Methadone Addiction Help-Line

Seeking Help For:
Age Of Person Needing Methadone Treatment?
Has The Person Ever Received Prior Drug Treatment?Yes No
General Situation:
Preferred Contact Method?Phone Email

Methadone Maintenance

Methadone maintenance treatment is a program in which individuals that are addicted to heroin or some other opiate, and receives daily doses of methadone. The Methadone program began over 50 years ago as part of a broad, multi component drug treatment program that also emphasized social education and vocational training. These Methadone maintenance programs were developed to reduce or stop the use of injection drugs, therefore reducing the risk of transmitting certain diseases such as HIV, hepatitis B or C, endocarditis, bacterial infections, tuberculosis and sexually transmitted diseases. Other benefits of the Methadone Maintenance program are reduced criminal activity, improved family stability and employment potential. Methadone Maintenance Treatment (MMT) is meant to help intravenous drug users to stop injecting drugs and return to productive lives. Methadone Maintenance Treatment is highly controversial and many different factors are limiting the effectiveness of MMT services. Recently, the federal government has implemented new regulations that include an overhaul of the Methadone Maintenance Treatment system. These new federal regulations promise a more flexible approach that will improve delivery of these life-saving services.

Methadone Maintenance Dosage Requirements

One of the key issues in effective Methadone Maintenance Treatment is in regard to methadone dosage requirements. Most patients require a dose of 60-120 milligrams of methadone a day in order to achieve the optimum therapeutic effects of the drug. Compared to individuals that are on lower doses of methadone, patients that are on higher doses are shown to stay in Methadone Maintenance Treatment longer, use smaller amounts of heroin and other types of drugs, and have a much lower rate of HIV infection. Some patients in Methadone Maintenance Treatment will require higher doses for fully effective treatment. Several studies of methadone effectiveness have shown a dose-response relationship. Higher doses of methadone have shown to be more effective in terms of helping individuals to stay in Methadone Maintenance Treatment and reducing criminal activity. Despite all of previously stated compelling evidence, some Methadone Maintenance Treatment centers administer fixed doses to all patients and provide less than optimal doses.

Length of Methadone Maintenance Length of Treatment

Many studies have indicated that the best outcomes from substance abuse treatment are unequivocally contingent on an adequate length of treatment. A research guide by the National Institute on Drug Abuse (NIDA) notes that "For Methadone Maintenance, the minimum treatment time should be 12 months or longer, and some individuals that are addicted to opiates can continue to benefit from the treatment for a period of years". Despite this fact, the majority of Methadone Maintenance patients drop out of the program before the end of the first year for various reasons. A large percentage of individuals who discontinue Methadone Maintenance Treatment will experience a heroin relapse shortly after leaving the program. This relapse can be especially dangerous if the individual attempts to take the same amount of heroin as he did before MMT treatment; this scenario can easily result in a deadly drug overdose.

Despite Methadone Maintenance Treatment being in place for 30 plus years, MMT has been publicly controversial in the United States. Critics have stated that Methadone Maintenance Treatment merely substitutes one drug addiction for another, and that achieving a state of abstinence should be the only treatment goal. These critics also oppose the idea of expanding Methadone Maintenance Treatment programs.  The specific concerns that are being expressing are that these types of programs may be a magnet for crime and drug dealings and that some MMT patients may sell their methadone supply on the street to make extra money. As a direct result of this controversy, the use of methadone in treating addiction has been heavily regulated and strictly controlled in this country. These new controls have resulted in Methadone Maintenance Treatment programs having a limited ability to respond to the needs of patients, even in such important areas such as dosage requirements and length of treatment. These regulations have even gone so far as to limit the number of doctors that are available to treat heroin addiction and also putting restrictions on the settings and locations where Methadone Maintenance Treatment can occur.

In 2001 a fundamental change was implemented in the approach to substance abuse treatment and in the government role of ensuring effective Methadone Maintenance Programs. It relies on treatment standards that have been developed by the Center for Substance Abuse Treatment (CSAT). These new standards reflect the most current research about the nature of opiate addiction as a chronic brain disease and the underlying principles of effective comprehensive long-term drug treatment. These standards are based on "best practice guidelines" and the emphasis is on improving the quality of care concerning Methadone Maintenance Treatment in many areas. The areas of improvement include increasing the amount of medical supervision, individualized treatment planning, and the assessment of patients. The new system will accommodate the concerns of the community by retaining regulations that are specifically designed to reduce the diversion of methadone.

Center for Substance Abuse Treatment (CSAT) Methadone Maintenance Standards

  • improving the quality and increasing access to Methadone Maintenance Treatment programs
  • make allowances for more professional discretion and medical judgment in the process of designing treatment plans that are based on the individual needs of the patient's, especially in regard to managing methadone doses and length of treatment, and whether withdrawal from the medication is desirable
  • moving Methadone Maintenance Treatment into the mainstream of health care practice (more MMT in physician's offices and seeking to increase the interest of hospitals and HMO's in providing these services)
  • improving oversight and accountability and promoting state-of-the-art treatment services
  • seeking to enhance the patient's responsibility and the rights of patient's in Methadone Maintenance Treatment programs

Continued use of heroin, cocaine, alcohol and other drugs is not uncommon for individuals that are receiving Methadone Maintenance Treatment. Many patients in the program have not had any professional drug treatment and need rehabilitation. Methadone Maintenance Treatment programs often do not include professional drug rehabilitation. Patients in these programs could benefit greatly from drug treatment in combination with the MMT program. The ultimate goal of the combination of both forms of treatment could ultimately lead to complete abstinence for the patient.

Methadone Facts

  • With methadone maintenance, the opioid addicts take regular doses of methadone to decrease the withdrawal and cravings that are associated with opioids.
  • The noticeable effects of methadone can wear off long before the drug is out of a person's system, making excessive use very risky.
  • About 20% of Methadone patients continue their Methadone treatment for more than 10 years.
  • Methadone is usually available as a liquid – linctus or methadone mixture – which should be swallowed. Tablets and injectable ampoules are sometimes prescribed, and like many other medicines, some of these prescribed drugs are diverted and become available illegally.
  • Many addicts of heroin prefer the high they get from combining Methadone with heroin because they claim it drastically increases the euphoric effects of heroin. This, of course, is a deadly combination and many have died from overdose trying to reach the "ultimate high".
  • Methadone does not get into the bones. This common myth likely comes from the severe bone and joint pain experienced during opioid withdrawal.
  • Consider this: if a Methadone treatment center is licensed to treat 150 individuals and they are currently only treating 149, you are not going to get off Methadone. This is due to the fact that they need you as a customer. Of course this is not true in 100% of the cases, but is very often the way it goes.
  • Methadone maintenance programs are not cures or rehabilitation. They simply maintain a patient's addicted status, just under the acceptable terms of society.
  • Methadone is one of the most difficult drugs to detox from, since its effects are long–lasting and Methadone is readily stored in the body's tissues.
  • There are now 115,000 Methadone maintenance patients in the United States, 40,000 of which are in New York State and about half that many are in California.
  • Methadone is one of a number of synthetic opiates (also called opioids) that are manufactured for medical use and have similar effects to heroin. Methadone and Subutex (Buprenorphine) are used as opiate substitutes for heroin in the treatment of heroin addiction.
  • Methadone that's prescribed by a doctor is subject to stringent controls, as with any other medicine, so you can be sure of its strength and that it has not been tampered with.
  • Major hazards of methadone addiction include respiratory depression, circulatory depression, respiratory arrest, shock, and cardiac arrest.