Understanding Methadone Maintenance Guidelines

Because of their high potential for addiction, opiate drugs are classified as controlled substances. Methadone, a type of treatment for opiate addictions, is also an opiate-based medication. Unlike other opiate drugs, methadone has a long-acting effect that helps to reduce drug cravings and withdrawal effects without the addiction potential found in other opiate drugs. These qualities make for an effective maintenance or long-term treatment for recovering opiate addicts.

Methadone’s classification as a controlled substance places it under the purview of federal regulating agencies. Methadone maintenance guidelines have been put in place by regulating agencies to prevent the illegal distribution and abuse of this treatment drug. Physicians and facilities providing methadone treatment must adhere to strict program requirements.

Depending on the severity of a person’s addiction, program participants may be required to receive methadone treatments from a clinic facility or provided with a take-home supply of methadone. Prior to starting treatments, methadone maintenance guidelines require all treatment providers to conduct a thorough evaluation for each program participant to assess their medical and psychological statuses. According to the University of Hawaii, the evaluation process enables providers to:

  • Identify a person’s opiate dependency level
  • Identify any existing psychological problems
  • Identify any medical conditions caused by drug use
  • Identify any high-risk behaviors that may jeopardize treatment efforts

Dosage Guidelines


Administering and taking methadone happens under certain guidelines, as methadone is itself a potentially addictive medicine.

Methadone maintenance guidelines layout out the procedures treatment providers must follow when administering methadone at the start of treatment and when instating a methadone maintenance schedule. Methadone treatments cannot be started until after a person is evaluated and diagnosed as opiate dependent. Initial doses should fall within the 15 to 30 milligram range per day for the first three days of treatment.

After the initial three day period, many people require dosage adjustments in order to stabilize levels of methadone in their system. Methadone maintenance guidelines require provides to base dosage adjustments on the following criteria:

  • Presence or absence of withdrawal symptoms
  • Continued opiate abuse behaviors
  • Presence or absence of drug cravings

During the stabilization period, methadone maintenance guidelines allow dosage adjustments to be made every three to four days as needed. Dose adjustment amounts can range anywhere between five to 15 milligrams during the stabilization period. On average, it can take anywhere from two to six weeks before the optimal dose of methadone is established.

Methadone Treatment Program Rules

Methadone maintenance guidelines include a set of program rules both providers and participants must follow. These rules address the following areas:

  • The types of information providers must relay to program participants at the start of treatment
  • Limits on the number of treatment visits per person
  • Requirements for urine screenings

At the start of treatment, participants must be advised on the conditions of the program, such as grounds for discontinuation and the types of services offered through the program. Methadone maintenance guidelines set a three to four day time span limit between treatment visits for every participant. Urine screenings are also a conditional requirement under methadone maintenance guidelines. Participants must submit a urine sample each time they go in for treatment. Results from urine screenings enable treatment providers to gauge dosage levels and determine whether participants are meeting program requirements.

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