Methadone

Methadone is typically dispensed at a federally certified opioid treatment program, although in certain scenarios, it can be started or continued at certain off-site locations.

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 dispensed at a federally certified opioid treatment program (OTP). Typically, an individual must present to their OTP every morning for a daily in-person visit to receive their methadone dose under supervision, although federal regulations now allow for a limited amount of "take-home" methadone doses. Individuals can begin taking methadone for the first time in some other limited settings, such as during a hospitalization or incarceration in prison/jail, but after being discharged from that setting, they must receive methadone from an OTP. Some states allow OTPs to dispense methadone from affiliated off-site locations called "medication units," which can be in a fixed location such as a community health center or residential treatment program, or a mobile unit such as a van.