Methadone maintenance treatment (MMT) has been helping people worldwide for half a century. It is the opioid use disorder treatment with the best record of success in the retention of participants and reduction of opioid misuse.1
Methadone is one of three medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder. Doctors prescribe methadone as replacement therapy. Replacing opioids with methadone is a way to prevent withdrawal symptoms and cravings while detoxing at the same time.2
In this Article:
- What Is Methadone Treatment?
- Why Choose Methadone Maintenance Treatment?
- Where Can I Get Methadone Maintenance Treatment?
- Step One: Assessment
- Step Two: Induction and Stabilization
- Step Three: Maintenance
- When Is Methadone Maintenance Treatment Recommended?
- Who Benefits Most from Methadone Maintenance Treatment?
- How Much Does Methadone Maintenance Treatment Cost?
What Is Methadone Treatment?
Methadone is a slow-acting opiate prescription medication used to help people recovering from heroin and opiate addiction since the 1950s. Physicians and nurses administer it in pill and liquid forms from a methadone clinic. Methadone is prescribed for opiate addiction because it can lessen painful withdrawal symptoms while simultaneously blocking the pleasurable and euphoric effects of opiate drugs. This combination of reducing both pleasure and pain associated with opiate use can aid patients in staying in treatment programs for extended periods without relapse.
Why Choose Methadone Maintenance Treatment?
Opioid use disorder is a disease of the brain. Misusing opioids over time damages different parts of the brain, including the area responsible for producing feelings of reward, motivation, and connection to others. 3
Many studies have measured recovery success among those who do not use medication-assisted treatment and those who do. Methadone maintenance has the best record of success of current treatment options for opioid dependence and addiction.4
Methadone is an opioid agonist. It attaches to receptors in the brain that produce a biological response of euphoria. These receptors are unable to respond when blocked. A person in methadone maintenance treatment can function normally and fulfill work and home responsibilities without experiencing any impairment.
Benefits of methadone maintenance treatment include:3,4
- Easing withdrawal symptoms and cravings
- Stabilizing the brain
- Blocking the euphoric effect in the brain
- Preventing overdose
- Reducing the risk of relapse
- Improving the overall quality of life
- Long-lasting effects
Call 800-530-0431 Toll Free. Privacy Guaranteed. No Commitment.Addiction help is standing by 24 hours a day, 7 days a week.
Where Can I Get Methadone Maintenance Treatment?
Clinical staff at a SAMSHA-certified clinic administer your daily dose of methadone. SAMSHA certification can include the clinic’s accreditation at the federal and state level, licensure by the State Opioid Treatment Authority, meeting the Department of Health and Human Services requirements, and registration and approval with the Drug Enforcement Administration (DEA).5
Medication-assisted treatment centers must also provide counseling to anyone receiving methadone or other addiction treatment medications.1 Methadone programs operate in several setting, including:4
- Stand-alone methadone clinics
- Inpatient hospitalization addiction treatment facility
- Inpatient residential addiction treatment facility
- Outpatient addiction treatment facility
- Addiction specialists’ practice
- Emergency rooms
The key is that each of these locations must have the proper certifications. If they lack the approval to dispense on-site, the doctor can write a referral to a certified program.
