How is methadone prescribed?

Methadone is prescribed through a medical doctor for pain. But when prescribed for people who are coping with drug addiction, there are many regulations for its prescription. More on methadone prescriptions here.

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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:

  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:

  • block the euphoric and sedating effects of opiates
  • move through the system slowly so it can be taken only once a day
  • relieve symptoms associated with withdrawal from opiates
  • relieve the craving for opiates that is a major factor in relapse

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
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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