Medication-assisted treatment (MAT) and opioid treatment programs (OTPs) are common methods for helping to sustain abstinence during recovery.
Methadone maintenance treatment programs are an option for decreasing the negative consequences related to opioid abuse and addiction while managing cravings and harsh withdrawal symptoms.
The Opioid Epidemic
There is a serious crisis involving opioid drug abuse in the U.S.
Opioids are a class of drugs that includes both prescription painkillers and illicit drugs like heroin and synthetic fentanyl.
The National Institute on Drug Abuse (NIDA) publishes that every day in America, more than 130 people die from a drug overdose involving an opioid drug.
In 2016, more than 2.5 million people in the United States battled addiction involving an opioid. Indeed, opioid drugs are highly addictive and commonly misused.
What is Methadone?
Addiction is a chronic disease when relapsing is common and requires long-term care and support. Methadone can provide beneficial assistance in opioid addiction recovery.
Methadone is a long-acting opioid agonist drug that is one of the FDA-approved medications to treat opioid dependence. Methadone maintenance is provided through clinics that are under strict federal supervision and specific guidelines.
The Washington Post published that as of fall 2018, there were more than 1,600 methadone maintenance clinics in operation in the U.S.
Since methadone is a controlled substance, it can only be dispensed through clinics that are federally regulated.
It is a long-acting drug with a half-life of 30 hours. This means the drug will stay active in the body for much longer than the short-acting opiate heroin, which wears off within a few minutes to an hour.
Methadone can be used as part of an OTP to manage withdrawal symptoms and cravings. In fact, around 10 percent of all facilities providing substance abuse treatment offers an OTP that prescribes methadone
When taken as directed in the proper dosage, methadone is less likely to create a euphoric high in the same way that a shorter-acting opiate might. In this way, it can be taken long- term to sustain recovery.
Though methadone is an opioid, it can be dispensed under strict supervision in oral form. This is considered to be less harmful than injection drug use of the illegal and unregulated drug heroin.
Some of the Benefits of Methadone Maintenance and MAT Programs Include:
- Reduction of injection drug use
- Lower rate of infectious drug transmission
- Less risk for drug overdose deaths
- Reduced criminal activities related to drug abuse
- Improved social function
- Higher likelihood of staying in a treatment program
To help you find a federally regulated methadone maintenance program, SAMHSA’s Behavioral Health Treatment Services Locator offers details, locations, and current information about the drug.
Guidelines for OTPs and Methadone
To dispense methadone, organizations much first obtain state licensing to do so.
They will need to ensure that their location meets local zoning ordinance approval before seeking approval at the federal level from the Substance Abuse and Mental Health Services Administration (SAMHSA) or the U.S. Drug Enforcement Administration (DEA).
Again, methadone can only be dispensed through federally regulated clinics under strict and specific guidelines and parameters. It is illegal to get methadone from other sources.
Federal Guidelines Require the Following:
- A medical diagnosis of an opioid use disorder before treatment
- Individual addiction involving opioids for at least a year prior to admission into an OTP
- Dispensation of the medication once daily under the direct supervision of a trained professional
- Evaluations and screenings to ensure the medication is being taken as directed and not combined with other illicit substances
- Assurance that methadone is locked up at night and kept behind Plexiglas when dispensed one dose at a time
- Take-home dosing for the weekend, week, or even month, only after stabilization is reached
- Individual and group counseling and therapy sessions offered at the same time as methadone dosing
Methadone vs. Buprenorphine
Methadone clinics can have long waiting lists. Sometimes, they are more public than desired.
There is not much flexibility with methadone clinics. Since methadone is an addictive drug, it needs to be dispensed under direct and constant supervision to ensure treatment compliance and proper use.
Methadone should only be given in conjunction with other treatment methods, such as therapy. It is not enough on its own to treat addiction. The real work of recovery takes place in therapy.
Buprenorphine is an alternative form of MAT. In Suboxone, it is combined with the opioid antagonist naloxone, which acts as an abuse deterrent. When crushed and injected, the naloxone portion will activate, and none of the pleasurable effects of the opioid will be felt.
Buprenorphine offers more flexibility, as it can be prescribed as a take-home prescription.
Since addiction has a high relapse rate of 40 to 60 percent, maintenance medications can be very beneficial, particularly in early recovery from opioid addiction.
When you enroll in an addiction treatment program, a physician will assess your situation and determine whether methadone maintenance is the right treatment for you.