Methadone is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates.
What Is Methadone?
Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives. For optimal results, patients should also participate in a comprehensive medication-assisted treatment (MAT) program that includes counseling and social support.
How Does Methadone Work?
Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
Methadone is offered in pill, liquid, and wafer forms and is taken once a day. Pain relief from a dose of methadone lasts about four to eight hours. SAMHSA's TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs – 2012 shows that methadone is effective in higher doses, particularly for heroin users, helping them stay in treatment programs longer.
As with all medications used in medication-assisted treatment (MAT), methadone is to be prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.
How Can a Patient Receive Methadone?
Patients taking methadone to treat opioid addiction must receive the medication under the supervision of a physician. After a period of stability (based on progress and proven, consistent compliance with the medication dosage), patients may be allowed to take methadone at home between program visits. By law, methadone can only be dispensed through an opioid treatment program (OTP) certified by SAMHSA.
The length of time in methadone treatment varies from person to person. According to the National Institute on Drug Abuse publication Principles of Drug Addiction Treatment: A Research-Based Guide – 2012, the length of methadone treatment should be a minimum of 12 months. Some patients may require treatment for years. Even if a patient feels that they are ready to stop methadone treatment, it must be stopped gradually to prevent withdrawal. Such a decision should be supervised by a doctor.
Patients who develop a problem with methadone or have questions can access information through SAMHSA's Find Help.
Methadone can be addictive, so it must be used exactly as prescribed. This is particularly important for patients who are allowed to take methadone at home and aren’t required to take medication under supervision at an OTP. Methadone medication is specifically tailored for the individual patient (as doses are often adjusted and readjusted) and is never to be shared with or given to others. Patients should share their complete health history with health providers to ensure the safe use of the medication.
Other medications may interact with methadone and cause heart conditions. Even after the effects of methadone wear off, the medication’s active ingredients remain in the body for much longer. Taking more methadone can cause unintentional overdose.
The following tips can help achieve the best treatment results:
- Never use more than the amount prescribed, and always take at the times prescribed. If a dose is missed, or if it feels like it’s not working, do not take an extra dose of methadone.
- Do not consume alcohol while taking methadone.
- Be careful driving or operating machinery on methadone.
- Call 911 if too much methadone is taken or if an overdose is suspected.
- Take steps to prevent children from accidentally taking methadone.
- Store methadone at room temperature and away from light.
- Dispose of unused methadone by flushing it down the toilet.
Learn more from the SAMHSA publication Follow Directions: How to Use Methadone Safely – 2009 (also available in Spanish).
Side Effects of Methadone
Side effects should be taken seriously, as some of them may indicate an emergency. Patients should stop taking methadone and contact a doctor or emergency services right away if they:
- Experience difficulty breathing or shallow breathing
- Feel lightheaded or faint
- Experience hives or a rash; swelling of the face, lips, tongue, or throat
- Feel chest pain
- Experience a fast or pounding heartbeat
- Experience hallucinations or confusion
Women who are pregnant or breastfeeding can safely take methadone. When withdrawal from an abused drug happens to a pregnant woman, it causes the uterus to contract and may bring on miscarriage or premature birth. Methadone’s ability to prevent withdrawal symptoms helps pregnant women better manage their addiction while avoiding health risks to both mother and baby.
Undergoing methadone maintenance treatment while pregnant will not cause birth defects, but some babies may go through withdrawal after birth. This does not mean that the baby is addicted. Infant withdrawal usually begins a few days after birth but may begin two to four weeks after birth.
Mothers taking methadone can still breastfeed. Research has shown that the benefits of breastfeeding outweigh the effect of the small amount of methadone that enters the breast milk. A woman who is thinking of stopping methadone treatment due to breastfeeding or pregnancy concerns should speak with her doctor first.
Learn more from the SAMHSA publication Methadone Treatment for Pregnant Women – 2009.
Training on Providing Methadone
Methadone as an opioid use disorder treatment is carefully regulated. MAT services professionals are required to acquire and maintain certifications to legally dispense and prescribe opioid dependency treatments. SAMHSA’s Division of Pharmacologic Therapies (DPT) makes available opioid prescribing courses for physicians, webinars, workshops, and summits, and publications and research.