What is methadone and how does it work?

What is methadone?

Methadone belongs to the opioid family of drugs. Since the 1960s, methadone has been used to help people who are dependent on or addicted to other drugs from the same family, including synthetic opioids like codeine and natural opioids (called opiates) like morphine and heroin.

Methadone is available through specialized drug treatment clinics or it may be prescribed by family physicians and dispensed by community pharmacists, in accordance with Canadian regulations. Methadone maintenance treatment or therapy priority is usually given to dependent users who are pregnant or who have HIV/AIDS or hepatitis C to reduce the risk to themselves and to others.

How does it work?

Methadone can be used to replace the opioid drug that a person is dependent on. It prevents withdrawal symptoms and cuts down on the person’s drug cravings. It does not alter someone’s ability to work, go to school or care for their family.

Users usually need one dose every 24 hours. When methadone is diluted in juice, it does not have a euphoric effect or interfere with a person’s thinking, however, it does block the euphoric effect of heroin and other opioid drugs, so it makes the idea of using those drugs much less attractive. Methadone works best when it is combined with drug counseling.

Why do people need it?

Using methadone allows opioid dependent people to stabilize and improve their lives and overall health. This is a harm reduction approach to opioid addiction, allowing people to reduce or eliminate the harmful consequences of their addiction. Not all opioid addictions are to illegal drugs; some people become dependent on prescription painkillers due to chronic pain conditions.

Pregnant women who use opioid drugs need methadone to protect the lives of their unborn babies since methadone maintenance keeps the expectant mother, and therefore the baby, free from their effects (for more information, see our FAQ What are the effects of alcohol and other drugs during pregnancy?). The methadone itself is safe for the baby and won’t cause the child to be born with illness or deformity.

People who use opioid drugs and who are infected with HIV or hepatitis C can take methadone to help protect their health and reduce the risk of spreading infection through needles shared to inject drugs.

The wider community can also benefit from methadone maintenance treatment due to reduced criminal activities related to illegal drugs and the prevention of disease transmission.

Is methadone safe?

When taken as prescribed, methadone is very safe and will not cause damage to the body or mind, even if it is taken daily for many years. On the other hand, methadone is a powerful drug and can be extremely dangerous if not taken properly.

How long do people stay on methadone?

People stay on methadone as long as they need to. Some health care providers promote short-term methadone detoxification, where the dependent person is stabilized on methadone and then tapers off using it over the next one to six months. Others may stay on it for up to twenty years. Whether short-term or long-term, research has shown that methadone maintenance is the most effective treatment for opioid dependence.

For help in your province, search the Treatment Services in Canada database produced by the Canadian Centre on Substance Abuse.

Additional resources