What is a Methadone Clinic?

Clinical Reviewer

A methadone clinic is a healthcare facility that is authorized to provide the medication methadone to patients struggling with opioid use disorder (ie. opioid addiction). 

As of 2023, methadone clinic patients are still required to visit the clinic 6-7 days per week for at least 90 days. Patients are supervised by doctors or nurses to ensure the medication is taken as prescribed and to help with side effects or cravings. In addition to methadone, patients may also receive counseling and other support services.

How Do Methadone Clinics Work?

The initial methadone visit can take several hours, but then patients come in, take their methadone dose and leave. A counseling appointment should be part of a methadone clinic experience too, but counseling is not offered or required at all methadone clinics.

How To Get Into A Methadone Clinic

Always call ahead before showing up at a methadone clinic. 

The Initial Appointment

The first visit at a methadone clinic can take 3-4 hours.

Methadone Clinic Photos

Induction Dosing Appointments

The goal of the induction phase is to continue to increase the methadone dose until patients feel good without having cravings, side effects or sedation. These are daily discussions with the medical staff, as no one dose amount works for every patient.

See also: Methadone Dosing

Maintenance Dosing Appointments

Getting to a stable maintenance dose of methadone usually takes 2-8 weeks. There are no appointments at this stage. Patients show up at any time the clinic is open to take methadone on a first-come-first-serve basis.

Methadone Clinic Hours

Generally, methadone clinics open early (around 6-7 AM) and close in the afternoon (around 2-3 PM). Methadone clinics are required to be open 6-7 days per week, but weekend hours are usually limited to a 2-3 hours window (ie. 6-8 AM).

NOTE: Many of Symetria’s clinics have extended dosing hours as early as 5 AM to as late as 8:30 PM. More flexible hours is one advantage of a private clinic versus a government-funded clinic.

Counseling Appointments

Combining methadone with at least one hour a month of counseling is recommended by all major health organizations. 

Leaving a Methadone Clinic

Patients are encouraged to stay on methadone for at least 12 months, but can remain in a methadone program for many years and can switch to a different methadone clinic instead of stopping methadone if there are issues.

See also: Tapering Off Methadone

Methadone Clinic Rules

Certain rules are federally regulated, like the schedule for take-home doses of methadone. Other rules are set by each individual clinic, though there is guidance from healthcare bodies like the American Society of Addiction Medicine (ASAM).

How Often Do You Have To Go To A Methadone Clinic?

Per regulations set by the national government, patients start out coming in every day or, if the clinic is closed Sundays, 6 days a week. The most methadone that patients can take home is 27 days of medication, coming to the clinic once per month.

Days Required in Clinic Take Home Doses Time Required in Treatment
6-7 days per week 0-1 doses 90 days
5 days per week 2 doses 180 days (6 months)
4 days per week 3 doses 270 days (9 months)
2-3 days per week 4-5 doses 12 months (1 year)
1 day per week 6 doses 15 months (1.25 years)
1 day every 2 weeks 13 doses 18 months (1.5 years)
1 day per month 27 doses 24 months (2 years)
To move through these levels, success in treatment is required. A patient would not be able to have a month of take-home doses and have positive opioid drug screens, even if they have been attending the methadone clinic for two years. Legislation was proposed in December 2022 to relax methadone clinic regulations and provide access to methadone with fewer in-person visit requirements but this has not yet been enacted.

Do Methadone Clinics Test For Drugs?

All methadone clinics utilize drug testing. However, each clinic sets its own rules around how frequently drug testing occurs and what happens when drug screens are positive.

Most methadone clinics use urine drug screens, which detect drug use in the past 1-4 days.

The American Society of Addiction Medicine (ASAM) recommends:

  • Drug testing during the initial appointment
  • Drug testing at least weekly during the initial phase of treatment
  • Drug testing at least 8 times per year during methadone maintenance
  • Using random drug tests instead of a fixed schedule

Each methadone clinic decides what drugs are included on a drug screen. Usually, clinics use screens that include: methadone, methadone metabolite, opiates, fentanyl, buprenorphine, benzodiazepines, cocaine, amphetamines, barbiturates, THC, heroin, alcohol and PCP.

Many of these substances (like alcohol) are included in drug screens because they can have dangerous interactions with methadone.

See also: Methadone Interactions

Additional drugs or one-off drug tests can be used, especially when trying to confirm the amount of a specific substance in a patient’s system for safety. For example, testing for Kratom is becoming more common. 

Drug testing should be used to gauge the effectiveness of the treatment and to ensure safety.

