Methadone Maintenance Therapy (MMT), a type of ORT, is the most-commonly-prescribed treatment for opioid addiction. There are more than 700 methadone clinics in the United States.
When included as part of a comprehensive recovery plan, 67% of MMT patients are able to abstain completely from illicit opioids, and up to 95% can at least curb their use.
Despite this, methadone is powerfully-addictive and carries a high potential for abuse and overdose. 40% of all single-drug prescription fatal overdoses involve methadone. This is TWICE the death rate of any other single opioid.
Side Effects: Dependence, withdrawal, and respiratory and central nervous system depression – especially when methadone is used to treat pain.
The initial dose should be administered when withdrawal symptoms present.
Day 1: Initial dose: 20 to 30 mg orally.
If after 2-4 hours, withdrawal symptoms have not been reduced or if they reappear, an additional dose of 5 to 10 mg may be given. 40 mg is the MAXIMUM recommended Day 1 dose.
Week 1: The dose is adjustable as needed to manage withdrawal symptoms.
CAUTION –Methadone levels in the body will accumulate during the first several days of dosing.
MMT has 4 dosing goals:
- Prevention of opioid withdrawal symptoms
- Reduce opioid cravings to tolerable levels
- Block the effects of illicit opioids
- Ensure patient safety
The effective dose range is between 80 to 120 mg a day, with greater success at higher doses.
- Patients given less than 46 mg of methadone are 5 times more likely to use heroin as those receiving higher doses.
- Patients given more than 80 mg of methadone are only one-fourth as likely to abuse heroin as those taking 60 mg or less.