Methadone alleviates the symptoms of opioid withdrawal. Once methadone reaches a sufficient level in a client's blood, his or her cravings are reduced. Methadone is longer acting (24 to 36 hours) than most other opioids. For example, heroin, which is short acting (three to six hours), is often injected several times a day while, in MMT, methadone is administered only once a day.
Tolerance to methadone develops slowly, so clients can be maintained in MMT indefinitely. If it is prescribed properly, methadone is considered medically safe as a treatment for opioid dependence.
Research shows that methadone is a cost-effective treatment for opioid dependence (Ward & Sutton, 1998; Rufener et al., 1977). A variety of studies have found that MMT is associated with a reduction in:
- the use of other opioids
- mortality
- injection drug-related risk behaviours
- high-risk behaviour associated with the transmission of HIV and other sexually transmitted diseases
- criminal activity.
In addition, MMT improves:
- physical and mental health
- social functioning
- quality of life
- retention in treatment programs.
For all of these reasons, increasing access to methadone maintenance treatment is a priority. Efforts to overcome barriers to access have included increasing awareness among health professionals of the benefits of MMT and increasing recognition of the need for services that are flexible and focus on the client's needs.
For a more in-depth discussion of methadone in the context of MMT, see Chapter 3 of Methadone Maintenance: A Pharmacist’s Guide to Treatment.
The pharmacokinetic properties of methadone are also discussed as part of the CAMH online course on opioid dependence.