Methadone

Methadone is typically administered as a once daily liquid solution during an in-person visit to an opioid treatment program, where other treatments such as counseling are also offered.

Evidence for the intervention

Methadone is an FDA-approved, front-line, evidence-based treatment for opioid use disorder, with over 50 years of research studies supporting its effectiveness. Data supporting methadone comes from multiple rigorous, highly controlled, randomized clinical trials. Trials have generally found that methadone is more effective in higher doses and when delivered over a longer treatment duration. In systematic reviews, methadone has been consistently shown to improve treatment engagement, reduce heroin use, and reduce the risk of opioid overdose death. When compared head-to-head versus buprenorphine, methadone has similar effectiveness and may have slightly better treatment retention.

Evidence-based Scale

Methadone is typically taken once daily as a liquid solution or tablet, although it can be administered in two divided doses per day. Federal regulations require that individuals taking methadone show up in person at a federally-certified opioid treatment program (OTP) to receive their daily methadone dose. However, recent relaxations in these regulations permit a limited number of "take-home doses" to be administered to an individual from the OTP. Federal regulations also require that OTPs provide counseling alongside methadone treatment, although individuals are not required to accept counseling in order to receive methadone. Federal regulations also require OTPs to conduct random drug testing of individuals receiving methadone, but do not require OTPs to act upon the results of these drug tests.