Methadone Maintenance Programming for Opioid Addiction

Methadone is an extremely effective medication that has been used for decades to help individuals successfully overcome their dependence on prescription painkillers, heroin, and other opioids. When used as directed under the supervision of a qualified professional, methadone can alleviate the intense cravings and other painful physical and psychological symptoms that are typically associated with opioid withdrawal.

Methadone interacts with receptors in the brain that are also impacted by opioid abuse. The medication satisfies the body’s hunger for opioids, but it does not cause the intoxication or sedation that result from opioid abuse. Thus, when a person takes methadone as part of a medication assisted treatment program, he or she can stop using opioids without fear of withdrawal symptoms, and with the mental clarity that he or she will need to participate in counseling and therapy and to meet his or her other responsibilities.

Some people use methadone in the early stages of their recovery, and then taper their use of this medication. Many others participate in long-term methadone maintenance, staying on the medication for months or even years. Determining which approach is best for any one individual is a decision that should be made by the individual and his or her healthcare provider, and should be based on a thorough assessment of the individual’s strengths, needs, personal history, progress, and treatment objectives.

Of the many medications that have been incorporated into addiction treatment programs through the years, none has been studied more thoroughly or monitored more closely than methadone has. With more than 50 years of successful use in medication-assisted treatment programs, and with more than five decades of research and data collection, methadone has a documented history of safety and effectiveness when used as directed and under the guidance and supervision of an experienced treatment professional.

In 2000, researchers who reviewed 35 years of methadone-related studies found that the medication has no record of significant health risks either in the short-term or when used for long periods of time. The medication does have some side effects (which are discussed in detail in a later section on this page), but the decades of research show that the vast majority of these effects occur when an individual first takes methadone, during the period that he or she is working with his or her healthcare provider to determine the optimal dosing level.

In addition to ensuring that the individual is taking methadone at the proper dosage level at the outset of his or her time in a licensed medication-assisted treatment program, the medical personnel who staff such programs will also monitor the individual’s health throughout his or her time in treatment. This continued attention to the ongoing impact of the methadone will ensure that the individual in treatment receives maximum benefit from the medication with limited risk of experiencing adverse effects.

The U.S. Department of Health and Human Services (DHHS), the National Institute on Drug Abuse (NIDA), and the U.S. Food and Drug Administration (FDA) are among the respected organizations that have verified and attested to the safety and effectiveness of methadone. For example, the CDC has noted that methadone maintenance has been associated with the following positive outcomes:

• Reduced use of opioids
• Reduced risk of developing HIV/AIDS, hepatitis B, and hepatitis C
• Increased life expectancy
• Decreased likelihood of engaging in criminal activities
• Improved family stability
• Improved likelihood of getting and keeping a job

Like all prescription medications, the safety of methadone is contingent upon its use as directed and under the supervision of a qualified professional. Individuals who abuse methadone put themselves at risk for a variety of negative outcomes, including overdose-related death. However, the risk of overdose and related damage is virtually eliminated with methadone is taken as instructed as part of a licensed medication-assisted treatment program.

The key to an optimal experience with prescription methadone is taking the medication under effective professional supervision as part of a comprehensive medication-assisted treatment program. Methadone’s ability to alleviate the distress of withdrawal and eliminate the cravings that would otherwise occur in the absence of opioids is significant, but medication alone cannot address all of the issues that may have a led a person into substance abuse or that may prevent him or her from achieving successful long-term recovery.

Methadone helps individuals to retain and improve their physical strength and mental acuity, which provides them with the ability to take the greatest advantage of individual therapy, group therapy, and other services that can be invaluable components of a successful treatment experience. While a person is taking methadone, he or she can drive a car, get a job, and participate in counseling and other recovery-related activities.

In a medication-assisted treatment program, individuals who are taking methadone may work with doctors, nurses, counselors, and other professionals who will monitor their health, guide them through the challenges of early recovery, and help them to make the lifestyle changes that will support long-term recovery. These non-medication aspects of the treatment experience can help individuals to address the overall impact that opioid addiction has had on their lives, and to develop the skills and strategies that will empower them to heal from past harm, avoid future damage, and learn to live a more productive and satisfying life.

As indicated earlier on this page, methadone use can lead to the development of certain side effects. Most of these occur during the induction phase, which is the period during which the individual in treatment first begins to take methadone. The presence or absence of side effects will be closely monitored by a member of the treatment program’s medical staff, who can adjust the individual’s dosage level.

The following are among the more common side effects that are associated with early use of methadone:

• Fatigue
• Dry mouth
• Constipation
• Abdominal pain
• Insomnia
• Nausea
• Diarrhea
• Anxiety
• Decreased sex drive
• Skin rashes
• Low blood pressure

As is the case with most prescription medications, any strong adverse reactions should be brought to the immediate attention of a member of the treatment staff.

With the assistance and oversight of experienced professionals, methadone use can be a safe and extremely effective component of one’s recovery at licensed medication-assisted treatment program.