Why Sticking with Your Methadone Dosage Matters

Whether it is in powder, tablet, or liquid form, your methadone dosage is specifically measured based on your needs. You may experience negative effects if you do not follow the dosage instructions.

What Is Methadone Used For?

Methadone is a medication approved by the Food and Drug Administration (FDA). It is available as diskettes, powder, and a liquid methadone dosage. It is typically prescribed to treat opioid use disorder, but may also be prescribed for pain management.1

Opioid Use Disorder

Opioid use disorder occurs when you become dependent on an opioid drug and misuse it for nonmedical uses. Opioid drugs include the illegal drug heroin, as well as prescription pain medications such as morphine and oxycodone. Drug dependence may mean you have become tolerant to the drug, needing to take higher doses to experience the same effects, or that you experience withdrawal symptoms when not taking it.

Methadone can be used to prevent withdrawal symptoms detoxing from an opioid. The methadone dosage for opiate withdrawal varies based on medical factors, such as weight and withdrawal symptoms experiences.

Methadone is a synthetic opioid agonist that works against the effects of other opioids in your body. Methadone attaches itself to the same receptors in your brain that opioid drugs, like heroin and OxyContin, attach to block those drugs from having their usual effect.

The difference between methadone and other opioid drugs is that, even though it occupies and activates the same receptors, it does so more slowly than the other harmful opioid drugs. The smaller doses used in treatment also do not produce a euphoric effect—or a “high”—in an opioid-dependent person.2

Methadone dosage is just one component of a comprehensive treatment plan, including counseling and other behavioral health therapies to provide you with a well-rounded approach to dealing with your substance misuse.1

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Pain Management

Methadone is also used to relieve severe pain, specifically if you are expected to need pain medication around the clock for a long time. Methadone works to treat pain by changing the way your brain and nervous system respond to pain.3 It blocks signals of pain similarly to other opioids.

What Is the Average Methadone Dosage?

If you are prescribed methadone to treat OUD, you must take that medication under the supervision of your practitioner. Most medical professionals allow you to take methadone at home between program visits after monitoring your progress and seeing consistent compliance with the methadone dosage.1

Pain Management

If you are taking methadone to help with pain management, the usual oral dose starts at 2.5-10 mg every 8-12 hours.4

Medication-Assisted Treatment

If you are being treated with methadone for managing withdrawal symptoms during detox, an initial dose of 20-30 mg of methadone will usually suppress those symptoms.4

There has been some discussion about the effectiveness of certain doses of methadone. Most recommendations state that you can adjust the dose on the same day but should wait at least 2-4 hours to reach the peak levels of the drug, and the daily dose should not be more than 40 mg on the first day.4

Special Cases

Some studies suggest that patients be divided into high-risk and low-risk categories to determine the best dosage. You would be considered high risk if:4

  • You are over 65 years old
  • You have a respiratory disease
  • You have severe liver dysfunction
  • You are under treatment with a sedating medication along with the methadone

If you are deemed “high risk,” then the suggested initial maximum dose of methadone is 30 mg with a maximum increase of no more than 20 mg per week.4

Will My Methadone Dosage Change Over Time?

Your length of time in a methadone treatment program varies depending on several factors. According to the National Institute on Drug Abuse, the length of methadone treatment is a minimum of 12 months, and you may require long-term maintenance.1

Your methadone dosage will most likely change throughout your treatment time. Doses start at a higher amount to help you manage withdrawal symptoms or pain levels. Over time, your doctor may decrease your dose or tell you to take methadone less often as your treatment continues. The doses are changed gradually to avoid experiencing negative side effects.

Talk to your doctor about how you are feeling during your treatment with methadone, and do not take extra doses of methadone or take doses of methadone earlier than they are scheduled, even if you experience pain.

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If you suddenly stop taking methadone, you may experience withdrawal symptoms such as:3

  • Teary eyes or enlarged pupils
  • Runny nose
  • Frequent yawning
  • Sweating and/or chills
  • Mood changes like anxiety or irritability
  • Backaches, muscle pain, joint pain, or general muscle weakness
  • Difficulty falling asleep or staying asleep
  • Intestinal issues like nausea, stomach cramps, decreased appetite, vomiting, or diarrhea.

What Are the Risks of Taking Methadone Not as Prescribed?

Methadone is a safe drug when you use it under the supervision of a medical professional and follow the recommended dosage and time of use. If you begin to take more or less methadone than is prescribed, you are at risk of methadone misuse.

You can experience serious side effects of methadone misuse. You might:1

  • Experience difficulty breathing or shallow breathing
  • Feel lightheaded or faint
  • Experience hives or a rash; swelling of the face, lips, tongue, or throat
  • Have chest pain or a fast or pounding heartbeat
  • Hallucinate or have feelings of confusion

Because methadone is a long-acting drug, it stays in the body for a long time. There is a risk of overdose if the methadone dosage for opiate withdrawal is misused or taken incorrectly.

Symptoms of overdose may include the following:3

  • Small, pinpoint pupils
  • Breathing difficulties
  • Sleepiness and drowsiness
  • Cool, clammy, or blue skin
  • Unresponsiveness or an inability to wake up

If you experience any of the serious side effects or symptoms of overdose, contact a doctor or emergency services.

How Can I Prevent Negative Side Effects?

You can do some things to avoid methadone misuse:1

  • Follow your prescription instructions for methadone, including how often to take your medicine.
  • If you miss a dose, or if it feels like the medicine is not working, consult your doctor before taking your next dose of methadone.
  • Do not share your prescription drug with anyone, even if they have similar symptoms to you or have been diagnosed with the same condition.
  • Dispose of unused methadone safely. Talk to your healthcare provider for guidance, or you can learn more about the safe disposal of unused medications at the FDA’s disposal of unused medicines or DEA’s drug disposal webpages.

If you need treatment for opioid use disorder, please call 800-994-1867Who Answers? to speak to a specialist about treatment options.


  1. Substance Abuse and Mental Health Services Administration. (2021, November 04). Methadone.
  2. National Institute on Drug Abuse. (2021, April 13). Medications to Treat Opioid Use Disorder Research Report.
  3. U.S. National Library of Medicine. Methadone. MedlinePlus.
  4. Office of Addiction Services and Support. (2006, December 01). Methadone Dosing. New York State.
  5. Substance Abuse and Mental Health Services Administration. (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.
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