Key Points

  • Methadone is a Schedule II Controlled Substance used to treat pain and withdrawal from opioid use disorder.
  • SAMHSA recommends 12 months as a minimum timeline for receiving methadone in a methadone maintenance program.
  • Some people can remain on methadone indefinitely.
  • Abrupt methadone cessation can cause severe withdrawal.
  • A standard methadone dose for severe pain relief is 2.5 to 10 mg every three to four hours.
  • A standard dose for treating opioid use disorder (OUD) is 10 to 20 grams per day.
  • The three-day rule allows physicians outside of a methadone clinic to administer one dose of methadone each day for 3 days to patients with acute withdrawal symptoms.
  • Patients in treatment programs may be provided with up to 28 take-home doses to manage opioid cravings upon completion.
  • Methadone doses may be titrated to provide each patient with sufficient symptomatic relief.

Methadone is a man-made opioid that is mainly used to help people with opioid use disorder.[1][2] It works by blocking the feelings of pleasure that come from using illegal drugs like heroin and cocaine.[3] This helps people control their cravings and lessen the tough withdrawal symptoms they may experience. Every year, over 400,000 patients receive methadone at treatment centers across the United States, making it an important part of the treatment for those dealing with opioid addiction.[4]

While methadone is considered a gold standard for managing opioid withdrawal, it carries a risk for addiction.[5] Prescribers must consider this risk when dispensing it to their patients and will usually only do so if the benefits outweigh these risks. The duration for which someone can take methadone depends on their recovery goals and their body’s response to the medication. Additionally, federal regulations dictate who is authorized to prescribe methadone and the length of time it can be used.

What is the Methadone Use Timeframe for OUD Detox Treatment? 

The first step in treating someone with an opioid use disorder (OUD) is detox. During this stage, the patient stops using opioids, which allows their body to clear the drugs out. Stopping suddenly can lead to uncomfortable withdrawal symptoms, so doctors often give patients medication to help.[6] One common medication used is methadone.

Doctors usually start OUD patients on 10 to 20 mg of methadone to help manage withdrawal symptoms.[6] They may increase the dose by 10 mg until they reach the right amount, typically around 40 mg for most people.[6]

After the patient stabilizes on this dose for two to three days, doctors will gradually lower the dosage until the patient can safely stop using opioids. This tapering process can take anywhere from a few weeks to several months.[6]

Do People with OUD Take Methadone Daily?

Yes, a physician can provide daily doses of methadone to inpatients with an opioid use disorder (OUD). Typically, the daily dose ranges from 10 to 20 mg, but it can be adjusted to find the right amount for each individual.[7] This dose must not exceed 40 mg per day to avoid negative effects.

The dosage will gradually decrease once the patient is stable over several weeks. If cravings for opioids arise, the dose can be increased by 5 to 10 mg every few days without exceeding 20 mg in a week.[7] This careful approach helps avoid some common side effects of methadone treatment, such as chronic constipation.

How Many Methadone Doses Can I Take Home?

The number of doses prescribers can provide to patients with OUD unsupervised varies from state to state. The patient and prescriber must follow specific guidelines set by their state to dispense and receive methadone. The following information published by the Substance Abuse and Mental Health Services Administration explains the general guidelines for methadone dispensing in the states that allow this flexibility:[8]

  • First 14 days of treatment: The take-home supply is no more than 7 days worth.
  • 15 to 20 days of treatment: The take-home supply is no more than 14 days worth.
  • 31 days of treatment and up: The take-home supply is no more than 28 days worth.

It’s important to note that before the OTP supplies any take-home doses, they must determine that you can safely manage these doses unsupervised. Furthermore, they must note their rationale for making this decision in their clinical files.[8] How long you can be unsupervised on methadone is ultimately determined by the OTP but may not exceed 28 days after attending 31 days of treatment.[8] Should you need more, you may be advised to re-enter treatment.

What is the Three-Day Rule for Unsupervised Methadone Treatment?

The three-day rule is a federal regulation that outlines restrictions on the administration of methadone outside of a licensed methadone program.[9] This rule permits physicians who are not affiliated with an opioid treatment clinic to administer a daily dose of methadone for a maximum of three days to patients experiencing acute opioid withdrawal symptoms who are seeking treatment. Once these three doses are given, the physician cannot renew or extend the treatment.

How Long Can Someone Safely Stay on Methadone Maintenance Therapy?

How Long Can Someone Safely Stay On Methadone

Most studies primarily examine the short-term effects of using methadone to treat opioid use disorder. As a result, the safety of long-term methadone maintenance remains unclear. Each prescriber will assess whether the benefits of long-term methadone maintenance therapy outweigh the risks for their patients. However, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends a minimum treatment duration of 12 months with methadone to achieve the best outcomes in therapy.[1]

Is There a Maximum Timeframe for Using Methadone in Long-Term Treatment?

There isn’t a maximum timeframe for using methadone for addiction treatment. However, there are restrictions regarding how many doses you can take home. Should you need more than 28 days’ worth of take-home methadone, you will have to receive subsequent doses in a treatment program. Additionally, it’s important to remember that methadone is addictive, so the longer you remain on the medication, the higher the risk of becoming physically and mentally dependent on it, even when you no longer need it.[5]

Can I Stop Using Methadone Once I Feel Better?

If you have been diagnosed with an opioid use disorder, you might feel better after using methadone for a while. However, this doesn’t mean the OUD has been adequately treated. Therefore, it is not advisable to stop taking methadone, as doing so can lead to a relapse. Additionally, methadone is classified as a Schedule II Controlled Substance, meaning it has a high potential for abuse and dependence, which can result in severe withdrawal symptoms for those who abruptly discontinue its use.[5]

The safest way to quit methadone is to speak to your physician about a taper schedule to avoid withdrawal and relapse.

Learn More About Methadone Treatment

Methadone continues to be an effective treatment option for individuals with opioid use disorder. However, it’s important to note that it can only be obtained through a substance use treatment program. While three doses can be provided to alleviate severe opioid withdrawal symptoms outside of a treatment center, this short-term use is insufficient for effectively treating OUD.

Even if you begin to feel better after these doses, it’s very important to join an OUD treatment program. Doing so can help you avoid withdrawal symptoms and lower your chances of relapsing, which can significantly decrease the risk of an opioid overdose.

To learn more about the use of methadone maintenance treatment for opioid recovery, contact Southeast Addiction Center GA. We provide evidence-backed services such as medication-assisted treatment, behavioral therapies, and adjunct holistic programs for individuals struggling with opioid addiction.

For convenience, we provide these services and many more at various levels of care, including partial hospitalization, inpatient treatment, intensive outpatient, and outpatient programs.

Call us today to discover more about these programs and how we can help you overcome OUD and reclaim the life you deserve.