Methadone

Methadone can work at any point in an individual's treatment journey.

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 can work at any point in an individual’s treatment journey, but they must be willing to take a daily medication rather than continue using other opioids, and they must be willing to show up daily to an opioid treatment program to receive their methadone. The individuals must also be willing to participate in certain federal requirements for ongoing methadone treatment, such as being subject to random drug testing. Individuals should not be actively intoxicated from opioid use when taking methadone, as taking other opioids with methadone can cause an opioid overdose. Unlike some other FDA-approved medications for opioid use disorder, an individual does not need to undergo a prolonged period of opioid abstinence or “detoxification” from opioids before starting methadone.