What is methadone?
Street names: juice, meth (also used to refer to methamphetamines)
Methadone belongs to the opioid family of
drugs. It is used most commonly to treat addiction to other opioid drugs
such as heroin, oxycodone (e.g., Percodan, Percocet), fentanyl (e.g.,
Duragesic, Sublimaze) and hydromorphone (e.g., Dilaudid).
Methadone is a synthetic opioid, which means
that it is made from chemicals in a lab. Methadone was developed in
Germany during the Second World War and was first used to provide pain
Methadone maintenance treatment, which
prevents opioid withdrawal and reduces or eliminates drug cravings, was
first developed in the 1960s. For many years, Canadian regulations
around the prescription of methadone were so restrictive that few
doctors offered the treatment. People who wanted methadone treatment
often had to wait months or years.
In the 1990s, the need to reduce the harm of
drug use was more clearly recognized, and changes were made to make it
easier for doctors to provide methadone treatment.
Methadone maintenance is not a “cure”: it is a
treatment.Through treatment, people who are addicted to opioids receive
the medical and social support they need to stabilize and improve their
lives. They are encouraged to stay in treatment for as long as it helps
Another treatment for opioid addiction, buprenorphine/naloxone (Subutex, Suboxone), was approved for use in Canada in 2008.
What does methadone look like?
Pure methadone is a white crystalline powder.
For the treatment of addiction, the powder is dissolved, usually in a
fruit-flavoured drink, and is taken orally once a day. Methadone is also
available as a tablet or oral solution for the treatment of severe
Who uses methadone?
Most people who are prescribed methadone are
being treated for addiction to opioid drugs. This includes people who
are addicted to illegal opioids, such as heroin, and also prescription
opioids, such as oxycodone, fentanyl and hydromorphone.
Methadone is also sometimes prescribed to
provide pain relief for people who have severe chronic pain or pain
associated with terminal illness.
Methadone is sometimes used as a street drug,
but when it is, it is usually to prevent symptoms of withdrawal from
other opioid drugs.
Women who use opioid drugs regularly and who
are pregnant are often treated with methadone to protect the fetus.
Short-acting opioids such as heroin or hydro-morphone must be taken
frequently to avoid withdrawal. Opioid withdrawal increases the risk of
miscarriage or premature birth. Methadone maintenance, combined with
medical care, improves the chances of having a healthy baby. There are
no known long-term effects of methadone on the baby.
People who inject opioid drugs regularly, and
who are HIV- or hepatitis C–positive, are enrolled in methadone
treatment to help protect their health. Methadone treatment also helps
to prevent these infections from spreading to others through needle
The number of people receiving
methadone maintenance treatment in Ontario has increased sharply in
recent years, from 6,000 in 2000 to 38,000 in 2012.
How does methadone make you feel?
When people begin methadone treatment, some may
experience sedation and other effects that are common to all opioid
drugs. As treatment continues and a stable dose of methadone is
established, tolerance to most of these effects develops. Those in
treatment often describe the feeling of being on methadone as “normal.”
Methadone treatment does not interfere with their thinking. They can
work, go to school or care for family. Methadone also blocks the
euphoric effect of heroin and other opioids, and in this way reduces the
use of these drugs.
Most people experience some side-effects from
methadone treatment. Possible side-effects include sweating,
constipation and weight gain.
How long does the effect last?
A person who is physically dependent on opioids is
kept free of withdrawal symptoms for 24 hours with a single dose of
methadone. In contrast, a person who uses heroin or other short-acting
opioids to avoid withdrawal must use three to four times a day.
Daily treatment with methadone may continue
indefinitely. If, however, the person taking methadone and his or her
doctor agree to move toward ending treatment, the methadone dose is
tapered down gradually over many weeks or months, easing the process of
withdrawal. If methadone is stopped abruptly, symptoms such as stomach
cramps, diarrhea and muscle and bone ache will occur. These symptoms
begin within one to three days after the last dose, peak at three to
five days and then gradually subside, although other symptoms such as
sleep problems and drug cravings may continue for months.
Is methadone dangerous?
When methadone is taken as prescribed, it is very
safe and will not cause any damage to internal organs or thinking, even
when taken daily for many years. On the other hand, methadone is a
powerful drug and can be extremely dangerous to people who are not
tolerant to its effects. Even a small amount may be fatal for a child.
For this reason, the dispensing of methadone is carefully monitored and
Is methadone addictive?
Modern definitions of addiction look at many
factors in assessing a person’s drug use. These include tolerance, or
the need to use increasing amounts to achieve the same effect; physical
dependence, resulting in withdrawal symptoms if drug use is stopped; and
compulsive use, despite the negative consequences of continuing to use
Some people say that methadone is just as addictive
as heroin. People in methadone treatment do become tolerant to certain
effects of the drug, and will experience withdrawal if they do not take
their regular dose. But methadone fails to meet a full definition of
addictive when we look at how and why the drug is used.
First of all, methadone maintenance is offered as a
medical treatment, and is prescribed only to people who are already
addicted to opioid drugs. For these people, methadone provides a safe
alternative to the routine danger and desperation of securing a steady
supply of opioid drugs illegally. It frees them from the nagging
compulsion to use, and allows them a chance to focus on improving their
What are the long-term effects of using methadone?
Methadone maintenance is a long-term treatment.
Length of treatment varies, from a year or two to 20 years or more. This
prolonged treatment with proper doses of methadone is medically safe
and is one of the most effective treatments currently available for
Copyright (c) 2003, 2011, 2012 Centre for Addiction and Mental Health
Where can I find help, treatment and support for using methadone?
Treatment and support are available for people living with drug use problems and addictions:
Treatment from CAMH
Help for Families from CAMH
Ontario Drug and Alcohol Helpline (open 24/7 for treatment anywhere in Ontario)
Kids Help Phone at 1 800 668-6868
Where can I find more resources from CAMH related to methadone?
Making the Choice, Making it Work: Treatment for Opioid Addiction
Opioid Agonist Therapy: Information for Clients (PDF)
Straight Talk: Street Methadone (PDF)
Do you know…heroin (PDF)
Addictions 101 (online tutorial) Please Note:Your pop-up blocker must be turned off to view this tutorial
Addiction: An Information Guide (PDF)