Methadone

Methadone is a medication used to treat Opioid Use Disorder (OUD). Methadone is a long-acting full opioid agonist, and a schedule II controlled medication.

What Is Methadone?

Used for decades as a medication-assisted treatment (MAT) for addiction to heroin and narcotic pain medication, methadone helps people sustain long-term success and to reclaim active and meaningful lives.

How Does Methadone Work?

Methadone reduces opioid craving and withdrawal and blunts or blocks the effects of opioids. Methadone, taken once a day, is available in various forms such as liquid, powder, tablets, and diskettes. As with all medications used in medication-assisted treatment (MAT), methadone is 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 OUD 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 is only dispensed through a SAMHSA-certified opioid treatment program (OTP).

The length of time in methadone treatment varies from person to person. According to the National Institute on Drug Abuse (NIDA) publication Principles of Drug Addiction Treatment: A Research-Based Guide – 2012 (PDF | 391 KB), the length of methadone treatment should be a minimum of 12 months. However, some patients may require long-term maintenance. Patients must work with MAT physician to gradually reduce their methadone dosage to prevent withdrawal.

Methadone Safety

Methadone is safe and effective, when taken as prescribed. 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. This is particularly important for patients who are not required to take medication under direct supervision at an OTP, and are able to take their methadone at home.

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. Unintentional overdose is possible if patients do not take methadone as prescribed.

The following tips can help achieve the best treatment results and ensure the safety of others:

  • 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.
  • Store methadone at room temperature and away from light.
  • Prevent children from accidental ingestion. For more information, visit CDC's Up and Away educational campaign.
  • Do not share your methadone with anyone even if they have similar symptoms or suffer from the same condition.
  • Dispose of unused methadone safely. Talk to your MAT physician for guidance, or for more information on the safe disposal of unused medications, visit FDA's disposal of unused medicines or DEA's drug disposal webpages.

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

Pregnant or Breastfeeding Women and Methadone

Women who are pregnant or breastfeeding can safely take methadone. Comprehensive methadone maintenance treatment should include prenatal care to reduce the risks of complications during pregnancy and at birth.

Undergoing methadone maintenance treatment while pregnant does not cause birth defects. Methadone's ability to prevent withdrawal symptoms helps pregnant women better manage their Opioid Use Disorder (OUD) while avoiding health risks to both mother and baby. Pregnant women who experience withdrawal may be at risk of miscarriage or premature birth, as withdrawal can cause the uterus to contract.

It is possible that some babies may experience withdrawal, also known as neonatal abstinence syndrome (NAS) after birth. Symptoms may begin within minutes to hours after birth, with most symptoms appearing within 72 hours. It is possible for symptoms to appear as late as up to two weeks after birth. It is important to speak with your physician, as NAS is influenced by many factors.

Research has shown that the benefits of breastfeeding outweigh the effect of the small amount of methadone that enters the breast milk.

If you are concerned about methadone maintenance treatment due to pregnancy or breastfeeding, it is important to speak with your physician before stopping your treatment.

Learn more from the SAMHSA publication Methadone Treatment for Pregnant Women – 2009 (PDF | 322 KB).

More information about Methadone can be found in TIP 63.

Last Updated: 11/22/2019