Methadone is an FDA-approved medication for opioid use disorder (OUD) that is taken once daily as a liquid or tablet. Methadone works by maintaining a steady level of opioid effects in the brain and body, which prevents uncomfortable withdrawal symptoms and cravings for other opioids such as heroin or oxycodone. Methadone has been shown to improve patient quality of life, treatment engagement, reduce heroin use, and reduce overdose deaths. 

Methadone is similar to buprenorphine. Both are evidence-based, FDA-approved medications for opioid use disorder. Methadone is a full opioid agonist, meaning that it activates the opioid receptors in the brain and produces a full opioid effect. Buprenorphine is a partial opioid agonist, meaning that it provides a weaker response compared to methadone, but has a lower risk of misuse. Another key difference between the medications is that methadone must be administered by a federally certified opioid treatment program (OTP), while buprenorphine can be prescribed by any prescriber with a DEA license and is filled at a pharmacy to be taken at home. Methadone treatment requirements may also vary state-to-state, which may impose additional restrictions on methadone access. When compared head-to-head, studies suggest that methadone and buprenorphine have similar effectiveness, but that methadone may have better long-term treatment retention.