Methadone Maintenance Treatment
Program Goals/Target Population
Methadone maintenance treatment (MMT) is medication-assisted treatment for individuals with opioid dependence. Methadone is a long-acting synthetic opioid analgesic that works as a pharmacologic intervention for patients in drug treatment and detoxification programs. MMT helps opioid-addicted patients alleviate withdrawal symptoms, reduce opiate cravings, and bring about a biochemical balance in the body in order to reduce the illicit use of opioids.
Program Components
Opioids, such as heroin or morphine, cause a release of excess dopamine in the body. Users become dependent on the drug because they need opiates to continuously occupy the opioid receptor in the brain. Methadone works by occupying this receptor and blocking the high that usually comes from illicit opioid drug use. This reduces the need and desire for users to seek and abuse opioids and diminishes the disruptive and uncontrolled behavior often associated with addiction. Subsequently, this allows patients to participate in normative activities, such as drug treatment clinics near me programs or therapies.
Methadone can suppress narcotic withdrawal symptoms for 24 to 36 hours in patients. Single oral doses are administered daily under observation at a licensed clinic. Patients may receive take-home doses for a day that the clinic is closed. Patients may also become eligible for unsupervised take-home doses after some time under monitored treatment.
Dosage is determined by several factors related to the patient, such as opioid tolerance level, history of opioid use, age, and current medical status. During detoxification, an initial dose of 20–30 milligrams (mg) is usually prescribed to suppress withdrawal symptoms. For MMT, doses of 80–120 mg per day are generally sufficient to prevent opioid symptoms for 24 hours, reduce cravings, and block the euphoric effects of opioids. The amount of time in MMT will also vary by patient. In general, MMT takes a minimum of 12 months, but some patients may require continuous treatment that lasts over a period of several years.
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In addition to administering medication, MMT also involves providing patients with comprehensive rehabilitation services. Services can include group therapy, individual therapy, medical services, and referrals to community-based agencies that can assist with health and mental health issues, HIV prevention and intervention services, education, housing, and employment.
Key Personnel
MMT is one of the most monitored and regulated medical treatments in the country. Therefore, methadone, when used in the treatment of opioid addiction, can only be dispensed by a federally licensed opioid treatment program (OTP). OTPs must be certified by the Substance Abuse and Mental Health Services Administration (or SAMHSA) and registered with the Drug Enforcement Agency (or DEA).
Additional Information
One limitation to MMT is the possibility of patients abusing and overdosing on methadone. The number of methadone-associated deaths has been increasing in the last decade. Yet part of this problem may be related to the increase in prescription methadone that, in Addition Recovery to treatment for opioid dependence, can also be used in the treatment of chronic pain. OTPs are subject to specific and strict regulations when using methadone to treat opioid-addicted patients. However, when methadone is prescribed to treat chronic pain, it is regulated under Federal and State laws that impose broad requirements for controlled substances in general but whose regulations are not as strict as they are for MMT use. Although it is unclear from the current data available how many methadone-related deaths are associated with MMT or chronic pain treatment, steps are being taken to prevent deaths related to methadone abuse and overdose that include educating practitioners, improving safety, and establishing prescription monitoring programs