Methadone Maintenance Treatment

What Is Methadone?

Methadone is a long-acting, synthetic opioid used for treating pain and opioid use disorder. It is often used as a medication-assisted treatment (MAT) for individuals struggling with opioid dependence.

Methadone is also known by the brand names Dolophine® and Methadose®.

When methadone is used in addiction treatment for opioid abuse, it is typically referred to as methadone maintenance treatment (MMT). Methadone has been used in opioid treatment programs since the 1950s and has proven to be effective in helping opioid addicts enter recovery.

Does Methadone Maintenance Treatment Treat Opioid Addiction?

Methadone works as an opioid agonist, meaning it blocks other opioids like oxycodone, hydrocodone, fentanyl, or heroin from activating the brain’s opioid receptors. Methadone also changes how the nervous system processes pain, providing pain relief caused by withdrawal symptoms.

While some people may point out that trading one opioid for another seems counterproductive, methadone is not like other opioids. Methadone is very slow-acting and rarely causes the intense euphoria other opioids do.

The use of methadone in treatment centers is usually focused on addressing withdrawal symptoms during detox and as medication-assisted treatment (MAT) to help avoid relapse.

Opioid Withdrawal Treatment

The first step in most treatment plans for substance abuse with opioids is to undergo medical detoxification. Not all opioid addicts will require a medical detox, but many will due to the intense withdrawal symptoms that can arise when quitting opioids.

Methadone is often prescribed during this stage to help treat cravings and withdrawal symptoms. Treating withdrawal symptoms, especially intense cravings, is essential to helping patients remain committed to their recovery.

Ongoing Management

Methadone completely blocks the effects of other commonly abused opioids. As the addict undergoes therapy, their healthcare provider may keep them on methadone as part of methadone maintenance treatment (MMT).

Patients may stay on their MMT for one to several years, depending on their recovery progress and risk of potential relapse. Depending on the state, MMT can only be carried out under strict doctor supervision as a take-home treatment or through a methadone clinic.

Although methadone is an opioid, the risk of dependence is lower when MMT is followed as prescribed. According to Harvard Medical School, around 25% of opioid addicts admitted to a methadone maintenance program will become abstinent from methadone over time.

Other Types of Addiction Medicine

Methadone is one of several medication-assisted treatments (MAT) approved by the FDA (Food and Drug Administration). Currently, MATs are only approved to treat alcohol use disorder and opioid use disorder.

MATs used for alcohol use disorder include:

• Disulfiram (Antabuse®)
• Naltrexone (Vivitrol®, Revia®)
• Acamprosate (Campral®)

MATs used for opioid use disorder include:

• Naltrexone (Vivitrol®, Revia®)
• Methadone (Dolophine®, Methadose®)
• Buprenorphine (Zubsolv®, Suboxone®, Sublocade®)
• Naloxone (Narcan®, Evzio®)

Are There Side Effects of Methadone Treatment?

Methadone is a very safe drug used for the treatment of pain and opioid use disorder. However, the drug does have potential side effects that your doctor will inform you of before treatment begins.

Common side effects of methadone use include:

• Headaches
• Nausea or vomiting
• Constipation
• Stomach pain
• Weight gain
• Restlessness
• Itchy skin
• Dry mouth
• Heavy sweating and flushing
• Slower breathing
• Sexual dysfunction
• Changes in sleep and appetite
• Mood changes
• Vision problems

Methadone Misuse and Addiction

Although methadone can be life-changing for the treatment of opioid use disorder, there is no avoiding that methadone does carry its risks of misuse and drug addiction. MMT is typically carried out through a tightly controlled and monitored regimen, but misuse can still occur.

Methadone Overdose

Patients taking methadone for opioid use disorder are typically under close supervision. However, patients may still gain access to illegal methadone and take more than their body can handle.

When too much methadone is taken or the drug is mixed with other sedatives, an overdose can occur.

Signs of methadone overdose include:

• Shallow breathing
• Weak pulse
• Blue lips or fingernails
• Drowsiness
• Convulsions
• Clammy skin
• Coma

If someone near you is experiencing an overdose, call 911 immediately and stay with them until help arrives. Take note of their symptoms and have any information ready for the first responders, such as age, dose taken, or medical history.

Things to Know Before Starting Methadone Treatment

Methadone is safe for most people. However, there are a few things to keep in mind while taking methadone.

Never take methadone with other sedatives like opioids, benzodiazepines, or alcohol. Drug use that combines sedatives can lead to unintentional overdose.

Although methadone is safe to be taken while pregnant or breastfeeding, talk to your doctor about it first, as small amounts of methadone can be passed through breast milk, so breastfeeding mothers require extra attention to ensure their baby doesn’t experience negative effects.

Individuals with the following health conditions should inform their doctor before taking methadone:

• Certain mental illnesses or conditions treated with sedatives
• Trouble urinating
• Gallbladder, pancreas, or thyroid problems
• An electrolyte imbalance
• Heart disease or heart rhythm disorder
• Breathing problems or lung disease
• Liver or kidney disease
• A history of brain tumor, head injury, or seizures

Find Methadone Treatment for Opioid Use Disorder

Treating drug abuse issues with opioids can be extremely challenging for addicts and their loved ones. However, there are treatment programs ready to guide you through the process of detox and recovery.

If you think methadone may help you address your opioid use disorder, talk to your doctor about whether methadone is right for you.

You can also check out SAMHSA’s online treatment locator or call 1-800-662-4357 to see what treatment centers or addiction specialists prescribing methadone are available in your area.