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How is methadone prescribed?

Methadone is in a class of medications called “opiate analgesics”. Methadone is used to treat people who were addicted to opiate drugs by occupying areas of the brain that these drugs target. In this way, methadone can prevent withdrawal symptoms in people who have stopped using these drugs and help eliminate cravings for these drugs.

But how do people start on methadone programs? How is methadone prescribed? By whom? We review those Q&A’s here, and then invite your additional questions in the comments section at the end. In fact, we try to respond to all questions with a personal and prompt reply.

What is methadone prescribed for?

Methadone is used to prevent withdrawal symptoms in patients who were addicted to opiate drugs and are enrolled in treatment programs. Methadone is a synthetic agent that works by “occupying” the brain receptor sites affected by heroin and other opiates. Methadone is also used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications.

Who can prescribe methadone?

If methadone is prescribed for pain, a licensed physician can write you a prescription. Federal law and regulations do not restrict the prescribing, dispensing, or administering of any narcotic medication (including methadone) for the treatment of pain, when such treatment is deemed medically necessary by a registered practitioner acting in the usual course of professional practice.

However, regulatory restrictions concerning the use of methadone for the maintenance or detoxification of drug addicted people require that doctors be registered with the DEA as a Narcotic Treatment Program (NTP) before they can write prescriptions. This is why most family doctors will refer you to an addiction specialist for diagnosis if you are ready to quit using drugs. Following assessment, methadone can be delivered only through specially licensed clinics, called Opioid Treatment Programs. This is because the use of methadone to treat addiction has been heavily regulated and strictly controlled in the U.S.

The main restrictions for methadone prescription follow. Methadone prescribers must be:

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  1. Licensed by the state as a methadone provider.
  2. Accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), the Council on Accreditation (COA) or The Joint Commission (TJC).
  3. Certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) as an opioid treatment program.
  4. Registered by the Drug Enforcement Administration (DEA).

Methadone prescription dosage and use

Methadone comes in different forms. It can come as a tablet, tablets that can be dissolved in liquid, a solution (liquid), and a concentrated solution to take by mouth.

When methadone is used to relieve pain, it may be taken every 8 to 12 hours. If you take methadone as part of a treatment program, your doctor will prescribe a dosing schedule that is best for you. Take methadone exactly as directed. Do not stop taking methadone without talking to your doctor. Your doctor will probably want to decrease your dose gradually. If you suddenly stop taking methadone, you may experience withdrawal symptoms.

Methadone prescription for opiate addiction treatment

Methadone is a synthetic agent that works by “occupying” the brain receptor sites affected by heroin and other opiates. Methadone prescriptions for opiate addiction specifically work to:

Methadone prescribing information

The prescription of methadone is highly regulated in the U.S. at the moment. In fact, some organizations are calling for revision of the process to make access to methadone medicines more open to users in need. This is because methadone maintenance treatment has shown important benefits for addicted individuals and for society. These benefits include:

  • employment potential
  • improved family stability
  • improved pregnancy outcomes
  • possible reduction in sexual risk behaviors
  • reduced criminal activity
  • reduced mortality
  • reduced or stopped use of injection drugs;
  • reduced risk of acquiring or transmitting diseases
  • reduced risk of drug overdose

Prescribing methadone: Why methadone may not be good for you

It is very important that you follow all prescription directions when taking methadone. Methadone may cause serious or life-threatening breathing problems, especially during the first 72 hours of your treatment and any time your dose is increased. Your doctor will monitor you carefully during your treatment.

Additionally, methadone may not be for everyone. Tell your doctor if you have or have ever had slowed breathing or asthma. Your doctor will probably tell you not to take methadone. Also, tell your doctor if you have or have ever had lung disease such as chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes chronic bronchitis and emphysema), a head injury, or any condition that increases the amount of pressure in your brain.

Furthermore, the risk that you will develop breathing problems while on methadone may be higher if you are an older adult or are weak or malnourished due to disease. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

  • long pauses between breath
  • shortness of breath
  • slowed breathing

Taking certain other medications during treatment with methadone may increase the risk that you will experience serious, life-threatening side effects. Your doctor may need to change the doses of your medications and will monitor you carefully.Tell your doctor if you are taking or plan to take any of the following medications:

  • antidepressants
  • medications for anxiety, nausea, or mental illness
  • muscle relaxants
  • other narcotic pain medications
  • sedatives
  • sleeping pills
  • tranquilizers

Drinking alcohol, taking prescription or non-prescription medications that contain alcohol, using street drugs, or overusing prescription medications such as benzodiazepines during your treatment with methadone increases the risk that you will experience serious, life-threatening side effects. Talk to your doctor about the risks of drinking alcohol or using street drugs during your treatment.

