About Mental Health & Addictions

Methadone Maintenance Treatment: Information for Clients

Copyright © 2002 Centre for Addiction and Mental Health

What is methadone?

Methadone is an effective and legal substitute for opioid drugs such as heroin, codeine, morphine, Dilaudid® and Percodan®. Methadone is a long-acting opioid drug. This means it acts more slowly in the body, for a longer period of time, than most other opioids. By acting slowly it can prevent withdrawal and eliminate or reduce drug cravings, without causing a person to get high. People who are dependent on opioid drugs can take methadone to help stabilize their lives and to reduce the harms related to their drug use. It has been used in treatment programs since the early 1960s.

How does methadone work?

Methadone is part of a long-term treatment for people dependent on heroin or other opioids.

The main goal of methadone treatment is to prevent physical withdrawal and help you to feel more stable, energetic and clear-headed.

The effects of one dose of methadone last for one to two days. So you can stop taking heroin or other opioids that you may have been using many times a day. You can then devote your time to focusing on other aspects of your life — like work, family or school — and taking care of yourself.

Methadone is a long-acting medication. So when your dose is adjusted, it may take four or five days for you to feel the full effect of the dose change. Be patient.

Treatment works best when combined with other types of support. For instance, you may want to explore individual or group counselling. You can also access other types of support, such as legal, financial, medical, dental and housing services.

Remember, the goal of treatment is to become more stable physically, so that you can make the best of your life.

How will methadone make me feel?

Drinking methadone won’t get you high, but it can help to keep away the physical cravings — the feeling that you need to get high.

When you first start treatment, you may feel lightheaded or sleepy for a few days, but you will quickly develop a tolerance to these effects. Expect to feel “normal” when you’re on methadone.

How is methadone taken?

Your doctor will give the pharmacy a prescription for your methadone. This prescription must be renewed regularly by your doctor. He or she will determine how often you come for appointments, depending on your needs and progress.

Your dose of methadone is usually mixed with orange juice. When you first start on methadone, you will be asked to go to your pharmacy each day to drink the medication. After two months you may be able to begin to take home some doses. These are called “carries.”

How long do I have to stay on methadone?

Length of treatment varies, from a year or two to 20 years or more. It depends on the person.

After you have made some changes in your life, you might want to stop taking methadone. Most people who are successful coming off methadone:

  • have been on methadone maintenance treatment for more than a year
  • have made the decision, with their doctor, to stop taking methadone (their doctor gradually decreases the dose while providing support) and
  • have made changes in their lives that show they’re stable. For example, they may have a stable family life, support from non-drug-using friends and family, steady work and fewer financial or legal difficulties.

When taken as prescribed, methadone is a safe and effective medication that people can take for years. We encourage you to use it as long as you feel it’s working for you, and there are no medical concerns.

Does methadone have any side-effects?

Most people experience few, if any, side-effects from methadone. However, as with any medication, unwanted side-effects may develop. While these side-effects may be distressing, they are rarely dangerous and most lessen with time.

Let your doctor or pharmacist know if any of these possible side-effects are bothering you:

Excessive sweating: This can be due to a methadone dose that is too high or too low. While the problem can be difficult to control, some things may help, such as wearing lighter, natural-fibre clothing or using strong antiperspirant and talcum powder.

Constipation: You can try increasing fibre (such as bran) in your diet if you have this problem. Regular exercise and drinking more fluids may also help.
Changes in sex drive: Some people on methadone say they have little sex drive, and are unable to experience an orgasm. Others say that their sex life has improved. If you are having sexual difficulties, your doctor may be able to help.

Sleepiness or drowsiness: This is common, and may be caused by too much methadone. Visit your doctor to see if your dose needs to be adjusted.
Don’t drive a car or do other activities that require you to be alert while this
is a problem.

Weight change: People sometimes put on weight, but this may be because they’re now eating properly and are healthier.

Can methadone interact with other drugs?

Methadone is a very potent drug. It can interact with alcohol, non-prescription drugs (including herbal medications), street drugs and even drugs your doctor may prescribe for you. These drugs can alter or interfere with the effectiveness of methadone. Tell your pharmacist or doctor about all medications or other drugs you are taking.

Is methadone dangerous?

When taken as prescribed, it is safe to use methadone for many years. However, methadone is a powerful drug. It can be extremely dangerous if taken by someone for whom it is not prescribed. Children are particularly at risk. Even a small amount can be fatal for a child. If someone takes your dose, especially if a child swallows methadone accidentally, seek emergency medical treatment immediately.

What are my responsibilities?

It is your responsibility to drink your methadone dose every day. If you have carries, you must make sure you store them safely in a refrigerator.

Your doses are to be taken by you and you only. Selling or giving away any of your dose is serious. You will lose your carry privileges, or you could even be taken out of the methadone maintenance program.

Will methadone cure me?

There is no “cure” for drug dependence or addiction. But by participating in a methadone treatment program, your life can become more stable. This will help you make positive lifestyle changes in an environment that respects and supports you.

Remember, you are the one making the changes. Your doctor, pharmacist or counsellor are there to support you in whatever way you feel will help improve the quality of your life.

Methadone Maintenance Treatment Pamphlet cover

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