Last published: October 07, 2020
What is methadone?
Methadone is a prescription drug, and is part of a group of drugs known as opioids. Opioids interact with opioid receptors in the brain and elicit a range of responses within the body; from feelings of pain relief, to relaxation, pleasure and contentment.1
Methadone is taken as a replacement for heroin and other opioids as part of treatment for dependence on these drugs. Replacing a drug of dependence with a prescribed drug in this way is known as pharmacotherapy. As well as improving wellbeing by preventing physical withdrawal, pharmacotherapy helps to stabilise the lives of people who are dependent on heroin and other opioids, and to reduce the harms related to drug use.2
Methadone is also used to relieve pain following heart attacks, trauma and surgery.
Done, ‘the done’.
Other types of opioids
How is it used?
The Victorian pharmacotherapy program uses the syrup form of methadone. There are 2 brands of this liquid: Methadone Syrup® and Biodone Forte®.3 Generally, there are 2 types of methadone programs:
- Maintenance (long-term programs): May last for months or years, and aim to reduce the harms associated with drug use and improve quality of life.
- Withdrawal (short-term detoxification programs): Run for approximately 5-14 days and aim to ease the discomfort of stopping the use of heroin.4
For pain relief methadone is administered through an injection or tablets.
How effective is it?
Methadone treatment is more likely to be successful if it is part of a comprehensive treatment program, which addresses the body, mind and environment in which heroin has been used.
For example, treatment may include a combination of methadone, counselling, alternative therapies and the development of a positive support network of peers, friends and a support group.5
Methadone maintenance may not work for everyone, so it is important to work with a doctor or drug counsellor to find the best approach.
Advantages of methadone maintenance over heroin use
- Using methadone on its own is unlikely to result in an overdose.
- Methadone maintenance keeps the person stable while they make positive changes in their life.
- Health problems are reduced or avoided, especially those related to injecting, such as HIV, hepatitis B and hepatitis C viruses, skin infections and vein problems.
- Doses are required only once a day, sometimes even less often, because methadone’s effects are long lasting.
- Methadone is much cheaper than heroin.5
Effects of methadone
There is no safe level of drug use. Use of any drug always carries some risk – even medications can produce unwanted side effects. It’s important to be careful when taking any type of drug.
Methadone affects everyone differently, based on:
- size, weight and health
- whether the person is used to taking it
- whether other drugs are taken around the same time
- the amount taken.
The effects of methadone last much longer than the effects of heroin. A single dose lasts for about 24 hours, whereas a dose of heroin may only last for a couple of hours.6
People with pre-existing impaired liver function (due to conditions such as hepatitis B, hepatitis C or prolonged alcohol use) may require careful monitoring while receiving methadone treatment.7
The most common side effects of methadone are:
- sweating (drink at least 2 litres of water each day to prevent dehydration)
- difficulty passing urine
- loss of appetite, nausea and vomiting
- abdominal cramps
- aching muscles and joints
- irregular periods
- low sex drive
- rashes and itching
- lethargy, mental clouding and confusion.7
Some people on methadone programs will experience unwanted symptoms during their treatment due to their dosage not being right for them. This occurs particularly at the beginning of treatment.7
If the dose is too low, the following symptoms may be experienced:
- runny nose
- high temperature but feeling cold and sweating with goosebumps
- irritability and aggression
- loss of appetite, nausea and vomiting
- abdominal cramps and diarrhoea
- tremors, muscle spasms and jerking
- back and joint aches
- cravings for the drug they were dependant on.1
If the dose is too high, the following symptoms may be experienced. Call an ambulance straight away by dialling triple zero (000) if you have any of these symptoms (ambulance officers don’t need to involve the police):
- depressed breathing, stupor or coma due to accumulation of the drug
- severe constipation with obstruction of the bowel, or inability to pass urine
- marked allergic reaction, with swelling of the face, lips, tongue and throat, wheezy breathing or tight chest
- intense red rash with itching or hives
Methadone in its pure form will not cause damage to the major organs of the body. Prolonged use of methadone will not cause any physical damage.
Methadone withdrawal develops more slowly and is less intense than withdrawal from heroin. Withdrawal symptoms are similar to those listed under ‘Dose-related effects’ under ‘too low’ dose. Most of these effects will begin within 1 to 3 days after the last dose and will peak around the 6th day, but can last longer.1
Help and support
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Using methadone without a prescription from a doctor, or selling or giving it to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain methadone or a prescription for the drug. It is also illegal to inject methadone.9
On a snapshot day in 2017, almost 50,000 clients received pharmacotherapy treatment for their opioid dependence at 2,732 dosing points around Australia.
Methadone was the most common pharmacotherapy drug, with around 60% of clients treated with this drug.
There were 3,074 prescribers of opioid pharmacotherapy drugs, an increase of 3% from 2016.10,11
- Upfal, J. (2006). The Australian Drug Guide. (7th ed.). Black Inc: Collingwood.
- Brands B; Sproule B; & Marshman J. (Eds.) (1998) Drugs & Drug Abuse (3rd Ed.) Ontario: Addiction Research Foundation.
- Harm Reduction Victoria. (n.d.). Methadone.
- Kleber, H. (2007). Pharmacologic treatments for opioid dependence: detoxification and maintenance options.
- Rankin, J. & Mattick, R. (1997). Review of the effectiveness of methadone maintenance treatment and analysis of St. Mary’s clinic, Sydney.
- NSW Health. (2013). Methadone.
- Henry-Edwards, S., Gowing, L., White, J., Ali, R., Bell, J. Brough, R., Lintzeris, N. Ritter, A. & Quigley, A. (2003). Clinical guidelines and procedures for the use of methadone in the maintenance treatment of opioid dependence.
- Centre for Addiction and Mental Health. (2011). Do you know… Methadone.
- State Library NSW. (2011). Possession, use and supply
- Australian Institute of Health and Welfare. (2013). National Opioid Pharmacotherapy Statistics Annual Data Collection 2015
- National Opioid Pharmacotherapy Statistics (2017)