Methadone is a Food and Drug Administration-approved medication for opioid use disorder in adults. Methadone is used to prevent opioid withdrawal symptoms, lessen cravings for opioids, and block the effects of opioids.
Only people under the supervision of certified programs can get methadone. People taking methadone tend to have the best recovery outcomes if they also attend therapy sessions and receive other medical, mental health, and social support.
Common side effects of methadone include anxiety, constipation, and diarrhea. Before taking methadone, check with a medical provider and consider potential interactions with other drugs you’re taking.
Methadone is a synthetic opioid that can help end your dependence on prescription or illicit opioids by preventing withdrawal symptoms, lessening cravings, and blocking their effects. Taken as prescribed — most often in liquid, powder, or tablet form — methadone is a safe and effective drug that for over 40 years has assisted adults with the management and treatment of opioid use disorder (OUD).
Stopping use of opioids can be very challenging. In the absence of treatment, many people with OUD have a hard time quitting opioids like heroin, morphine, and pain medications such as oxycodone. This is partly because halting the use of these drugs can cause people to experience painful opioid withdrawal symptoms such as intense cravings, diarrhea, nausea, and vomiting.
Methadone, one of three Food and Drug Administration (FDA)-approved medications for OUD, helps people stay off opioids by lessening withdrawal symptoms and cravings for the drugs. Although methadone targets the same receptors as other opioids, it is long-lasting, acts more slowly, and doesn’t generate a “high.” Studies show that methadone, when used as prescribed, can assist people in recovery from opioid dependence.
Methadone may be part of a medication for OUD (MOUD) program. Formerly known as medication-assisted treatment (MAT), MOUD treatment combines medication and behavioral therapies and can aid you or a loved one in adjusting to life in recovery. Effective MOUD programs can motivate you to remain in treatment, follow prescribed therapies, and, if needed, address other physical and mental health issues. Buprenorphine and injectable extended-release naltrexone are the two other FDA-approved medications for OUD.
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Because methadone is considered a controlled substance, its distribution is highly regulated. People can receive the medication only under the supervision of an opioid treatment program or methadone maintenance program certified by the Substance Abuse and Mental Health Services Administration. However, people who show they are consistently taking the drug as prescribed may be able to take methadone dosages home in between clinic appointments.
Typically, methadone is taken daily by mouth in tablet or syrup form, although it’s available in other forms. The dosage of methadone for opioid dependence usually starts at 30 to 40 milligrams per day. If a licensed health care provider documents that the patient still has opioid abstinence symptoms, the dosage may be increased by a small amount on a weekly basis until the treatment is working to maximum effect. The maximum dosage usually is 80–150 milligrams per day.
Evidence indicates that people treated with methadone are more likely to remain in treatment and less likely to die by overdose, especially when treatment lasts for at least 14 months.
People treated with methadone tend to have the best outcomes in recovery if they also attend individual and group therapy and receive referrals to other medical, mental health, and social support services. However, studies of patients after six and 12 months of methadone treatment show that the medication is effective in helping people stay in treatment for OUD, even if other support is limited.
When not taken as prescribed, methadone can cause an overdose. If you are being treated with methadone, your medical provider may recommend that you or your loved ones carry naloxone, which can reverse an opioid overdose. Get naloxone in a product called Narcan, which is sold over the counter. Learn how to get naloxone.
Although methadone is considered safe when taken as prescribed, it can cause side effects and pose other health risks, especially if it’s not used properly. Stopping use of methadone abruptly can also lead to withdrawal symptoms such as anxiety, cramps, tremors, and vomiting.
Common side effects of methadone include anxiety, constipation, diarrhea, difficulty sleeping, drowsiness, dry mouth, itchiness, sexual issues (e.g., lower sex drive, impotence, or trouble orgasming), nausea, lack of appetite, sweating, and vomiting.
Report these more serious side effects immediately to a licensed medical professional: chest pain; confusion or hallucinations; feeling faint; hives or a rash; racing heartbeat; shallow breathing; or swelling around the face, in the mouth, or in the throat.
Consult a licensed medical provider before taking any medication, including methadone. Here are some other factors to consider before seeking methadone treatment:
Dependence and overdosing. Because you can become dependent or even overdose on methadone, you should take it just as the doctor orders. In other words, don’t take a larger dose, take it more often than prescribed, or share it with others. Let your medical provider know if you are at risk of experiencing a methadone overdose. Risk factors include a personal or family history of drinking alcohol in large amounts, obtaining drugs on the street, misusing prescription drugs, overdosing on drugs, or depression or another mental health condition.
Pregnancy and breastfeeding. You can safely be treated for OUD with methadone even if you’re pregnant or breastfeeding, although newborn babies of mothers taking methadone may experience neonatal abstinence syndrome, which could lead to withdrawal symptoms. There is also a risk of a small amount of methadone-containing breast milk passing to a baby. However, evidence indicates that the benefits of breastfeeding may outweigh that risk.
Interactions. Because methadone is a depressant, the risk of overdose is greater if it’s taken with other drugs that have similar effects. These include alcohol; certain antipsychotics; benzodiazepines; cimetidine, a heartburn medication; ciprofloxacin, an antibiotic; and other opioids. Other drugs may lessen methadone’s effects and increase the risk of withdrawal symptoms. These include the antiretroviral medications efavirenz and ritonavir and the antiseizure medication carbamazepine. Tell your health care provider if you take any prescription or nonprescription medications, including vitamins and supplements, to make sure they don’t unsafely interact with methadone.
Cost. The cost of methadone varies. According to one government estimate, the combined cost of OUD treatment with methadone and other counseling and medical support services is $126 per week. The cost of methadone and other OUD treatments may be fully or partially covered by private insurance, Medicaid, or Medicare, but there are disparities in coverage among states. If you are uninsured, underinsured, or otherwise have trouble paying for treatment, contact methadone clinics near you to find out whether they offer financial assistance.
Medications to Treat Opioid Use Disorder Research Report, How do medications to treat opioid use disorder work? Opioid Agonists and Partial Agonists (Maintenance Medications), National Institute on Drug Abuse, Aug. 10, 2022