Opioid Rehabilitation: How Does a Methadone Clinic Work?
What Is a Methadone Clinic?
A methadone clinic is a specialized facility, known federally as an opioid treatment program (OTP), that dispenses methadone as part of a structured treatment plan for opioid use disorder (OUD).
Methadone is a long-acting, synthetic opioid agonist. It binds to opioid receptors in the brain, helping reduce cravings and withdrawal symptoms. When taken as prescribed, methadone may also blunt or block the effects of other opioids, including illicit substances like heroin.¹
As a Schedule II controlled substance, methadone has to be administered under the supervision of a qualified medical practitioner. It can be used during both detox and maintenance treatment in combination with social and medical services.²
How Do Methadone Clinics Work?
Methadone is dispensed through federally regulated methadone clinics, which must:
- Maintain current Substance Abuse and Mental Health Services Administration (SAMHSA) certification, DEA registration, and accreditation status.3,4
- Provide or coordinate access to:
- Medical assessments and treatment.
- Counseling and behavioral therapy.
- Drug testing.
- Vocational and educational support.¹
These services may be offered onsite or through formal referral agreements.
Currently, methadone can only be dispensed at certified OTPs, not through physician offices or retail pharmacies. However, this may change with proposed legislation. The Modernizing Opioid Treatment Access Act (M-OTAA) would allow qualified physicians to prescribe take-home doses that retail pharmacies could dispense.⁵
For now, patients enrolled in OTPs who meet specific criteria may receive limited take-home doses, typically for clinic closures on Sundays and federal holidays.⁴
How Is Methadone Administered?
At a methadone clinic, the medication is administered orally in one of several forms:
- Liquid concentrate.
- Dispersible tablets or powders.
- Ready-to-use oral solutions.
Qualified medical professionals at the clinic assess each patient individually to determine the appropriate starting dose and make ongoing adjustments based on clinical response.1,2
How Does Methadone Work?
Methadone is a full opioid agonist, meaning it fully activates mu-opioid receptors in the brain—similar to heroin or prescription opioids, but in a slower, more controlled way. This action helps:
- Relieve withdrawal symptoms.
- Reduce cravings.
- Block the euphoric effects of other opioids if used concurrently.1,2,6
When taken at an appropriate therapeutic dose, methadone typically does not produce a “high” in individuals dependent on opioids.
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Possible Side Effects of Methadone
Methadone maintenance treatment is generally associated with a low incidence of side effects and with significant health improvements. Studies indicate that around 75% of individuals who receive methadone maintenance treatment respond well.7
That being said, methadone is still a medication, and as with any medication, side effects are possible. Some of the potential side effects associated with methadone use include:1
- Drowsiness or sedation.
- Lightheadedness or dizziness.
- Nausea and vomiting.
- Constipation.
- Sweating.
The supervising healthcare professional may titrate or adjust the dose of methadone for each individual; the appropriate dose may depend on several factors, including the individual’s history, health, and previous substance use. Strict supervision by a physician ensures that dosing adjustments can be made based on factors such as an individual’s opioid tolerance as well as any treatment side effects that may arise.8
People who experience side effects during methadone maintenance treatment, especially if those effects are distressing or persistent, may benefit from a treatment review and adjustments to their individual treatment plan.⁸
Risks of Interactions with Other Medications and Substances
Methadone can interact with a wide range of substances—including both prescription and over-the-counter medications, as well as recreational or illicit drugs. These interactions may increase the risk of adverse effects or overdose.²
Before beginning methadone treatment, it’s essential to talk with your provider about all medications and substances you use.1,8
Interaction risks can include:
- Heart rhythm complications. Methadone can affect heart rhythm on its own. Combining it with antiarrhythmics, certain antidepressants and antipsychotics, or OTC products like laxatives and diuretics may increase this risk.²
- CNS depressants. Using methadone with alcohol, benzodiazepines, sleeping pills, tranquilizers, or other central nervous system depressants may lead to respiratory depression, extreme sedation, coma, or death.2,8
- Other drug interactions. Substances such as antihistamines, blood pressure medications, HIV treatments, MAO inhibitors, and certain antibiotics can interfere with methadone’s effectiveness or cause harmful side effects.2,8
To ensure safety, your treatment team will conduct a thorough medication review and monitor for any potential drug interactions throughout the course of methadone maintenance treatment.