Step One: Assessment
When entering treatment, a treatment professional gathers information on current and past substance misuse, family history of substance misuse, psychiatric health, physical health, social influences, and withdrawal symptoms. The report helps your team create a treatment plan.6
To be admitted to a methadone treatment center, you must:7
- Meet the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria for opioid use disorder, including:8
- Misusing opioids even though physical or mental issues are worsening
- Experiencing withdrawal symptoms when not taking opioids or taking smaller amounts of opioids
- Taking more opioids than intended or wanted
- Being unable to quit even when trying
- Continuing to misuse opioids even though it leads to interpersonal, employment, or other consequences
- Spending a significant amount of time seeking and misusing opioids
- Engaging in risky or illegal behavior to obtain opioids
- Have had an opioid use disorder for at least one year or can provide proof of pregnancy, incarceration, or previous treatment
- Authorize consent for treatment
- Review and understand methadone treatment, as explained by the doctor or professional staff
- Have not been admitted for MMT more than two times in the same year
Program participants can receive additional services. These services may include counseling, vocational, medical, and educational resources that benefit recovery. Random drug testing is often a part of treatment so staff can verify participants are not taking other substances that may interact with methadone.7
Step Two: Induction and Stabilization
Induction and stabilization are the second steps in the methadone treatment process. Once approved for the program, daily methadone dosing begins. The standard protocol is to start at the lowest dose, monitor the effects, and increase as needed. It can take two or more weeks to find the correct methadone dose, which will vary for every person.4
Stabilization is the period in which methadone levels reach their peak and then begin to decrease. A stable dose usually peaks 2-4 hours after dosing, and the gradual decrease happens slowly enough that you avoid withdrawal symptoms and cravings for at least 24-36 hours. Stabilization doses last from one dose to the next.4
Step Three: Maintenance
Maintenance is the next phase of methadone treatment, recommended for at least one year. Once the appropriate dose is established and no more adjustments are needed, you enter methadone maintenance treatment.
This doesn’t mean adjustments won’t occur in the future, but for now, your dosage remains the same.
Reasons for future adjustments include changes to a person’s mental or physical health, medications, or misuse of alcohol or other substances. Some people stay on methadone maintenance treatment for multiple years and some go on and off treatment intermittently. Evaluation occurs regularly with the treatment team.4
Call 800-530-0431 Toll Free. Privacy Guaranteed. No Commitment.Addiction help is standing by 24 hours a day, 7 days a week.
When Is Methadone Maintenance Treatment Recommended?
Methadone maintenance treatment is a natural progression to stage 3 in methadone treatment.
Programs are set up to dispense daily doses to program participants at the clinic. However, take-home doses are available. Some programs allow a person to take home multiple days’ doses, and some allow a week or more. Every person is evaluated based on their progress in the methadone maintenance treatment program.
The requirements include:9
- Stability with the current dose of methadone for at least 60 days
- Progress toward treatment goals
- Compliance in the methadone program
- Consistency in complying with rules and protocols
- Negative toxicology reports for 60 days
- Stable home and social support
- Proof of proper storage for medication
Providers can determine if you meet the requirements for taking a 28-day or 14-day prescription home. You agree not to:10
- Take your methadone dose in an amount different than prescribed, such as taking an extra dose
- Combine your methadone with any prescription, over-the-counter, or other substances your doctor hasn’t approved
- Change the method of administration of your methadone, such as taking it by snorting or injection
- Trade your methadone for any other substances
- Sell your methadone for any reason
Who Benefits Most from Methadone Maintenance Treatment?
Medication-assisted treatments help almost anyone, regardless of age, culture, or opioid of choice. However, little current research supports methadone prescriptions for teenagers or older individuals.
Studies show differences between men and women receiving methadone maintenance treatment for opioid use disorder. Research suggests that women:11
- Tend to enter methadone treatment at a younger age than men and may seek treatment after a shorter period of problematic opioid use.
- May have shorter stays in treatment, sometimes less than the typical 12 months.
- Are more likely to have past trauma and co-occurring mental health disorders that must also be treated. Women seeking treatment also reported more extensive family histories of opioid use disorder.
Methadone is also highly likely to be offered as a perinatal treatment option because it is safe while pregnant and breastfeeding.
Racial and Ethnic Differences
Opioid misuse, dependence, and addiction affect all races and ethnicities. The highest rate of opioid use disorder diagnoses and methadone maintenance treatment is observed among whites.
However, researchers note that several disparities make it difficult to make any generalizations about opioid misuse, addiction, or treatment, including: 11
- Whites are more likely to enter treatment, while other demographics are more likely to be denied treatment or have barriers that make treatment inaccessible.
- Substance misuse has been substantially criminalized among Blacks, which decreases the likelihood of treatment entry.
- Even after receiving a diagnosis, Black and Latino individuals are significantly less likely to receive medication-assisted treatment within 6 months than whites.
- Individuals seeking treatment have reported that their physicians used race or ethnicity to make decisions about treatment instead of relevant factors.
