How Does Methadone Treat Opioid Use Disorder?

Opioid use disorder (OUD) is a chronic brain disease linked to significantly higher morbidity and mortality rates. The misuse of prescribed opioid medications, diverted opioid prescriptions or illicitly obtained heroin are all examples of opioid use disorder. Opioid use disorder is treated through a comprehensive treatment program that involves the use of FDA-approved medications, therapies, counseling, and aftercare programs. 

The use of medications to treat OUD is referred to as opioid maintenance treatment (OMT), opioid substitute therapy (OST), and medication for opioid use disorder (MOUD). There are currently three medications approved by the U.S. Food and Drug Administration to treat OUD, and methadone is one such medication. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), methadone treatment accounted for around 21-25 percent of MOUD treatments each year.

What Is Methadone?

Methadone is a long-acting prescription medication that blocks the effects of opioids such as heroin, morphine, and prescription pain relievers. During the recovery process, methadone can help decrease cravings and withdrawal symptoms. It’s considered an effective treatment for opioid use disorders when taken under medical supervision and in conjunction with therapy, counseling, and aftercare support.

Methadone is available as:

• Oral tablets
• Oral dispersible tablets
• Oral concentrate solution
• Oral solution
• Intravenous form 

Methadone, sold under the brand names Dolophine and Methadose, is a Schedule II substance with a high potential for misuse and dependence. As a result, most states require individuals to visit special clinics to get their prescribed daily doses of methadone. 

How Does Methadone Work?

Methadone, when administered as part of a MOUD treatment, reduces the symptoms of opioid withdrawal by interacting with opioid receptors in the brain. This interaction helps reduce the risk of relapses during recovery by blocking the “high” caused by other opioids. The effects of methadone are slower than that of other misused opioids and tend to gradually build up and stay in the body for as long as one to three days.

Methadone maintenance treatment (MMT) is a long-term treatment approach for OUD. Treatment can last anywhere from one to two years to up to 20 years or more. If the individual in recovery and their doctor decide to stop treatment, the methadone dose is progressively reduced over weeks or months to mitigate the withdrawal process.

How Can Someone Receive Methadone?

Methadone can only be dispensed through a SAMHSA-certified opioid treatment program (OTP), also known as a methadone clinic. In addition, individuals receiving methadone maintenance treatment must do so under the supervision of a medical professional. However, individuals may be allowed to use methadone at home between program visits after a period of stability and compliance to treatment regulations.

Methadone is only prescribed to individuals who have undergone a series of initial screenings and interviews and have been determined to be qualified. To meet state and federal requirements for MMT, an individual must be above 18 years and physically dependent on opioids for at least a year before seeking treatment. MMT is often reserved for individuals with severe or long-term opioid addiction and has failed to respond to other forms of treatment. 

Since the emergence of COVID-19, the federal government published proposals allowing for the extension of take-home methadone dosages, among other regulatory changes, to help ease restrictions and provide better access to MMT.

Methadone Maintenance Treatment 

Methadone is an opioid medication that has been used to treat opioid addiction for more than 50 years. And methadone maintenance treatment remains an effective treatment approach in the battle against opioid addiction. Methadone reduces opioid cravings and withdrawal, as well as blunting or inhibiting opioid effects during a relapse. Methadone maintenance treatment is tailored for each individual, and dosages are frequently altered and re-adjusted upon progression. 

There are numerous advantages for selecting MMT over residential treatment, including:

• Cost-effectiveness and convenience.
• Time efficiency with minimum disruption to daily life.
• Ability to apply what was learned in therapy and counseling in real-life situations.
• Allows you and your counselor to work through problems as they emerge. 
• Methadone clinics offer a way to start and maintain recovery while staying self-sufficient.

To ensure that methadone is used safely, individuals should share their complete medical history with their healthcare provider as other medications may interact with methadone. In addition, the active components in methadone linger in the body for much longer after its effects have worn off. Therefore, if you don’t take methadone as prescribed, you could be at risk of an unintentional methadone overdose.

The following practices and precautions can help you achieve the best treatment results from MMT:

• First, use as prescribed by your doctor. 
• Avoid alcohol while taking methadone.
• Avoid driving or operating heavy machinery while on methadone.
• If you have taken too much methadone or suspect an overdose, seek immediate medical attention.
• Store methadone at room temperature and away from bright light.
• Refrain from sharing methadone with anyone even if they have similar symptoms or suffer from the same condition.

Benefits of Methadone Maintenance Treatment

Methadone’s effectiveness in lowering opioid misuse has been proven in numerous research. In addition, MMT has also been proven to provide other benefits such as:

• Decrease in infectious diseases 
• Decrease in criminal activity 
• Overall improvement in quality of life
• Higher chance of achieving long-term recovery
• Improved social functioning 
• A higher retention rate for addiction treatment
• Increased employment rate

Methadone treatment programs aim to return people to productive functioning with their families, workplaces, and communities, in addition to reducing opioid misuse. 

Using Methadone During Pregnancy

According to the National Institute on Drug Abuse (NIDA), methadone has effectively treated pregnant women with OUD since the 1970s and was recognized as the standard of treatment by 1998. Moreover, both the American College of Obstetricians and Gynecologists (ACOG) and the American Society of Addiction Medicine (ASAM) recommend methadone treatment for opioid use disorder during pregnancy as the best practice.

Untreated opioid use disorder during pregnancy can have severe implications for the unborn child. For example, low birth weight, preterm birth, and fetal death are linked to OUD during pregnancy. However, receiving proper treatment for opioid use disorder during pregnancy can help minimize these risks to a great extent.

Since methadone is eliminated from the body rapidly during pregnancy, pregnant women may require higher doses of methadone during treatment. However, only the healthcare practitioner can determine the right dosage and duration of treatment.

Common Misconceptions About MMT

Many maintenance medications like methadone are opioids, which can cause misuse and dependence after prolonged use. Unfortunately, this has led many to believe that this type of treatment replaces an existing substance use disorder with a new one. Subsequently, this belief has hampered the adoption of many beneficial medications in treating addiction in the past.

Although people who don’t have OUD can feel intoxicated from methadone, these medications have a different effect on individuals who have formed a high tolerance to opioids. Methadone doesn’t cause a “high” at the levels prescribed; rather, it reduces withdrawal symptoms and cravings. And in turn, helps individuals in recovery function normally, go to school or work, and focus better on other elements of rehabilitation.

Alternatives Medications to Methadone 

A variety of alternative medications are available for treating opioid use disorder. Some of such FDA approved medications that are utilized in MOUD programs are:

• Buprenorphine 
• Naltrexone
• Vivitrol 
• Suboxone

It’s vital to note that MOUD encompasses more than just the use of medications. It requires a multifaceted approach that involves counseling, vocational training, psychosocial therapy, family support, and establishing connections to community resources to be fully effective. 

However, the right medication can help you maintain a positive attitude and make it easier for you to get through the difficult stages of recovery. And Eleanor Health’s program is designed to meet the highest clinical safety and standard of care.

If you are seeking help with your loved one’s addiction, contact us today or complete our quick contact form below, to speak with an addiction treatment specialist.

If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in Louisiana, Massachusetts, North Carolina, New Jersey, Ohio, and Washington.