Methadone Treatment for Opioid Use Disorder

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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What do I need to know about methadone for opioid use disorder (OUD)?

Methadone is medicine used daily to help reduce opioid cravings and make the symptoms of withdrawal less severe. Methadone is provided as part of an opioid treatment program (OTP). Your prescription may be for up to 3 days of home use between OTP appointments. You may be given methadone as a liquid or powder, or as diskettes. Treatment is recommended for at least 12 months.

What do I need to know about methadone safety?

• You must continue to participate in your OTP. Methadone is meant to be used with counseling, medical care, and other services to help you manage OUD. Continue to go to all OTP appointments.
• Use methadone exactly as directed. Use only the amount you are prescribed, at the correct time each day. Follow directions carefully so you do not get too much medicine at one time. Methadone reduces opioid cravings for 24 to 36 hours. If you miss a dose or do not think the methadone is working, do not double the next dose. Too much can cause life-threatening poisoning. Call your healthcare provider or OTP counselor right away for instructions on when to take the next dose.
• Do not mix methadone with other medicines or alcohol. The combination can cause poisoning, or cause you to stop breathing. Alcohol, sleeping pills, and medicines such as antihistamines can make you sleepy. A combination with methadone can be life-threatening.
• Be careful if you must drive or operate heavy machinery after you use methadone. You may feel drowsy or have trouble concentrating. You can injure yourself or others if you drive or use heavy machinery when you are not alert. Your provider can tell you how long to wait after a dose before you do these activities.
• Ask how to manage side effects safely. Common side effects of methadone are constipation, nausea or vomiting, and itchy skin. Methadone can also cause serious side effects, such as chest pain, a fast and pounding heartbeat, a rash, and face or mouth swelling. Stop using methadone and seek immediate care for any serious side effect. Your close contacts also need to know signs to watch for and what to do if you develop any.
• Do not give methadone to others or use methadone that belongs to someone else. Methadone can only be given by a healthcare provider through an OTP. The amount prescribed for one person may not be right for another person.
• Talk to your provider about family planning. Methadone is safe to use during pregnancy and breastfeeding. If you are male, ask if methadone may affect your ability to get your partner pregnant.
• Work with your provider if you want to stop using methadone. Your provider will create a plan to help you taper (slowly stop) methadone use. This will help prevent withdrawal symptoms. Do not use opioids, alcohol, or street drugs to prevent or relieve withdrawal symptoms.

How do I store methadone?

Your prescription will have specific instructions. The following are general guidelines:

• Keep methadone in the original packaging. Do not put methadone in a pill box or other container.
• Store methadone where others cannot easily get to it. Keep it in a locked cabinet or secure area. Do not keep methadone in a purse or other bag you carry with you. Make sure methadone is stored out of the reach of children.
• Store methadone at room temperature. Keep the medicine away from heat, moisture, and direct light. Do not put methadone in the freezer.

How do I dispose of methadone?

The laws vary by country and area. Talk to your healthcare provider about how to dispose of methadone that expired or you did not use. Follow instructions carefully. The following are general guidelines:

• Take any methadone you did not use to a drug take-back location right away. In the United States, this program is offered by the US Drug Enforcement Agency (DEA). Certain facilities are authorized to receive methadone. Examples include a DEA collection site, or an approved pharmacy or hospital. Ask your provider about take-back locations in your area. You can also check the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm.
• Ask about if you can flush the methadone. If you cannot flush the medicine, ask your waste management company about rules for putting methadone in the trash. Scratch out personal information on the original medicine label so it cannot be read. Then put it in the trash. Do not label the trash or put any information on it about the methadone. It should look like regular household trash so no one is tempted to look for methadone. Keep the trash out of the reach of children and animals. Always make sure trash is secure.

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Where can I get support and more information?

The following organizations provide information on opioid treatment programs near you:

• Substance Abuse and Mental Health Services Administration (SAMHSA)
  PO Box 2345
  Rockville , MD 20847-2345
  Web Address: http://www.samhsa.gov or https://dpt2.samhsa.gov/treatment/
  

• National Institute on Drug Abuse
  6001 Executive Boulevard, Room 5213
  Bethesda , MD 20892-9561
  Phone: 1- 301 - 443-1124
  Web Address: www.nida.nih.gov
  

Call your local emergency number (911 in the US) or have someone call if:

• You have chest pain or trouble breathing.
• You have a seizure.
• You cannot be woken.
• You used a larger dose of methadone than your prescription said to use.
• You have signs of an allergic reaction, such as swelling of your face or mouth, a rash, and severe breathing problems.

When should I seek immediate care?

• Your breathing is slow or shallow.
• You have a fast, pounding, slow, or irregular heartbeat.
• You have pale or cold skin.
• You feel lightheaded or faint.
• Your speech is slurred, you have a hallucination, or you are confused.

When should I call my doctor or OTP counselor?

• You feel restless or are sweating heavily.
• You have nausea or are vomiting.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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