- Treatment completion rates are low among Latinos, with many exiting treatment before 6 months, though the cause of this issue is currently under researched.
- The opioid epidemic has an extreme impact on American Indians and Alaskan Natives, with high overdose rates and low treatment rates. These demographics have been observed to have the least access to treatment and, researchers note, many treatment centers are not trained to be culturally competent in the needs of these patients.
Differences Among LGBTQ+ Populations
Research is highly limited on LGBTQ+ people in general, as well as on individual demographics under that umbrella. However, preliminary research and related studies indicate that sexual minority respondents are much more likely to have lifelong substance use disorders than straight peers, especially sexual minority respondents who are women. 11
Regardless of gender, individuals who identified as bisexual in the 2015 National Survey on Drug Use and Health were 1.5 times more likely to have opioid use disorder than straight peers. 11
LGBTQ+ people have also been shown to be significantly less likely to enter addiction treatment due to issues with access, availability, safety, cultural competency, and cost. 11
Co-Morbid Condition Differences
Most people with an opioid use disorder also have other physical or psychological symptoms. Below are some of the findings among these groups:11
- Methadone maintenance treatment for those with co-occurring mental health conditions reduces the need for inpatient treatment. They also have higher rates of adhering to their mental health medication regimens.
- Depression improves quickly in the first few months of methadone maintenance, especially among women, young adults, and adolescents.
- Up to 80% of people with an opioid use disorder also have another substance use disorder, with nicotine, alcohol, stimulants, and marijuana as the most reported substances.
- Participants between 35 and 65% of medication-assisted treatment reported they took opioids for chronic pain—a condition that must be treated separately to reduce the risk of relapse.
How Much Does Methadone Maintenance Treatment Cost?
If you have Medicare and the methadone maintenance treatment program is contracted with Medicare, it will cost you nothing to receive care. This includes medication management and counseling activities.12
Private health insurance carriers should also pay for mental health and substance use disorder treatment. In 2008, the Mental Health Parity and Addiction Equity Act passed requiring insurers to provide coverage comparable to medical and surgical care.13
Many treatment centers offer discounts, payment plans, and scholarships. This should be a priority question when talking to a provider. According to the National Institute of Drug Abuse, methadone treatment typically costs around $130 per week, which is a yearly cost of $6,500.14
We can connect you with a local facility specializing in methadone maintenance. Call us 800-530-0431Who Answers? today to speak with a treatment specialist.
- Substance Abuse and Mental health Services Administration. (2021). Methadone.
- Substance Abuse and Mental Health Services Administration. (2021). MAT Medications, Counseling, and Related Conditions.
- Department of Healthcare Services. Medication-Assisted Treatment Toolkit for Counselors.
- National Center for Biotechnology Information. (2018). Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families. Treatment Improvement Protocol (TIP) Series, No. 63. Rockville (M.D.): Substance Abuse and Mental Health Services Administration (U.S.).
- Federal Opioid Treatment Standards. (2022). Title 42, Chapter 1, Part 8, Subpart C.
- U.S. Department of Health and Human Services. (2016 ). Early Intervention, Treatment, and Management of Substance Use Disorders. Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (D.C.): Substance Abuse and Mental Health Services Administration (U.S.).
- Substance Abuse and Mental Health Services Administration. (2015). Federal Guidelines for Opioid Treatment Programs.
- Dydyk, A.M., Jain, N.K., & Gupta, M. (2021). Opioid Use Disorder. Treasure Island (F.L.): StatPearls Publishing.
- Substance Abuse and Mental Health Services Administration. (2021). Methadone Flexibilities Extension Guidance.
- U.S. National Library of Medicine. (2021). Prescription Drug Misuse. MedlinePlus.
- National Academies Press. (2019). Treatment with Medications for Opioid Use Disorder in Different Populations. Medications for Opioid Use Disorder Save Lives. Washington (D.C.): National Academies of Sciences, Engineering, and Medicine.
- Medicare. Opioid Use Disorder Treatment Services.
- S. Department of Health and Human Services. (2020). Does Insurance Cover Treatment for Opioid Addiction?
- National Institute on Drug Abuse. (2021). How much does opioid treatment cost?