The results of a positive drug test should always be discussed with the patient in an effort to provide additional support, like:

  • Requiring more in-person visits / less take-home medication to get more accountability
  • Adding therapy sessions or therapy services like Intensive Outpatient Program (IOP) to better cope with the mental side of addiction
  • Changing or adding psychiatric medications like antidepressants or antianxiety if triggering
  • Increasing methadone dose if cravings are not well-controlled


That said, too many methadone clinics ignore test results or, on the other end, kick patients out for a positive drug test.

Since drug testing is handled very differently at different clinics, patients have to ask their clinic for their specific rules around positive drug screens.

Methadone Clinic Regulations FAQ

Methadone clinics are officially licensed as Opioid Treatment Programs (OTPs) and regulated by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) with regular unannounced check-ins.

Some methadone clinics choose additional accreditation beyond federal licensure. The most rigorous accreditation body is CARF. An initial CARF accreditation takes around nine months and involves separate ongoing monitoring, usually annually.

Yes, methadone clinics are bound by ethical and legal obligations to protect the privacy and confidentiality of patients. 

Methadone clinics are subject to the Health Insurance Portability and Accountability Act (HIPAA) and are not allowed to share medical records or personal information without the patient’s consent.

In fact, unlike other medical professionals, methadone clinics do not report positive drug tests while pregnant.

Like most healthcare, methadone clinics are mostly funded by insurance and patient payments.
Clinics that are not-for-profit are also able to fundraise from the public and receive grants from the government.

In the case of Symetria, we are a private healthcare clinic funded by patients usually using private insurance. We are not government funded. It is a misconception that taxpayers foot the bill for all methadone clinics.

See more: Methadone Myths

Yes, methadone clinics are legal in all states. However, states have varying levels of access to methadone clinics.

How Many Methadone Clinics Are In The U.S.?
As of March 2023, SAMHSA lists 1988 clinics across the country.

  • Wyoming is the only state without a methadone clinic and South Dakota has only one clinic.
  • Delaware and Rhode Island have the most methadone clinics per population.
  • As expected, California (168) and New York (137) have the most total methadone clinics, followed by Ohio (117) and Massachusetts (109). Florida, Pennsylvania and Texas also have more than 100 methadone clinics.

Methadone clinics began in the 1960s when heroin addiction was on the rise and traditional drug treatment methods were not very effective.

The Food and Drug Administration (FDA) initially approved methadone for the treatment of moderate to severe pain in 1947.

In 1964, two researchers at Rockefeller University in New York City found that methadone could relieve withdrawal symptoms and reduce cravings, allowing patients to function normally and maintain productive lives.

Based on this research, the first methadone clinic was established in New York City in 1965. Over the next several years, methadone clinics spread across the United States and around the world. 

Methadone was officially approved by the FDA to treat opioid addiction in 1972.

Why Do People Go To A Methadone Clinic?

Methadone clinics help people prevent the harsh symptoms that happen when opioids are stopped. Most people that are addicted to opioids, especially heroin or fentanyl, need help to stop. Methadone clinics are the best option for some of these patients.

Methadone Clinics vs. Inpatient Drug Rehabs

Patients may have children or job responsibilities that they are not able to leave for several weeks to go away to inpatient rehab. Methadone clinics are outpatient and offer flexible scheduling.

Also, patients that have been unsuccessful with inpatient rehab may choose a methadone clinic to get much longer support since methadone programs are recommended to last at least a year.

Methadone Clinics vs. Suboxone Clinics

Suboxone is usually a first-choice medication. Patients tend to go to a methadone clinic if they are unsuccessful on Suboxone or if they have been successful on methadone before. Chronic pain patients may also find methadone clinics more helpful than Suboxone clinics. 

NOTE: Symetria is both a Suboxone and methadone clinic. While Suboxone clinics are not able to offer methadone, methadone clinics are able to offer Suboxone though not all do. Dual-option clinics give patients unbiased information and allow flexibility to switch between medications.

Methadone Clinics vs. Inpatient Hospitals

Hospitals are not a good option for detoxing off opioids. Hospital stays are usually too short and don’t provide support for the mental side of addiction. Patients that detox or partially detox at a hospital are at high risk of overdose. Going to directly to a methadone clinic after a hospital stay helps prevent relapse.

Pros and Cons of Methadone Clinics

Methadone clinics are a valuable resource for people struggling with opioid addiction but are not right for everyone.  In an ideal world, all methadone clinics would also offer Suboxone, Vivitrol and IOP so patients have flexibility and are informed of all options. 

