Methadone: What is Methadone? How does Methadone Work?

Clinical Reviewer

Methadone was the first of several medications approved by the FDA to treat Opioid Use Disorder (previously known as opioid addiction). 

Brand names: Methadose and Dolophine

Methadone Basics FAQ

Methadone is an opioid, but not technically an opiate.  

The words opioid and opiate are often used interchangeably. However, opiate specifically refers to naturally-occurring compounds such as opium, heroin, morphine and codeine. Methadone is a synthetically made opioid and, therefore, not an opiate. 

Yes, methadone is both a DEA Schedule II controlled medication and a narcotic.

Because it s a controlled substance, methadone can only be dispensed for the treatment of opioid use disorder by a certified Opioid Treatment Program (OTP), which is monitored by the DEA. 

The word “narcotic” describes a substance that binds to receptors in the brain to block pain, most associated today with illicit opioids. Methadone blocks pain, is an opioid and is a scheduled medication, so it’s certainly a narcotic.

Yes, methadone can be habit-forming and should be tapered down instead of being stopped abruptly to avoid withdrawal symptoms.

See also: Methadone Taper

What is methadone used for?

Methadone is used to treat opioid use disorder (addiction to opioids). Opioids include heroin and prescription pain medications like hydrocodone (Vicodin), oxycodone (Percocet) and morphine.

Methadone helps to relieve withdrawal symptoms and cravings. It can be safely taken for years or even indefinitely, depending on a patient’s needs.

Is methadone used as a pain medication?

Yes, methadone can be prescribed for severe, chronic pain including in patients who are terminally ill. In most cases, methadone is only used when other pain medications don’t work or can’t be tolerated.

Methadone’s primary use today is for the treatment of Opioid Use Disorder (OUD) to address the dependency to opioids that exists in these patients. It can be a good treatment option for those with both chronic pain and OUD.

Is methadone the best treatment for opioid addiction?

Methadone may be the best treatment option if patients:

Methadone is used most often to treat severe opioid use disorder. Due to requirements for more frequent clinic visits, methadone treatment comes with a higher level of accountability than the two other FDA-approved medication treatments: Buprenorphine (Suboxone) and Naltrexone (Vivitrol). 

Using any of these anti-craving medications in the treatment of opioid use disorder is recommended by national and international health organizations but should always be combined with behavioral therapies to be most effective.

What is the success rate of methadone?

There is a large body of research that shows that methadone significantly improves patient outcomes. It is difficult to give one specific number because success can be defined in several ways. 

A Swedish study showed 76% of methadone patients were no longer misusing drugs and were gainfully employed after two years. (Compared to only 6% of those not using methadone). 

Other research shows patients on methadone:

Data from Symetria also supports the use of medications like methadone. Harvard-led statisticians compared healthcare claims data for around 4 million opioid patients in the country to Symetria patients. Symetria patients had a significant reduction in ER visits and healthcare costs and were 88% less likely to be misusing opioids 12 months after starting treatment.

Rather than focusing on a specific number, know that treatment with anti-craving medications like methadone improves outcomes.

What happens after you take methadone?

Methadone relieves withdrawal symptoms, so patients don’t feel “dope sick.” When on the proper dosage of methadone, patients shouldn’t feel sleepy or get a burst of energy. Instead, methadone helps patients function normally throughout the day and reduce cravings for other opioids.

The medication’s peak blood level occurs about 4 hours after dosing.

What happens the first time you take methadone?

"I didn't feel much the first day on methadone, just not sick. Within a week or two, I felt a clear headedness that I hadn't felt in years. I started feeling normal, but by no means high."

"The first time I took methadone was from my dealer. I felt a small head change but kept wondering when it was going to peak. Maybe 2-3 hours later, I felt pretty good and it lasted way longer than other drugs. It felt kind of like a low dose of hydrocodone. Good, but not a real high. Probably exactly how it's supposed to feel."

WARNING: Trying methadone outside of a medical setting is likely to cause a methadone overdose for those without opioid dependency or for those without knowledge of proper methadone dosing or taking more methadone seeking a high.

When starting methadone at a clinic, the initial dose is around three times less than the dose used during methadone maintenance. And, patients are monitored by medical professionals for several hours.

How does methadone work?

Opioid receptor filled by methadone

Methadone works by occupying the opioid receptors in the brain that have become dependent on opioids. When these receptors are occupied, they stop sending signals throughout the body that cause cravings and physical withdrawal symptoms like vomiting or pain.

See also: How Long Does Methadone Stay in Your System article

Does methadone get you high?

Those with tolerance to opioids are unlikely to get a “high” from methadone. While methadone is an opioid, it has a weaker ability to activate the dopamine systems which lead to the euphoric effect. It’s not a matter of potency, but different preferences for opioid-galanin receptors versus mu-opioid receptors. Read next: Methadone Myths

What are the most common side effects of methadone?

Methadone side effects tend to be mild and go away over time. Diet changes and additional medications can usually relieve lingering side effects. 

The most common of which include:

It can take some time to achieve a stable dose of methadone, but patients on methadone maintenance function normally without feeling high or sick. 

For tips on dealing with side effects read: Methadone Side Effects

What drugs interact with methadone?

The most dangerous interactions with methadone are: 

These drugs have depressant (“downer”) qualities. When combined with methadone which is also a depressant, the effects can slow breathing to the point of death.

There are other drugs including some HIV medications and antidepressants that interact with methadone as well. However, there are alternatives that don’t interact or dose adjustments that can be made to take these medications with methadone safely. 

Read more: Methadone Interactions 

How can you get methadone?

For the treatment of opioid use disorder, methadone is only available for dispensing from an Opioid Treatment Program (OTP).  This type of clinic receives certification from SAMHSA and is registered with the DEA.  No doctor is able to prescribe, through a pharmacy, any form of methadone for the treatment of opioid use disorder.

See also: How To Get Methadone

To find a methadone clinic in your state, use the OTP search tool or call the number on the back of your insurance card.

If you’re looking to help in Illinois or Texas, check the list below for your city.

Start Methadone Today

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.

Gunne, L., & Grönbladh, L. (1981, January 28). The Swedish methadone maintenance program: A controlled study. Drug and Alcohol Dependence. Retrieved June 29, 2022, from

Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev. 2009;(3):CD002209. doi:10.1002/14651858.CD002209.pub2.

NIDA. 2022, April 8. References. Retrieved from on 2022, June 29

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