Learn whether methadone can support your recovery from opioid use disorder.
How methadone can help
Learn how methadone works to reduce opioid withdrawal symptoms and lessen cravings.
Is methadone right for you?
Learn how your individual needs, health, and treatment goals can help determine whether methadone may be right for you.
Considerations before taking methadone
Learn about dosing, side effects, cost, and additional considerations to determine if methadone is right for you.
How to access treatment
Explore methadone clinics near you.
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. For some people, methadone can provide the stability needed to reduce or stop other opioid use and support recovery. Taken as prescribed, methadone is a safe and effective medication that has assisted adults with the management and treatment of opioid use disorder (OUD). Understanding how methadone works, its benefits and risks, and what treatment involves can help you decide whether to discuss it with a health care provider.
Stopping use of opioids can be very challenging. In the absence of treatment, many people with OUD have a hard time quitting opioids. This is partly because halting the use of these drugs can cause people to experience painful opioid withdrawal symptoms.
Methadone, a Food and Drug Administration (FDA)-approved medication 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, when dosed appropriately, doesn’t generate a “high.”
Methadone may be part of a medication for OUD (MOUD) program. Under the umbrella category of Medications for Addiction Treatment (MAT), formerly known as medication-assisted treatment, MOUD treatment approaches OUD as a medical condition and can aid you in achieving and maintaining recovery. Buprenorphine and injectable extended-release naltrexone are two other FDA-approved medications for OUD.
Many MOUD programs combine the medication with behavioral therapies on site. Programs providing methadone, known as Opioid Treatment Programs (OTPs), are required to offer counseling, though attending counseling is no longer a requirement for patients to receive methadone. Effective MOUD programs can motivate you to remain in treatment, follow prescribed therapies, and, if needed, address other physical and mental health issues, either directly or through coordination of care with external providers.
Methadone is safe and appropriate for long-term use. Some people choose to taper off methadone; others may continue maintenance doses for years or even lifelong. What is right for you depends on your unique circumstances. If you want to stop, talk to your treatment team to learn more about the risks and benefits and to develop a tapering plan if appropriate.
If you do choose to taper off methadone, consider an alternative medication to help you maintain abstinent recovery. One danger of tapering off methadone, particularly if this is done without starting another MOUD treatment, is overdose. While you are maintained on a stable dose of methadone, you lose your tolerance to stronger opioids like nonpharmaceutical fentanyl. Should cravings occur after coming off methadone treatment, if you use the opioid drugs that you used in the past, without a new medication to block their effects, they will now have much stronger effects. Fentanyl overdose is highly fatal.
As a rule, medical providers recommend staying on a given medication for a chronic condition for as long as its benefits outweigh the risks. Given the high risk of overdose as above, clinicians typically recommend staying on methadone unless unexpected adverse effects develop. At the same time, if the patient expresses a strong preference to come off the medication, that preference should be respected. No one should ever feel forced to stop methadone without supervision, as this can lead to withdrawal symptoms which in turn increase the risk of resumption of non-prescribed opioid use and overdose.
Whether methadone is right for you depends on your unique situation. A health care provider can assess your opioid use, medical history, withdrawal symptoms, and treatment goals to help determine whether methadone is an appropriate treatment option. Other medications for opioid use disorder, including buprenorphine and naltrexone, may also be considered based on your needs. If you’re considering methadone, learn what to look for when choosing a program.
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CloseIt can take time to find the right dose, and you may still experience some discomfort early on in treatment. Methadone can remain in the body for a long time and can build up during the first days of treatment, so increasing your dose too quickly can be dangerous. Your treatment team will monitor your response and adjust your dose based on various factors.
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.
The main side effect of methadone is constipation. Sexual issues, including low sex drive and erectile dysfunction may also occur. Both of these adverse effects are unlikely to be as severe as with the long-term use of non-prescribed opioids, such as nonpharmaceutical fentanyl. As long as it is dosed appropriately, methadone is unlikely to have other adverse effects. If the dose is too high, methadone may cause drowsiness. In addition, certain medications may interact with methadone to increase the risk of irregular heart rhythms. However, this can typically be prevented with monitoring.
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; 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 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 (under 3%) of methadone-containing breast milk passing to a baby but 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, and other opioids. In addition, certain medications which are not sedating when used in isolation may increase blood levels of methadone, thereby increasing the risk of overdose. These include cimetidine, a heartburn medication. Other medications may interact with methadone in a way that increases the risk of other side effects. For example, ciprofloxacin, an antibiotic, in combination with methadone may lead to low blood sugar as well as irregular heart rhythms. Other drugs may lessen methadone’s effects and increase the risk of withdrawal symptoms. These include the antiretroviral medications rifampin, 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. What you pay for methadone depends on your insurance, the services you receive, and the program you choose. Learn more about finding and paying for methadone treatment.
People who have developed dependence on kratom, concentrated 7-OH, tianeptine, or other substances with opioid-like effects may be evaluated for medications used to treat opioid use disorder, including methadone. Whether methadone is appropriate depends on multiple factors, such as the substance you’re using, your pattern and amount of use, withdrawal symptoms, other substance use, your medical history, and your diagnosis. A treatment provider can evaluate your situation and discuss which treatment options may be appropriate.
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.
Methadone for opioid use disorder is provided through certified opioid treatment programs (OTPs). Depending on your treatment plan, you may initially receive methadone at the clinic and later become eligible for take-home doses.
Ready to explore treatment? Browse available programs below.
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