit opioid use and its adverse consequences including:  

Cellulitis  

Hepatitis 

HIV infection from use of nonsterile injection equipment  C

riminal behavior associated with obtaining drugs 

How long will I take methadone? What will my dose be?

Generally, the length of time spent in treatment is positively related to treatment success. The duration of treatment should be individually and clinically determined, and treatment should last for as long as the physician, treatment team and the individual patient agree is appropriate.


It is critical to successful patient medication management to determine a medication dosage that will:  

minimize withdrawal symptoms 

minimize cravings 

decrease or eliminate opioid abuse


Dosage requirements for methadone must be determined on an individual basis. There is no single recommended dosage or fixed range of dosages for all patients. For many patients, the therapeutic dosage range of methadone may be between 80 to 120 mg per day, but it can be much higher, and occasionally it is much lower.


Optimal dosage goals:

  1. Prevention of opioid withdrawal for 24 hours or longer, including both early subjective symptoms and objective signs typical of abstinence  
  2. Elimination of drug hunger or craving  
  3. Blockade of euphoric effects of self- administered opioids
  4. Tolerance for the sedative effects of treatment medication (patients can function normally without impairment of perception or physical or emotional response
  5. Tolerance for most analgesic effects produced by treatment medication

Cross Tolerance:

Medication diminishes or prevents the euphoric effects of heroin or other short- acting opioids so that patients who continue to abuse opioids no longer feel “high.” The medication dosage needed for this result depends on how long and how recently a patient has abused heroin or other opioids and how much he or she has used, along with individual differences in the level of brain receptor adaptation induced by chronic opioid use.


Tapering off methadone is monitored closely in a controlled environment and at a slow and steady pace. 

What are the side effects of methadone?

 Methadone is generally well tolerated when used to treat opioid use disorder by a qualified physician. Common side effects can include:

Sweating

Somnolence

Constipation

Nausea

Sexual dysfunction

Weight Gain
Our medical director is board certified in addiction medicine and oversees all clients prescribed and administered methadone for opioid addiction.  You will be closely monitored for any serious side effects. 

Where can I find more information on methadone for treatment of opioid addiction?

Substance Abuse and Mental Health Services Administration (SAMHSA)
National Institute on Drug Abuse (NIDA)
American Society of Addiction Medicine (ASAM)


References
Baxter L., Campbell A., Deshields M., Levounis P., Martin J., McNicholas L. & Wilford B. (2013) Safe methadone induction and stabilization: Report of an expert panel. Journal of Addiction Medicine,7(6), 377-386. 


Center for Substance Abuse Treatment. (2005). Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43. HHS Publication No. (SMA) 12-4214. Rockville, MD: Substance Abuse and Mental Health Services Administration. 

  

Substance Abuse and Mental Health Services Administration. (2015). Federal Guidelines for Opioid Treatment Programs. HHS Publication No. (SMA) PEP15-FEDGUIDEOTP. Rockville, MD: Substance Abuse and Mental Health Services Administration