Methadone prescription questions

Still have some questions about prescribing methadone? Please leave them below. We invite all questions about prescription of methadone and try to respond to each with a personal and prompt reply.

Reference Sources: DEA: FAQs on prescriptions
MedlinePlus: Methadone
CDC: Methadone Maintence Treatment
Michigan State: Criteria for using methadone

Photo credit: Darko Stojanovic

Leave a Reply

7 Responses to “How is methadone prescribed?
Kylie
3:57 am July 7th, 2015

Thank for the post.

Darlene
11:25 am November 5th, 2015

I Have been on this drug for 15 years.J am prescrtbed them from what they call themselves PATN MANAGEMENT, I fell backwards down about 20 steps in work and have had approximately 8 spine surgeries and 2 surgertes for the putting tn then removing a TENS UNIT whjch did absolutely nothing for me,T have repeatedly told this Dr, from this pain management that this methadone does nothing at all for the constant pain I endure, I have had rods and instrumentation throughout my whole back,Do you have any recommendations? I feel being dead is better then just EXISTING. Thanks for listening, I feel i am at my witts end.

5:08 pm November 5th, 2015

Hello Darlene. Narcotic pain medications like codeine, fentanyl, morphine, and oxycodone work on the nerve cells’ pain receptors and are very effective in controlling severe chronic pain. Maybe you can speak with your doctor and go through these pain medication options since the methadone is not managing your level of pain.

David
11:01 pm January 30th, 2016

I’ve been taking 20mgs of Methadone three times a day for about four years. What is a safe tapering method to avoid withdrawal. What would be considered harmful or even illegal tapering? I forgot to add that I take the methadone for pain management not for drug abuse.

Lydia @ Addiction Blog
1:53 am February 2nd, 2016

Hi, David. I suggest you consult your doctor or a pharmacist to help you plan an individualized tapering schedule. Also, consider using over-the-counter medications, home remedies, hot baths and teas to ease withdrawal symptoms.

Jennifer
4:35 am March 14th, 2016

I currently on a methadone clinic which I hate so much for so many different reasons and im looking for a private doctor that prescribe it in Las Vegas N.V. about 8 yrs age my friend had called a doctor and set up appointment for me for right when I got off the plane. I cant remember where only what I had called him Dr. Nick I had only stayed out there a few months and when I first seen him all I had to do is go up to desk, pay $200 and he spoke with me and we spoke about a recovery plan and he gave me 2 wks of pills my first time and than after I went back again he prescribed me 3 months worth therefore I was able to stabilize myself and detox myself off methadone all together. Than I decided to go back to N.Y. and hang around old friends that were still using be I wasn’t as educated and no better like I do now and you already know I went back to herion. Since than 8-9 ive been battling mainly going to methadone clinics and having to go everyday and no travel and not being able to taper myself off being I have to go by their rules , not what works for me. Can someone please recommend where or even how I would find a Private Doctor NOT a Methadone Clinic? Ohh Yea…. I have no pain diagnosed pain problems even tho I do have some pain but never been to doctor because I don’t have any serious medical issues so Pain Management wont work. If anyone knows where I can look for a doctor or knows of one please let me know cause im having a hard time finding one preferably in Las Vegas, N.V. Thank You Everyone for Your Time!!!!

Zegota
11:48 pm April 25th, 2016

I have been on Methadone for over six years for pain management, going from five mg twice a day, to three 10 mg per day. Recently tried to reduce my intake of Methadone by stopping all at once, please do not try to do this. I had bad withdrawals and ended up in the hospital, anyway my pain is so bad that I am now heading back to three 10 mg per day. The Methadone is the only thing that works for me, but I do not like the addiction and the control it has over me. I had the first spinal fusion in the state of Michigan over fifty years ago, and I do not have any metal, so you can see just how old my surgery is. All of my spine is fused except for two small vertebrae in the lower section, so I can walk. At my age any surgery is out of the question and anyway, just what could it accomplish, I just want to be comfortable until the time comes. But please be careful of this drug, it does work and can bite back, good luck and God Bless.

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