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Medication-Assisted Treatment: Methadone Treatment for Opioid Use Disorder (OUD)

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Pinnacle Team
1 year ago
Pinnacle Icon
Pinnacle Team •
1 year ago

Methadone was the first FDA-approved medication for treatment for opioid use disorder. The model created in 1964 – almost 60 years ago – is the template and gold-standard for all medication-assisted treatment today.

Methadone Programs Save Lives

People in treatment for opioid addiction face a simple fact: all available evidence indicates relapse rates are very high.

Relapse is defined as a return to drug use after a significant period of non-use.

Estimates show that between 70% and 90% of people who try to quit using opioids without professional support relapse within 12 to 36 months.

However, those estimates leave out one thing. People who participate in methadone maintenance programs relapse far less frequently than people in other types of treatment programs. In fact, some studies show that people who receive treatment at licensed methadone clinics have a relapse rate between 32% and 44%. That’s a significantly lower rate than non-methadone programs. It’s also lower than abstinence-only programs for other substances such as alcohol or cocaine.

That begs the question. Why are methadone programs so much more effective than other approaches?

Because a methadone program is not just about methadone.

Methadone reduces the symptoms of withdrawal, reduces cravings, and blocks the action of other opioids in the brain.  This helps people in a methadone program get through the first week of treatment, which many say is the most difficult.

All that is true. It’s a big part of why methadone treatment is effective.

But that’s not the whole story.

When an individual commits to treatment in an Opioid Treatment Program (OTP) that’s certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and registered with the Drug Enforcement Agency (DEA), federal law requires that OTPs provide the following:

  • Professional support:
    • OTPs are required to provide counseling for substance use disorder – a.k.a. substance abuse counseling – provided by a program counselor with the appropriate credentials, education, and experience to assess their psychological and social needs
  • Education:
    • OTPs are required to provide educational workshops and classes on addiction, safety, and prevention of communicable diseases related to opioid use.
  • Community Engagement:
    • OTPs are required to provide support, mentorship, and guidance necessary to access community resources, vocational rehabilitation, ongoing education, and employment services.
  • Treatment Plan:
    • OTPs are required to design a treatment plan that includes relapse prevention techniques, stress management techniques, and recommend lifestyle changes such as healthy eating, regular exercise, and other activities that support long-term recovery.

Evidence shows that when an individual participates in a detoxification program only and does not follow detoxification with a medication-assisted treatment program (MAT) such as a methadone program that includes counseling, community support, education, and a comprehensive treatment plan, they often relapse within days – if not the same day they leave detox.

What is Methadone?

Here’s how SAMHSA describes methadone:

“Methadone is a medication approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD) as a medication-assisted treatment (MAT). When taken as prescribed, methadone is safe and effective. Methadone helps individuals achieve and sustain recovery and to reclaim active and meaningful lives. Methadone is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach.”

Researchers first synthesized the compound that became known as methadone in the early 1940s while searching for an alternative to opioids for pain relief and exploring treatments for asthma and other respiratory conditions.

In the late 1940s, several U.S. pharmaceutical companies produced and sold methadone as an oral cough medication. In the early 1950s, Dr. J.F. Maddux treated people with heroin and morphine use disorders with oral methadone in a United States Public Health Service (USPHS) hospital in Fort Worth, Texas.

His work led to the opening of the first methadone clinic in New York City in 1964.

Following an exhaustive process of clinical research and safety trials, the Food and Drug Administration (FDA) approved methadone replacement therapy as a long-term treatment for opioid addiction. Over the following five decades, researchers have confirmed methadone as an effective and safe treatment for all types of opioid use disorder (OUD), including addiction to prescription opioids such as oxycontin and illicit opioids such as heroin.

The Benefits of Methadone Programs

Evidence published by SAMHSA shows that methadone treatment programs:

  • Decrease opioid use
  • Decrease opioid-related overdose deaths
  • Reduce criminal activity
  • Reduce transmission of infectious diseases
  • Improve social functioning
  • Increase time in treatment
  • Improve ability to participate in family life
  • Increase ability to seek and gain employment

It is due to these benefits that SAMSHA says “…Methadone helps individuals achieve and sustain recovery and to reclaim active and meaningful lives.”

Since methadone works so well and has a long history of safe and effective use for OUD treatment, why is there still so much stigma around methadone treatment?

The answer: myths and misinformation. Here are four common myths about methadone:

  1. People use methadone to get high.
  2. People in methadone programs lack willpower.
  3. Methadone programs just replace one addiction with another.
  4. Methadone programs are for heroin addiction only.

Thankfully, we know how to address these myths. We published a series of articles to refute each of these misconceptions in clear, simple, and direct language. If you read the myths listed above and agree with them, we encourage you to click the links and read the articles.

We hope that when you finish, you can re-evaluate your opinions and decide for yourself. Experts say the harm reduction approach, which includes methadone treatment and other forms of MAT, leads to better outcomes than the traditional, abstinence-only approach to treatment.

We concur.

While abstinence is, of course, the final goal, it’s one part of the big picture. We embrace this treatment model because helps people. It saves lives, improves communities, and reduces the overall negative impact of opioid addiction on society as a whole.

Methadone Treatment at Pinnacle Treatment Centers

In our medication-assisted treatment programs, we use every tool available – including Methadone – to help as many people as possible achieve sustainable recovery and rebuild a full, vibrant, purpose-driven life beyond opioid addiction.

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