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Methadone is a prescription opioid used to treat severe pain that does not respond to alternative methods of pain management. It is also sometimes used in opioid addiction treatment to help people detox from opioids and stay committed to recovery. While methadone does have legitimate medical uses, it has the potential to be addictive. In some cases, a person may need support to help them come off of the medication and cope with methadone withdrawal symptoms. One option for managing methadone withdrawal is taking a medication called Suboxone. Learn about this option, as well as what to expect when coming off methadone, below.
Methadone Overview
Methadone is a prescription medication belonging to the opioid class of drugs. It is long-acting, meaning that its effects do not wear off quickly as is the case with some shorter acting drugs. Below are the details of methadone and its uses.
Uses
Methadone is FDA-approved for two uses: treating chronic pain that does not improve with non-narcotic drugs, and treating opioid use disorder as a part of the detox or medication-assisted treatment process. While not FDA-approved for this purpose, methadone is also used to treat neonatal abstinence syndrome, which occurs when newborns experience withdrawal symptoms after being exposed to opioids during the prenatal period.
Prescription
Patients must have a prescription to take methadone. Because it is a Schedule II Controlled Substance, its use and prescription is highly regulated. Historically, patients have had to report regularly to a treatment center to receive dosages of methadone, but restrictions were reduced as a result of the COVID-19 pandemic.
As a result of pandemic-related flexibilities, stable patients, defined as those who have been on methadone for at least 60 days and who have provided negative drug screens for illicit drugs, can take home a 28-day supply of methadone, rather than returning to a clinic regularly to receive more medication. Those who have been in methadone treatment for 30 days and who have demonstrated at least partial compliance with their treatment plan can receive 14 days of medication to take home.
The government has decided to extend these flexibilities for one year following the end of the COVID-19 Public Health Emergency and is exploring options to make the flexibilities permanent.
Administration
Methadone is available in a number of formulations, including oral tablets, as well as IV, intramuscular, and liquid solutions. The most common routes of administration for methadone are an oral tablet or a concentrated syrup.
Dosages
A person’s methadone dose will vary based upon the reason they are taking the medication. For patients taking methadone for pain management, a beginning dosage is typically 2.5 mg taken by mouth once every 8 hours. The dose may be increased if needed. For patients who are already tolerant of opioids, a beginning dose for pain management will be higher, depending upon the patient’s needs.
For patients in MAT treatment for opioid use, methadone doses begin at 30 to 40 mg per day and then increase by 10 to 20 mg a week until a patient stabilizes on a dose of 80 to 150 mg a day.
Keep in mind that these dosages are just general guidelines. A person’s exact dose will vary based upon their needs and health history. It is important to consult with a doctor regarding the appropriate methadone dose if you are taking or planning to take this medication.
Side Effects
As with any medication, methadone can have side effects. Some common side effects that patients experience when taking methadone include sedation, nausea, constipation, dry mouth, flushing, lethargy, itching, and breathing problems. In rare cases, methadone can cause cardiac problems and hypoglycemia. Consult with your doctor about any side effects you experience with methadone.
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