PROS CONS
Shown to save lives (prevent overdoses and spread of infectious diseases) Can be highly stigmatized and misunderstood
Helps with painful withdrawal symptoms Can lead to physical dependency / requires a taper
Offers long-term and daily accountability Requires frequent in-person visits
Can be more affordable than inpatient care or Suboxone Suboxone is a safe option

“For me, methadone was an immediate relief, both physically and mentally. It lifted an enormous weight off my shoulders.”

How Much Do Methadone Clinics Cost FAQ

Are Methadone Clinics Free?

No, methadone clinics are not free. Most methadone clinics are self-pay and require payment upfront. Self-pay rates range from $50-350 per week.

NOTE: Symetria is not generally a self-pay clinic and most patients use insurance. 

Are Methadone Clinics Covered By Medicaid?

As of 2021, all Medicaid plans are required to cover methadone treatment, but states can set limits. However, not all methadone clinics accept Medicaid. 

NOTE: Symetria is not a Medicaid facility. Family Guidance Center Chicago accepts Medicaid plans in Illinois.

Are methadone clinics covered by Medicare?

Yes, medicare covers methadone treatment but not all methadone clinics accept Medicare.

Medicare typically has limited benefits for inpatient drug rehab, so methadone clinics can be a good option for patients with Medicare.

NOTE: Symetria accepts Medicare at all Texas and Illinois clinics.

Do Methadone Clinics Take Insurance?

Private insurance companies often do not cover methadone clinics. However, all major insurance companies cover methadone treatment at Symetria — including Blue Cross Blue Shield, Aetna, Humana, United Healthcare, Cigna / Evernorth, Multiplan and Magellan. 

If you live in the Chicago, Houston or Fort Worth areas, check your insurance coverage online. Most patients here use insurance and for some patients, there is no additional cost to patients for methadone treatment here, especially when coming from the hospital or inpatient rehab.

If you live outside of Illinois and Texas, check your insurance company and check with local clinics for options. While rare, it is possible for other methadone clinics to be in-network with insurance too.

Is There A Methadone Clinic Near Me?

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.

Accreditation Index, Why does accreditation matter? – benefits, fees, programs. (2023). Retrieved February 22, 2023, from Carf.org website: https://www.carf.org/Accreditation/

Certification of Opioid Treatment Programs (OTPs). (2023). Retrieved February 22, 2023, from Samhsa.gov website: https://www.samhsa.gov/medications-substance-use-disorders/become-accredited-opioid-treatment-program

CMS Issues Guidance about Expanded Medicaid Coverage for Treatment of Opioid Use Disorders | CMS. (2020, December 30). Retrieved February 22, 2023, from Cms.gov website: https://www.cms.gov/newsroom/news-alert/cms-issues-guidance-about-expanded-medicaid-coverage-treatment-opioid-use-disorders

Health Insurance Portability and Accountability Act of 1996 (HIPAA). (2023). Retrieved February 22, 2023, from https://www.cdc.gov/phlp/publications/topic/hipaa.html

HIGHLIGHTS OF PRESCRIBING INFORMATION. (n.d.). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/006134s038lbl.pdf

Jarvis, M., Williams, J., Hurford, M., Lindsay, D., Lincoln, P., Giles, L., … Safarian, T. (2017). Appropriate Use of Drug Testing in Clinical Addiction Medicine. Journal of Addiction Medicine11(3), 163–173. https://doi.org/10.1097/adm.0000000000000323

OTP Directory. (2020). Retrieved February 22, 2023, from Samhsa.gov website: https://dpt2.samhsa.gov/treatment/directory.aspx

SAMHSA Proposes Update to Federal Rules to Expand Access to Opioid Use Disorder Treatment and Help Close Gap in Care. Retrieved February 22, 2023, from HHS.gov website: https://www.hhs.gov/about/news/2022/12/13/samhsa-proposes-update-federal-rules-expand-access-opioid-use-disorder-treatment-help-close-gap-in-care.html

Seek – The long overdue science of addictions. (2015). Retrieved February 22, 2023, from Rockefeller.edu website: https://seek.rockefeller.edu/the-long-overdue-science-of-addictions/

Disclaimer
All content is for informational purposes only. No material on this site, whether from our doctors or the community, is a substitute for seeking personalized professional medical advice, diagnosis or treatment. Never disregard advice from a qualified healthcare professional or delay seeking advice because of something you read on this website.

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2 Comments

    1. This certainly would not happen at Symetria Recovery. Deliberately refusing to dose someone with methadone purely as a punitive measure is very unethical and does not help the patient’s recovery, nor the patient-provider relationship.

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    Do you live in Illinois or Texas?

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