Methadone Maintenance Treatment Tips

Jessica Payne, LMSW, CAADC Info icon
Calendar icon Last Updated: 03/8/2022

Reading Time: 6 minutes

For individuals with an opioid use disorder, methadone maintenance can be an extremely beneficial form of treatment.1 Methadone is an opioid medication that is approved by the Food and Drug Administration (FDA) to treat opioid use disorders and pain management. Methadone maintenance treatment programs can help you achieve and sustain recovery.1

What is Methadone Maintenance?

Methadone is a long-acting opioid agonist that mitigates opioid withdrawal symptoms and reduces cravings.1 Methadone maintenance is a form of medication-assisted treatment (MAT) in which an individual takes methadone every day as a treatment for opioid addiction.

Methadone is to be taken daily and can be in the form of:

  • Oral solution
  • Tablet

Unlike other opioids, such as heroin, methadone has a gradual onset, which can produce a stable level of the drug in the brain.2 Due to this gradual onset, people don’t experience the rush that other opioids produce. Additionally, if someone on methadone takes other opioids, such as heroin, it does not produce the same euphoric effects, which deters opioid misuse.2

Benefits

The goal of any medication-assisted treatment, such as methadone maintenance, is for individuals to be able to live a self-directed life.3 Furthermore, utilizing methadone maintenance treatment has shown to:3

  • Improve survival rate
  • Increase treatment retention
  • Decrease criminal activity
  • Increase ability to gain and maintain employment
  • Improve birth outcomes of those who have substance use disorders

Methadone maintenance treatment can be misunderstood, as many think it is substituting one drug for another. However, that is not the case; taking methadone as prescribed can assist you in:2

  • Holding down a job
  • Avoiding crime and violence
  • Reducing your risk of exposure to communicable diseases, such as HIV
    • By decreasing or stopping drug use via injection
    • By decreasing or stopping the use of drug-related high-risk sexual behavior

How to Start Methadone Maintenance Treatment

Methadone maintenance treatment is provided by a treatment center that has been certified by the Substance Abuse and Mental Health Services Administration (SAMHSA).1 You can get connected with these treatment centers by calling your insurance provider or primary care physician. You may also call us at 800-926-9037 (Info iconWho Answers?) to connect you with methadone providers in your area.

Once you have learned where methadone maintenance treatment programs are available, you will connect with these providers to complete a formal assessment. This formal assessment will be used to determine your appropriateness for medication-assisted treatment and the methadone maintenance treatment program.

Although each methadone maintenance treatment program slightly differs due to program expectations and state/federal regulations, the intake process may include a biopsychosocial assessment along with a physical examination. The biopsychosocial assessment will examine your:

  • Demographic information
  • Religious and cultural identities
  • Education and employment history
  • Social history (e.g., family history, current levels of support)
  • Medical history
  • Psychiatric/psychological history
  • Substance use history
  • Legal history
  • Goals for treatment

In addition to this assessment, the methadone maintenance treatment program will conduct a physical examination of your opioid withdrawal symptoms or risk of severe withdrawal. Your treatment provider will obtain a detailed history of opioid use and work with you on administering the appropriate amount of methadone to treat your symptoms.

Does Insurance Cover Methadone Maintenance?

Many insurance companies provide some sort of coverage for methadone maintenance, but the extent of coverage tends to vary across insurers and plans, so you will want to talk to your provider to learn more details.

Methadone maintenance is available in all but three states.2 Methadone maintenance can range from $460 to $1,176 per month as an outpatient participant.

You have several options to pay for methadone maintenance treatment. These include:

  • Using your existing healthcare insurance: As of 2008, insurance companies must provide coverage for substance use treatment
  • Applying for insurance through the Affordable Care Act: Opioid use disorder is no longer considered a pre-existing condition; therefore you cannot be denied coverage due to an addiction
  • Apply for short-term disability: While getting treatment, you may be able to collect short-term disability benefits
  • Scholarships and grants: Many methadone maintenance treatment programs offer assistance packages
  • Medicaid: Many opioid treatment programs accept Medicaid to pay for methadone maintenance and care
  • Assistance from federal and state agencies: Agencies, such as the Department of Health and Human Services, may be able to assist you if you have been denied insurance coverage, or cannot pay your deductible

How to Get the Best Methadone Maintenance Treatment Results

Although the length of time in a methadone maintenance treatment program varies, it should be a minimum of 12 months in order to experience the best outcome.1