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Methadone Safety
When used as directed, methadone is a safe and effective medication for the treatment of OUD.1 However, as previously mentioned, methadone is a Schedule II controlled substance under the Controlled Substances Act, which means that—like other opioids—there is the potential for diversion and misuse.2
But the risk of misuse or addiction should not discourage individuals from receiving methadone maintenance treatment as part of an OUD treatment plan.
Who May Benefit from Visiting a Methadone Clinic?
Methadone clinics primarily serve adults aged 18 and older who are living with OUD. However, not everyone diagnosed with OUD is a suitable candidate,particularly those with a mild OUD diagnosis, who may benefit from other forms of treatment instead.¹
Why Choose an Opioid Treatment Program That Uses Methadone
According to research, when taken as prescribed, methadone is safe and effective and can help individuals achieve and sustain recovery. It is, however, only one component of a comprehensive OUD treatment plan, which includes counseling and behavioral therapies to help individuals understand the thoughts, emotions, and behaviors that led to opioid use and teach them skills to avoid relapse.9
Enhanced Methadone MAT at AdCare Rhode Island
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AdCare Rhode Island has developed specialized enhanced medication for addiction treatment (MAT) protocols specifically designed for patients struggling with OUD.
Beyond the traditional MAT protocols utilizing naltrexone (Vivitrol) or buprenorphine for opioids, AdCare Rhode Island provides three distinct and innovative methadone protocols specifically tailored for individuals grappling with OUD.
- Methadone Induction and Maintenance: Individuals seeking inpatient treatment for OUD can choose to begin methadone treatment during their stay. AdCare Rhode Island will stabilize patients on methadone and, upon discharge, seamlessly transition them to their preferred methadone clinic for continued maintenance.
- Transition from Methadone to Suboxone or Vivitrol: AdCare Rhode Island facilitates transitions from methadone maintenance to Suboxone or Vivitrol for suitable patients. Individuals in methadone programs can opt for a rapid detox and transition to Suboxone or Vivitrol within 4 weeks.
Rapid Methadone Detox: AdCare also provides rapid methadone detox for patients wanting to discontinue methadone use, significantly expediting the traditional clinic taper process. This 4-week detox is designed for individuals with established recovery programs who are ready to transition off methadone maintenance.
To find out more about AdCare Rhode Island’s Enhanced Methadone MAT Program, reach out to us today at
(866) 959-6822
Current Viewpoints on Methadone
The M-OTAA Debate
There is growing support for expanding access to methadone treatment, particularly through the proposed Modernizing Opioid Treatment Access Act (M-OTAA). This legislation aims to remove certain restrictions and allow qualified physicians to prescribe methadone outside of traditional OTPs.⁴,⁵
Support and Concerns Surrounding M-OTAA
Some critics argue that the bill could lead to methadone being prescribed with minimal oversight, increasing the risk of misuse. However, the American Society of Addiction Medicine (ASAM) refutes this concern, stating that non-OTP providers and pharmacies would still be bound by federal and state regulations. These rules are in place to ensure that controlled substances, including methadone, are dispensed only for legitimate medical purposes.¹⁰
Meanwhile, the American Association for the Treatment of Opioid Dependence has voiced concern that M-OTAA focuses solely on medication access, not comprehensive treatment.¹¹ In response, ASAM notes that the legislation does not prevent non-OTP providers from also offering therapies and recovery supports.¹⁰
Why Increasing Access Matters
Currently, only about 20% of individuals with OUD are receiving one of the FDA-approved medications for treatment. Expanding access to methadone—particularly through primary care settings—may help close this gap and address the growing crisis of opioid overdose deaths.¹²
Making methadone more accessible through community-based healthcare could also help reduce the stigma of OUD, framing it more like other chronic health conditions treated in primary care environments.¹²
Find a Treatment and Methadone Clinic Near You
Treatment for OUD is available at addiction rehabs throughout the United States. Many OTPs offer methadone as part of OUD treatment.9 That being said, there’s no one-size-fits-all treatment, so it’s important to consult your primary care physician or an addiction treatment specialist about the options that are right for your unique needs.
American Addiction Centers (AAC) offers customized treatment plans for OUD at our facilities located throughout the country. We offer medical detox and withdrawal management, counseling and evidence-based therapies, and treatment for co-occurring disorders in a variety of settings, including inpatient and outpatient rehab. Call our free, confidential helpline at (866) 959-6822 to speak to a caring and knowledgeable admissions navigator about your treatment options or to find methadone clinics near you.
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