Methadone
Methadone is a medication that is used for pain management and for treating opiate addiction. Methadone is distributed through highly-regulated methadone maintenance programs.
By federal guidelines, methadone clinics must:
- Conduct an initial medical exam
- Minimum of 8 random urine screens a year
- Initial and periodic assessments
- Medical, counseling, vocational, and educational assessments and treatment services
- Special services for pregnant women (onsite or by referral)
- Substance abuse counseling
- HIV awareness and prevention counseling
Services
Services offered at methadone programs include:
- Health care
- Crisis intervention
- Case management
- Social and human services
- Mental health services
- Voc/ed services
- Family support and education
- HIV/AIDS casework
Dosage
One of the most controversial aspects of methadone treatment is dosage – how much is appropriate. It is important to recognize that methadone is a medication, and as such, the optimal dosage is a medical decision. It is based on an individual’s response to medication, rather than a legal or social service determination of what is “right.”
The appropriate dose for an individual is the dosage required to produce the optimal response for the appropriate duration of time, with an allowance for a margin of effectiveness and safety. Optimal response is when the medication:
- Prevents onset of withdrawal syndrome for 24 or more hours
- Reduces/eliminates cravings
- Blocks euphoric effects of self-administered opioids
Dose ceilings, or caps on allowable dosages, have no foundation in science or clinical medicine. Programs with “dose caps” can expect problems with accreditation. Dose caps are not supported by the American Society for Addiction Medicine, the US Center for Substance Abuse Treatment, or any credible entity.
Methadone and Pregnancy
For information on methadone and pregnancy, click here.
