Methadone is an opioid medication that is used to relieve pain for those with ongoing conditions. It is also used in medication-assisted treatment (MAT) for people with opioid addictions.
Methadone is available as a tablet, dissolvable tablet, liquid, or concentrate.
In addition to pain management, it is used to treat people with opioid addictions. MAT helps to control drug cravings and painful withdrawal symptoms, so people don’t return to opioid abuse.
According to the Substance Abuse and Mental Health Services Administration, methadone can be safe when used as directed, and it is an effective treatment option for some people with opioid addictions. SAMHSA’s research has shown that methadone helps those struggling with heroin addiction to stay in treatment longer.
Methadone works by targeting the same opioid receptors in the brain as heroin and prescription opioids to prevent symptoms of withdrawal and reduce cravings. It is one option that is used in MAT treatment, but other options include Suboxone, buprenorphine, and naltrexone.
Methadone maintenance treatment (MMT) has been researched for decades. It has been found to be effective at:
- Reducing rates of injection drug use
- Decreasing risk factors for HIV transmission
- Reducing death rates associated with opioid overdose
- Lowering crime rates associated with addiction
- Increasing treatment compliance
- Decreasing the risk of relapse
When is Methadone Most Useful?
Methadone is most useful to help people get off heroin or other opioid drugs.
People who participate in a comprehensive treatment program will have the best opportunity for success in staying off drugs of abuse. Medication is not enough on its own to support ongoing sobriety; therapy is needed.
According to the National Institute on Drug Abuse, methadone is not just a way to switch people from one opioid substance of abuse to another. For people with serious opioid addictions to heroin, methadone will help to control their cravings and prevent them from going into withdrawal, but it will not provide the same euphoric high as heroin.
People with prolonged addictions to heroin will have a higher tolerance for opioids than those who have not abused these drugs. Due to their higher tolerance, candidates for methadone treatment will not get high on the same amount of methadone that would produce a high in someone without an opioid dependency.
Who Should Consider Methadone Treatment?
People with certain risk factors should be considered for methadone treatment because of the potential benefits associated with MAT.
An addiction professional will first ensure individuals understand the risks and benefits of methadone treatment before prescribing the medication.
Methadone should be considered when:
Methadone treatment has been useful in the past for an individual
Those with a history of good treatment outcomes in the past with MMT are good candidates the treatment.
Other forms of addiction treatment have not been effective
People who have tried other addiction treatment programs but have relapsed and gone back to using illicit substances may benefit from MMT.
An individual has a prolonged history of addiction to opioids
People who have a long-term addiction to opioids will most likely need MAT to recover from addiction.
People who use IV drugs and are at risk for HIV transmission
Intravenous drug use is a major risk factor for contracting HIV. People at risk for HIV should be considered candidates for MMT to reduce the risk of injection drug use.
Pregnant women who have opioid dependence
Withdrawing from opioids can be dangerous to both the mother and fetus. Pregnant women are often recommended for MMT. Withdrawal could increase the risk for miscarriage, so it is generally not recommended until after delivery. Pregnant women may not be good candidates for other MAT options such as buprenorphine. The supervising physician will make the ultimate decision on what is best in the specific case.
Each individual will have unique health considerations depending on their history of opioid use and their biological and behavioral risk factors.
Who Should Not Use Methadone?
According to the clinical guidelines for methadone treatment, patients with severe liver disease should not use methadone. MMT can contribute to hepatic encephalopathy.
Some people may not need prolonged MMT for opioid dependency. People who have a minimal history of drug abuse or who have only been using opioids for a short period of time may be able to successfully detox without using any treatment medication.
Can Methadone bee Used at Home?
Methadone is a controlled substance, and it can be abused.
Distribution of the drug during the course of treatment for addiction is always a safety consideration. Methadone is mostly dispensed from licensed clinics, and patients have to be given the dose on site on a daily basis.
Typically, patients who receive methadone will come daily for their prescribed dose, and they may also participate in other treatment services while there. Methadone can be taken on an outpatient basis, but it is almost always dispensed directly on site.
In some cases, when a patient has demonstrated treatment compliance and a period of stability, they may be allowed to bring limited doses home with them for self-administration.
Is Methadone the Right Choice?
Methadone treatment can be a good option for people with opioid addictions. However, it is not the only option for medication-assisted treatment.
Discuss your personal situation with your treatment providers before deciding on the best course of action.