5 Ways to Maximize Success in Methadone Maintenance Treatment

Methadone Maintenance Treatment (MMT) is the most widely known and well researched treatment for opioid dependency. However many of those considering this as a treatment option for opiate addiction, and even some patients currently on methadone, have hesitations towards certain aspects of treatment or are unaware of how to maximize the effectiveness of treatment.

I have personally found tremendous success through Methadone. A MMT patient for just under 2 years now, I have gone from a homeless IV drug user, to a functional person, once again full of life and potential. It has truly given me the opportunity to reclaim my life, and has the ability to do the same for many addicts in need of treatment; but if you are not taking full advantage of all methadone has to offer, the power of addiction can win.

Here are 5 simple ways to help maximize success in Methadone Maintenance Treatment!

1. Be 100% Honest & Participate Fully

This is an important one, so take note.

Counselling and regular contact with a physician is a major and important part of Methadone Maintenance Treatment.

Depending on the physician or clinic, frequency and style of appointments can vary, but regardless of where you've decided to seek treatment, honesty and attendance are absolutely imperative.

During appointments, you have the opportunity to speak with your physician about anything and everything regarding drugs and drug use/abuse. And yes, I really do mean absolutely anything and everything. Shoot heroin? Smoke crack? Had a puff off a joint? Few drinks with friends? Cravings for drugs? Feeling down? Feeling good?

Spill it all. Every dirty little detail. It's imperative to inform your treating physician of absolutely everything. Without full disclosure, you may not be receiving the most effective treatment possible to combat your addiction.

"There is strong evidence to support improved outcomes when methadone treatment for opioid dependence includes addiction counselling".

The role of a counsellor is a important one. Drug use, physical, mental, social, and legal issues and goals are all aspects that a counsellor or physician is there to assist you with. Be sure to take full advantage of any and all help offered in order to maximize success.

2. Abstain From Other Drug Use

The main goal of methadone maintenance treatment is to allow the patient to reduce or stop drug use and overdose risk. Other benefits include reducing risk of acquiring disease, reduced criminal activity, increased family stability and the ability to once again become a fully functional member of society.

However, do not forget that you are very much still an addict. Just because you're now on Methadone Maintenance Treatment for opiate addiction, does not mean it's a good idea to go out and get yourself in trouble with a slew of other drugs. Methadone's effects are limited to opiates, so tread with caution.

As with all medications, there is also the risk of interactions when Methadone is taken with other medications or street drugs.

"Methadone is digested by enzymes, beginning in the gut and continuing in the liver. This process is called 'metabolism'. Some drugs or substances interact with these same enzymes to either speed up or slow down methadone metabolism. This unexpectedly decreases or increases the amount of methadone in your system."

Be sure to tell your Physician about anything and everything you are taking. Your health and safety depend on it.

3. Don't Skip Doses or Double Dose!

When you make the decision to skip a dose of Methadone, or for whatever the reason circumstances don't allow for it, there can be consequences.

One risk factor associated with missing a dose or consecutive days doses is level of tolerance to opiates. This is a  serious concern, because tolerance to opiates drops rapidly and going back to the previous dose could lead to an overdose. In some clinics, missing a days dose or several doses can result in a decrease in the amount of Methadone prescribed to ensure the safety of the patient.

Another risk associated with skipping doses is that the full benefits offered by Methadone will no longer be in your system. Obviously, when you don't take your medication, you stop receiving its benefits and effects! Urges can return, possibly leading to drug use and relapse.

Ensure you are taking your Methadone exactly as prescribed.

4. Don't Fear Dose Increases or 'Higher Doses'

The hesitation towards dose increases or high range doses is another very real concern I've observed amongst my fellow Methadone patients. Somewhat strange coming from a group of drug addicts, don't you think?

Generally speaking, I have found there are two main reasons behind the hesitation towards dose increases or what are perceived to be 'higher range' doses. First, is a fear of a long treatment and withdrawal process. Second, is the desire for the withdrawal relief of methadone while actively wanting to avoid the opiate blocking effects of the drug.

The thing is, being on a 'higher dose' of methadone is nothing to fear. In fact, it can be much more beneficial to be at a higher dose rather than a low to mid range dose!

Studies have shown that doses in excess of 100mg/day are not only safe but necessary to prevent illicit opiate use, stabilize psychiatric symptoms and diminish abuse of alcohol and benzodiazepines in many patients. Not only that, but it can also improve psychosocial functioning.

As for the case of some addicts desiring the withdrawal relief of Methadone, while attempting to avoid the opiate blocking effects - it is a real issue and can be a very large barrier to success.

It has been shown that low to moderate doses can manage to effectively reduce withdrawal symptoms, but fail to eliminate the effects of heroin. Doses of 100mg or greater are superior when it comes to suppressing withdrawal symptoms, use, as well as the effects of heroin.

Give that the ultimate goal of Methadone Maintenance Treatment is to suppress withdrawal symptoms, drug use, as well as the effects of heroin; being on a higher dose of Methadone can be a very good option for many patients.

As for Methadone detox and it's process, cessation of treatment is one decision that should be taken seriously and made with the support and supervision of a physician. When it ultimately does eventually come time to cease Methadone Maintenance Treatment, there is a process in place in order to make the transition to a Methadone free life as easy as possible.

"Regardless of whether you have been in Methadone treatment for a short or long time, on a high or low dose, the process is the same, and the degree of difficulty in withdrawing is the same."

The process of discontinuing Methadone is done using a method called tapering, or titration of dosage, where the general rule is the slower the better! The Methadone dosage is gradually reduced over a period of time, often at whichever rate is most comfortably tolerated by the patient.

Don't allow unfounded fears and hesitations stop you from receiving the full benefits offered by Methadone!

5. Don't Rush The Process!

When it comes to Methadone Maintenance Treatment, there is no standard length of treatment or time frame to be adhered to. However, I've observed a very real concern amongst many patients and about the length of treatment, or hesitation towards long term Methadone Maintenance Treatment.

Hold up! What is all the rush about?! I certainly understand the absolute burning desire to be drug free and wanting that to happen as quickly as humanly possible. However, when it comes to drug addiction, treatment just isn't something you should rush.

If you've just started out, that's all you need to be worrying about! I of course recommend being fully engaged, involved and knowledgeable in all aspects of treatment, but don't get your mind bogged down with elaborate plans to be methadone free in months - it's just not realistic if you're looking for safe and effective treatment.

Not only is it unrealistic, studies have shown that it's not at all beneficial either. In fact, the opposite is true - it's been found that patients who remain on methadone for longer periods of time achieve greater success in abstaining from opiates.

"The optimum duration is for each individual to continue receiving treatment for as long as they continue to benefit from it. Indefinite or lifetime maintenance on methadone is an option for some clients/patients."

Everyone is different, and therefore treatment plans and lengths need to be tailored to suit each individual. Addiction treatment, like Methadone Maintenance, is not a one size fits all deal.

Addiction is a tricky disease. There are, of course, many other factors that will contribute to success with Methadone Maintenance Treatment; all of which should be properly monitored and achieved with the close supervision of a physician.

Whichever method of addiction treatment you choose, ensure you are fully informed, committed and ready to receive the best care possible to help ensure success on the road to sobriety!


Studio L is a freelance writer living in Southwestern Ontario. She is a recovering IV drug user, methadone patient, and harm reduction advocate, and covers these issues in her blog.