A few tips can help you achieve the best treatment outcomes, such as:1

  • Never use methadone than is prescribed to you
  • Always take your methadone at the same time of day
  • Do not take an extra dose, even if you feel it is not working or you missed a dose
  • Do not consume alcohol
  • Be careful when you operate any machinery and while driving
  • Immediately call 911 if you feel you have taken too much methadone and you suspect an overdose
  • Make sure you keep your methadone away from pets, children, and others to prevent accidental ingestion
  • Make sure to keep your methadone at room temperature and out of direct light
  • Do not share your methadone, even if someone has opioid use disorder
  • If you have unused methadone, speak with your provider on the best way to dispose of it

Addressing Co-Occurring Mental Health and Medical Conditions

Methadone can help stabilize you, and once achieve stabilization, it’s important to address and treat your comorbid medical and psychological problems.2 Research has consistently shown methadone maintenance treatment is most effective when it is combined with individual and/or group counseling. Research has also shown even better outcomes when participants of methadone maintenance treatment are referred to and connected to other services needed for their:2

  • Physical health
  • Psychiatric and psychological well-being
  • Social and legal needs (e.g., employment, family assistance)

You may choose to pursue methadone maintenance treatment to help avoid or eliminate:4

  • Harm caused by illicit use
  • Overdoses
  • Withdrawal symptoms
  • Illegal activity and arrests
  • The hustle and hassle caused by your substance use

Many methadone maintenance treatment programs will either require or strongly encourage you to seek additional support, such as:

  • Individual therapy
  • Group therapy
  • Family counseling
  • Support groups (e.g., Narcotics Anonymous, SMART Recovery)

Furthermore, your involvement in extra support systems can significantly improve your treatment outcomes.

Common Side Effects of Methadone

Some of the most common side effects of methadone include:1

  • Restlessness
  • Nausea
  • Vomiting
  • Slowed breathing
  • Itchy skin
  • Increased sweating
  • Constipation
  • Sexual dysfunction

Some of the more serious side effects of methadone include:1

  • Difficulty breathing
  • Shallow breathing
  • Feeling lightheaded or faint
  • Experiencing a rash or hives
  • Swelling of the face, lips, tongue, or throat
  • Feeling pain in your chest
  • Experiencing your heart pounding or a fast heart rate
  • Experiencing hallucinations
  • Experiencing confusion

It’s important to communicate with your doctor or provider about the methadone side effects you’re experiencing. If they become too difficult to manage, talk to your doctor and they can adjust your dose or switch medications.

Interactions: Medications to Avoid During Methadone Maintenance Treatment

While taking methadone, you should not take certain medications. Many of these medications affect the potency of methadone, increasing or decreasing the effects, which could lead to harmful side effects or ineffective treatment. Additionally, you should avoid grapefruit or grapefruit juice as it can cause opioid toxicity.

Increasing the Effects

Medications that increase the effects of methadone include:5

  • Azole antifungals: Fluconazole and Ketoconazole
  • Selective serotonin reuptake inhibitors: Fluoxetine

Decreasing the Effects

Some medications that decrease the effects of methadone include:5

  • Anticonvulsants: Carbamazepine, Phenobarbitone, and Phenytoin
  • Antibiotics: Rifampicin
  • Non-nucleoside reverse transcriptase inhibitors: Efavirenz and Nevirapine

Central Nervous System Depressants

Medications that are central nervous system (CNS) depressants can cause detrimental effects. These effects include increased sedation, respiratory depression, and risk of overdose. Other central nervous system depressants include:5

Find Treatment for Opioid Addiction

Medication-assisted treatment or methadone maintenance treatment has been life-saving for so many people with opioid use disorder. Taking methadone in the long run can decrease the risk of relapse, reduce cravings, and lead to better quality of life.

If you’re ready to take the next step toward quitting opioids, give us a call at 800-926-9037 (Info iconWho Answers?) to speak to a compassionate and caring treatment support specialist. We can help you find the right program for you.

Resources

  1. Substance Abuse and Mental Health Services Administration. (2021). Methadone.
  2. National Institute on Drug Abuse. (2020). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
  3. Substance Abuse and Mental Health Services Administration. (2022). Medication-assisted treatment (MAT).
  4. Frank, D. (2020). Methadone maintenance treatment is swapping one drug for another, and that’s why it works: Towards a treatment-based critique of the war on drugs. International Journal of Drug Policy, 83, 102844.
  5. Medsafe. (2018). Medicines interacting with methadone. Prescriber Update, 39(2), 20.