The Top 5 Methadone Myths

Misinformation about methadone stops people from getting life-saving treatment. After you read, please help spread the facts about methadone. 

  In This Article

MYTH 1: Methadone substitutes one addiction for another.

Methadone is a drug in the same way insulin or ACE inhibitors for heart conditions are drugs. We wouldn’t say someone taking other medications is addicted even though the medication is taken every day and required for the body to function correctly.

Some people find the comparison of methadone to drugs like insulin offensive because they see addiction as a choice. It’s not. Addiction is a chronic brain disease. And, just like many other diseases, medications (like methadone) can help.

Drug Addiction Changes The Brain

healthy brain showing much more DA D2 availability

Also, the myth that methadone is a substitute addiction implies that methadone is the same as prescription painkillers or heroin, which is scientifically inaccurate.

MYTH: Methadone is the same as heroin.

Methadone is designed to treat addiction and doesn’t activate opioid receptors in the same way as other opioid drugs. Overdosing from methadone (by abusing and mixing the medication) is 10x less likely than with other opioids.

Without getting too technical, methadone stabilizes brain chemistry to reduce cravings without giving off the same kind of euphoric feeling. 

(To learn more about how methadone works see: What is Methadone?)

MYTH: Methadone is a legal high.

Those already abusing opioids would be unlikely to get a “high” from methadone — especially in a methadone clinic setting where doses are slowly increased over time.

Methadone is long-acting and doesn’t offer the intense, instantaneous “high” of short-term opioids like heroin or morphine.

Where This Myth Comes From

The misunderstanding of addiction as a disease fuels this myth. We need to change this stigma around addiction so more people feel comfortable seeking the treatment they need, which can include medications like methadone.

MYTH 2: Those on methadone aren’t in real recovery.

If you lined up people successfully on methadone maintenance with the general population, you would not be able to tell who is on methadone. Patients are able to function normally. In fact, some patients here go years without telling their parents or spouse about their treatment.

Where This Myth Comes From

Ironically, this myth is most prevalent within the 12-step circles that should empathize most. “Like-me” bias instills judgment. (ie. I could find recovery without methadone, therefore everyone should find recovery without methadone).

However, research shows methadone is effective at stopping opioid abuse and more effective than 12-step programs. Studies from 1991, 2003 and 2007 show 70%+ methadone patients stop opioid misuse long-term, while 12-step success rate studies range from 10-50%.

Read more: What Is The Sucess Rate Of Methadone?

MYTH 3: Methadone should only be used short-term.

Methadone can be used in opioid detox for just 3-10 days, but it can also be continued for years. There is not a specific time limit to use methadone that is right for every patient.

What is demonstrated consistently by researchers is that:

Because this data is unequivocal, the National Institute on Drug Abuse recommends methadone treatment be a minimum of 12 months. 

MYTH: If you start methadone, you have to go to the clinic every day forever.

Patients actually have control over how often they need to come into a methadone clinic and how long their methadone treatment should last. After the first few weeks, patients can earn “take home” medication instead of going into the clinic. Eventually, patients may earn up to 28 days — coming to the clinic only monthly. And, it’s not “forever”.

MYTH: Methadone is harder to stop than heroin.

When trying to stop cold turkey or within a matter of days, heroin may feel easier than methadone. However, the benefit of methadone is that it can be tapered down slowly to avoid most or even all withdrawal symptoms.

Where This Myth Comes From

The discouragement of long-term methadone use is mostly seen on inpatient rehab websites. It could be because someone using outpatient methadone maintenance would not need inpatient rehab services. Though, hopefully, this is simply confirmation bias. (ie. Not seeking out or disregarding research which supports methadone use because of their singular belief in inpatient rehab).

MYTH 4: Methadone gets in your bones.

Whether using methadone or not, those that struggle with opioid addiction are at higher risk of developing osteoporosis (ie. weak bones). This population has higher rates of tobacco use, HIV infections, poor diet and heavy alcohol use which are all known risk factors.

Research published by the Society for the Study of Addiction shows that methadone may contribute to mineral depletion of the bones specifically in lower-weight men with heavy alcohol use. There was no impact to bones found for women using methadone.

Ultimately, methadone doesn’t “get in your bones” and asking your doctor about calcium and vitamin D supplements can help those at risk for osteoporosis.

Where This Myth Comes From

While there is a connection between general opioid abuse and osteoporosis, the myth of methadone getting into bones seems to stem from the bone aches of opioid withdrawal.

Methadone doses are increased slowly, so patients may experience manageable opioid withdrawal symptoms while starting methadone. (ie. Cold-turkey opioid withdrawal has been described as “feeling like every bone in my body was breaking.” With methadone, this may instead feel like “bone pain” that should be relieved with a dose increase).

MYTH 5: Health Insurance Doesn't Cover Methadone.

Methadone is covered by every major health insurance company, but that doesn’t mean all methadone clinics accept insurance. 

Many government-run methadone clinics focus on self-pay and Medicad, but Symetria is in-network with nearly all private health insurance companies — including Blue Cross Blue Sheild, Aetna, Cigna / Evernorth, United Healthcare, Humana and many smaller plans — as well as Tricare and Medicare. 

Where This Myth Comes From

Accepting insurance adds a layer of complexity that not all methadone clinics are willing to take on. (Even though using insurance lowers the overall cost for patients).

Ready to Start Methadone?

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Symetria doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

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Gerra, G., Maremmani, I., Capovani, B., Somaini, L., Berterame, S., Tomas-Rossello, J., … Kleber, H. (2009). Long-Acting Opioid-Agonists in the Treatment of Heroin Addiction: Why Should We Call Them “Substitution”?. Substance Use & Misuse, 44(5), 663–671. https://doi.org/10.1080/10826080902810251

Grey, A., Rix-Trott, K., Horne, A., Gamble, G., Bolland, M., & Reid, I. R. (2010). Decreased bone density in men on methadone maintenance therapy. Addiction, 106(2), 349–354. https://doi.org/10.1111/j.1360-0443.2010.03159.x

Kim, T. W., Alford, D. P., Malabanan, A., Holick, M. F., & Samet, J. H. (2006). Low bone density in patients receiving methadone maintenance treatment. Drug and Alcohol Dependence, 85(3), 258–262. https://doi.org/10.1016/j.drugalcdep.2006.05.027

NIDA. 2022, October 5. Preface. Retrieved from https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/preface on 2022, November 23

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