Methadone Treatment

What is Methadone?

Methadone is a long-acting opioid agonist used to manage pain and, more commonly, to treat opioid use disorders (OUDs).² It’s regularly employed in medical detox to manage opioid withdrawal and as a maintenance treatment for OUDs.¹

When used properly, methadone reduces opioid cravings and withdrawal, blunts the effects of illicit opioids, and helps people to achieve and sustain recovery from opioid addiction.^1,2 

Often taken in liquid or dispersible tablet (e.g., diskette) forms, methadone has a 50-year track record and is the most studied opioid use disorder (OUD) medication available today. OUD medications such as methadone decrease illicit opioid use, retain people in treatment, and reduce the risks of opioid overdose death better than treatment with a placebo or no medication.¹ In fact, methadone is on the list of essential medicines recognized by the World Health Organization (WHO).³  This list comprises roughly 400 medications—which are selected based on safety, efficacy, cost-effectiveness, etc.—that are essential to a fully functioning healthcare system.⁴

Note, however, that methadone is just one part of a comprehensive treatment plan that often includes behavioral therapies, counseling, and more to promote long-term recovery from opioid addiction. And since methadone is a schedule II controlled medication, methadone is only dispensed through opioid treatment programs (OTPs) certified via the Substance Abuse and Mental Health Services Administration (SAMHSA).²

How Does Methadone Treatment Work?

As a synthetic, long-acting opioid agonist, methadone binds to the same opioid receptors in the brain as substances such as heroin, morphine, other opioids, etc. However, methadone’s impact on these receptors is much more gradual, and when used properly, should not elicit the rewarding euphoria characteristic of many other types of opioid use.⁵ Plus, when used as part of an OUD treatment regimen, methadone decreases opioid cravings, and thanks to its slow elimination, prevents withdrawal and related symptoms.^1,6 

According to insights from SAMHSA, OUD medications such as methadone safely afford people the ability to make important life changes associated with long-term recovery.¹ Minimizing cravings and withdrawal symptoms, methadone maintenance treatment makes it possible for people to function normally, maintain employment, attend school, and participate in other forms of treatment or recovery support, which can help them cope with their substance use disorder over time and enter recovery.⁷

Methadone is typically administered daily via dosing that’s tailored to each individual and often adjusted and readjusted as needed.  While the National Institute on Drug Abuse suggests that methadone treatment should last a minimum of 12 months, some patients require long-term maintenance.² When taken as prescribed and under a physician’s guidance, methadone is safe to use for months, years, or even a lifetime.⁸ General guidance offered by SAMHSA indicates that stable patients can continue OUD medication indefinitely as long as it is beneficial to them. Patients who have stabilized on methadone are considered to be in recovery.¹

Methadone is administered via a certified OTP where dosing is initially performed under supervision. After a period of stability, patients may be provided with take-home doses to take between methadone clinic visits.⁹ 

Side Effects—How Does Methadone Make You Feel? 

Almost all pharmaceuticals have side effects. Some of the potential side effects of methadone include:² 

• Restlessness. 
• Nausea, vomiting.
• Slowed breathing.
• Itchy skin.
• Heavy sweating.
• Constipation.
• Sexual dysfunction.

More serious side effects of methadone include:²

• Difficult or shallow breathing.
• Lightheadedness.
• Chest pain, fast or pounding heartbeat. 
• Hallucinations or confusion.

Methadone can be used safely and effectively when taken as prescribed. However, given methadone’s long-acting nature, its potential for overdose may increase when it is not used as directed (i.e., when it is used in higher than recommended doses and/or dosed more frequently than it should be).²

Benefits of Methadone for Opioid Use Disorder

As described above, methadone can help patients reduce or eliminate illicit opioid use and improve their health and functioning.¹ However, methadone is also associated with a host of other benefits. 

According to SAMHSA insights, methadone treatment can:¹

• Reduce the risk of overdose-related deaths. 
• Lower rates of cellulitis (i.e., a type of skin infection potentially associated with injection drug use). 
• Reduce the risk of HIV and hepatitis C infection by decreasing the potential for relapse.
• Decrease criminal behavior. 

