Methadone Treatment for Opioid Use Disorder

Methadone is an FDA-approved medication used to treat opioid use disorder. It helps people reduce or stop their use of heroin, fentanyl, or prescription painkillers by:

• Alleviating withdrawal symptoms
• Reducing cravings
• Blocking the euphoric effects of other opioids

Methadone may also be prescribed for severe pain outside of BrightView. Although, its primary use today is in opioid treatment programs (OTPs).

Patients typically stay on methadone for at least 12 months, sometimes longer. Stopping abruptly can cause severe withdrawal symptoms, so tapering must always be guided by a physician.

Methadone is available as a pill, wafer, or liquid, though liquid dosing is most common in OTPs. Because it carries a risk of misuse, methadone can only be prescribed by specially licensed physicians and dispensed through SAMHSA-certified OTPs.

Common brand names include Methadose and Dolophine.

Methadone is a type of medicine that helps people stop using drugs like heroin or fentanyl. It works by attaching to the same parts of the brain as these drugs, but does so more slowly and steadily. This helps reduce withdrawal symptoms and cravings without causing big highs or lows.

A dose of methadone usually lasts four to eight hours, and most people take it once a day at a treatment center. The amount someone needs can be different for each person and must be carefully adjusted to avoid side effects or overdose. When used the right way, methadone is safe and helps people recover.

• Pregnant women with OUD: Research shows therapeutic doses are safe and effective, and breastfeeding is still recommended.
• Patients with severe OUD: Methadone is stronger than buprenorphine or naltrexone and can be a first step for those with long-term, high-dose opioid dependence.

However, methadone has disadvantages:

• It’s tightly regulated, often requiring daily clinic visits.
• It can interact dangerously with alcohol, benzodiazepines, and other CNS depressants.
• It interacts with certain medications (antivirals, antifungals, blood thinners, some antidepressants, HIV protease inhibitors).
• Patients with compromised lungs or heart conditions may not be good candidates.

Unfortunately, methadone also carries social stigma. Myths like “it just replaces one addiction with another” ignore decades of research. In reality, methadone is a lifesaving treatment that stabilizes the brain, reduces overdose risk, and supports long-term recovery.

Before beginning methadone, patients complete a comprehensive assessment, including:

• Verification of moderate to severe OUD
• Medical and mental health history
• Prior drug use and treatment attempts
• High-risk behaviors (such as needle sharing)
• Living situation, work, and legal history

Common side effects of methadone include restlessness, nausea, constipation, sweating, itchy skin, and sexual side effects. More serious side effects may include:

• Breathing problems (respiratory depression)
• Fainting or dizziness
• Chest pain, rapid heartbeat, or arrhythmia (QT prolongation)
• Rash, hives, or swelling (allergic reaction)
• Hallucinations or confusion

If you experience severe side effects, seek medical care immediately. Overdose is possible if methadone is misused or combined with other substances.

Methadone is available at most BrightView centers as part of an integrated medication assisted treatment plan. Call us to confirm if your local BrightView offers methadone.

All patients are medically assessed before starting methadone treatment. Our providers may sometimes recommend transitioning to another MAT option, such as Suboxone or Vivitrol, depending on health history, lifestyle, and recovery goals.

If you are currently enrolled in methadone treatment elsewhere, and you transfer to a BrightView center that doesn’t offer methadone, we can partner with a waivered physician to help you transition safely to a medication we carry.

At BrightView, we offer same-day appointments, weekday walk-ins, and 24/7 phone support for new patient scheduling. Call 888.501.9865, schedule an appointment online, or visit one of our locations.