Methadone Use During Pregnancy

Methadone also has been shown to improve birth outcomes among pregnant women with opioid use disorders.⁸ Pregnant women and those who are breastfeeding can safely take methadone.² Plus, withdrawal during pregnancy is associated with a risk of miscarriage or premature birth. Since methadone can prevent withdrawal symptoms in the perinatal period, it can help pregnant women to better manage their OUD while avoiding health risks to both the mother and baby.²  

That said, neonatal abstinence syndrome (NAS) is possible in newborns whose mothers were treated with methadone. Thus, it’s important for pregnant women undergoing methadone treatment to work with their healthcare providers to best manage any symptoms of neonatal abstinence, should they arise.¹

Can I Become Addicted to Methadone?

Since methadone is an opioid, it can produce euphoria in people who are not already dependent on opioids, and as a Schedule II drug, it has a potential for dependence and addiction.^7,10 As such, one might assume there’s considerable methadone misuse and diversion (i.e., the illicit redistribution of prescription drugs that transfers them from their intended recipients to unauthorized users). 

However, methadone produces different effects on those with a high tolerance to opioids versus those who are not dependent on them. When used for OUD treatment and taken at prescribed doses, methadone doesn’t produce a high and rather minimizes withdrawal symptoms and cravings.⁷ 

Additionally, data shows that the majority of methadone misuse involves obtaining the drug from an unauthorized source for the purpose of controlling withdrawal symptoms and cravings. That is, methadone diversion usually isn’t prompted by the desire to get high. Rather, it’s typically associated with a lack of access to the medication for OUD treatment, and the most common reason for this is a missed medication pickup.¹¹

Also note that cases of methadone diversion and overdose deaths are most often associated with methadone that has been prescribed for the treatment of pain, not for OUD treatment.¹¹ So is methadone addiction possible? Yes. Is it regularly associated with OUD treatment? No.

Methadone Withdrawal Symptoms and Timeline

As described above, methadone diversion is most often associated with methadone prescribed for the treatment of pain — not for OUD treatment.¹¹ Within this misuse framework, methadone withdrawal symptoms can include:¹²

• Restlessness.
• Irritability, anxiety. 
• Insomnia.
• Yawning.
• Runny nose, watery eyes. 
• Fever, chills, sweating.
• Muscle aches, joint pain.
• Nausea, vomiting, diarrhea.

When it comes to a methadone withdrawal timeline, symptom onset varies from person to person depending on a host of factors, such as duration of use, quantity used, and individual factors regarding the person’s overall health. The same ambiguity exists with regard to how long methadone withdrawal lasts. Generally speaking however, withdrawal for long-acting opioids such as methadone can begin within 36 hours after the last use and can last for 14 days or more.¹

Methadone Detox 

As described above, patients using methadone as part of OUD treatment can continue the medication indefinitely as long as it’s beneficial to them and used as described.¹ If methadone dependence has developed due to misuse (which, again, is more likely to occur when methadone is used for pain than for OUD treatment) or if an individual wants to stop using methadone as a treatment drug, it’s important to seek medical advice to slowly reduce the dose rather than abruptly stopping use.^9,11,13 

In cases of misuse, methadone detox protocols are similar to that of other opioids. That is, detox involves medications and practices to ensure patient safety and to ease withdrawal symptoms. Detox is simply one part of a multipart treatment program that can include multiple levels of care, such as inpatient treatment, outpatient services, aftercare, and more.

Methadone Treatment for Opioid Use Disorder

If you or someone you love is struggling with an opioid use disorder, treatment is available. However, treatment isn’t a one-size-fits-all solution. Rather, each treatment plan is tailored to the unique needs of each individual. As such, professionals will assist you in making decisions about methadone treatment as part of detox and/or ongoing opioid use disorder treatment.

If you’re ready to learn more, American Addiction Centers (AAC) can help. Offering accredited facilities and staff paired with evidence-based treatment, AAC offers the full spectrum of care via multiple U.S. treatment centers, which are in-network with myriad insurance providers that typically cover part of treatment costs. AAC’s Rhode Island-based treatment facility, AdCare RI, offers methadone for patients when appropriate. 

Available 24/7 for a free and confidential conversation, admissions navigators at can not only help you explore various treatment options and facilities but also answer your treatment questions, discuss financing and payment options, and more. Additionally, staff can verify any insurance benefits, or you can verify your insurance benefits online. Plus, if you’re not ready to talk, you can sign up to receive insights via text.

Reach out now to take your first step toward a lasting recovery.

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