Guide to Methadone Clinics

A methadone clinic is a location where those addicted or prescription painkillers or illicit narcotics like heroin and fentanyl can engage with supervised MAT (medication-assisted treatment).

What is a Methadone Clinic?

Methadone is a long-acting opioid agonist used to treat opioid use disorder and heroin use disorder. Methadone is administered as part of a comprehensive medication-assisted treatment program.

Occasionally, methadone is prescribed for the purposes of pain management.

The FDA (U.S. Food and Drug Administration) approved methadone for analgesic and antitussive use in 1947.

During the 1960s, it became apparent that methadone could be effective for the treatment of opioid use disorder when prescribed as a component of MAT alongside counseling and behavioral interventions. The FDA approved methadone for this purpose in 1972.

When methadone is taken exactly as directed, it is both safe and effective. The medication can help to promote abstinence from all types of opioids, from heroin and fentanyl to oxycodone and hydrocodone. Methadone can also help you to sustain recovery without relapse.

If you require methadone as part of an opioid use disorder treatment program, you’ll need to attend a methadone clinic to obtain your medication.

A methadone clinic is also known as:

• OTP (opioid treatment program)
• SUDS (substance use disorder services) clinic

In addition to methadone, OTPs can also dispense naltrexone, buprenorphine, and Suboxone. Despite this, the term methadone clinic remains widely used.

All methadone clinics must be:

• Registered with the DEA
• SAMHSA-certified

This 2021 study reports there are roughly 1,700 methadone clinics in the U.S. Most methadone clinics are located in New York, New Jersey, and California.

Methadone clinics come in two varieties:

1. Private OTP: A private methadone clinic will provide rapid treatment for opioid use disorder, but you’ll need to pay for this convenience.
2. Public OTP: While public methadone clinics are inexpensive, these OTPs attract minimal government funding. Expect lengthy wait times, potentially a barrier to treatment if you need help promptly for a severe opioid addiction.

Methadone offers many benefits when used as part of an overarching treatment plan for heroin addiction or addiction to opioid-based pain medications like OxyContin. These include:

1. Eliminating the physical need for opioids or opiates.
2. Improving overall functionality.
3. Reducing cravings for opiates or opioids.
4. Minimizing the intensity of withdrawal symptoms during opioid detox.
5. Blocking the euphoric effects of opioids, so inhibiting further opioid use.

Methadone is always most beneficial when delivered in combination with evidence-based treatments like counseling (individual and group) and psychotherapy (talk therapies like CBT and DBT). You will work closely with a therapist to dial in what triggers you to use opioids. The therapist will also help you to discover healthy coping strategies so you can confidently deal with stressors without resorting to substance use.

MAT typically starts with a supervised medical detox. Medications will ease the severity of cravings and withdrawal symptoms, while you’ll have emotional and clinical care available around the clock.

While all clinics must offer a minimum array of services to obtain certification – more on that below – the best methadone clinics will provide those basics as well as holistic therapies, counseling, and a variety of interventions like psychotherapy.

How Do Methadone Clinics Work?

If you are struggling with an addiction to opioids, you can go to a methadone clinic if you want treatment. The OTP will confirm your eligibility through an initial interview and screenings – more on the specifics below.

Once accepted onto the program, you can receive methadone at the clinic. Many methadone clinics reward ongoing abstinence with privileges like self-administration of medication.

Methadone is dispensed by a licensed practitioner. If supervised by a licensed practitioner, nurses, nurse practitioners, and pharmacists can also dispense methadone.

The regime at a methadone clinic includes daily dosing of methadone, counseling, and psychotherapy sessions.

The general process at a methadone clinic unfolds along similar lines as follows:

Assessment/induction

When you first attend an OTP for treatment, expect to complete some paperwork and to engage in discussions with medical professionals.

The first visit will involve a complete physical assessment. This helps to establish your overall health status and will also highlight any physical consequences of addiction.

A drug screen will confirm if you are in an appropriate stage of withdrawal to start taking methadone. Tests will also indicate if any other addictive substances are in your system.

You will speak with an intake counselor to discuss your opioid addiction. Be open, transparent, and truthful. Expect to discuss any other substances of abuse and any co-occurring mental health disorders. This conversation will help inform your treatment plan, ensuring that it can be appropriately personalized.

Depending on the outcome of your physical assessment, you may begin taking methadone as soon as that same day. You must sign a consent form before commencing methadone treatment.

Stabilization phase

During the initial stabilization phase of treatment, you begin with a low dosage of methadone, typically between 10mg and 30mg. Methadone comes in the following forms:

• Oral solution
• Dissolvable tablet
• Pill

You will receive the same dosage for the first three days. This allows methadone to slowly build up in your system.

After three days, your treatment team will evaluate how effectively the methadone is working and whether or not you are still experiencing opioid withdrawal symptoms.

From this point, the dosage will be increased every three days until you reach an appropriate maintenance level of methadone.

Maintenance phase

You can continue taking a maintenance dose of methadone until you are ready to stop using opioids completely.

For the first 90 days of treatment at a methadone clinic, you’ll need to visit the clinic for daily dosing. When the clinic is closed, you will be provided with a take-home dose in advance. As methadone treatment progresses, you will become eligible for more frequent at-home doses.

Federal law mandates that no more than a one-month supply of methadone may be provided to someone undergoing treatment at an OTP. This maximum supply will be only be issued if you have been engaged with continuous and successful methadone treatment for at least two years.

Rules and Regulations

You need to meet the following criteria to qualify for treatment at a methadone clinic:

• You have been diagnosed with opioid use disorder at least one year before requesting methadone treatment.
• You are physically dependent on opioids.

There are three main exemptions to the above one-year ruling:

1. Those who have previously engaged with a methadone treatment program.
2. Pregnant women.
3. Recently released prisoners.

If you decide methadone treatment would be the best route to life opioid-free, these are the most common methadone clinic rules and regulations:

• Examination/evaluation: Every patient at a methadone clinic must receive a complete physical examination. Clinics are compelled to provide documentation of the physical exam.
• Assessment: Your treatment plan will form part of your initial assessment. Methadone clinics must also provide intermittent assessments throughout ongoing treatment.
• Drug tests: Methadone clinics must conduct drug tests at least eight times each year. With short-term methadone treatment, this is usually limited to an initial drug screen. Longer-term methadone treatment at approved OTPs often involves randomized monthly drug screens.
• Counseling: Methadone clinics must provide patients with access to counseling from certified mental health specialists.
• Services for pregnant women: Every methadone clinic should robustly address the needs of pregnant women seeking treatment.

Finding MAT Near You

The object of medication-assisted treatment for opioid use disorder involving methadone is to stop withdrawal symptoms becoming so intense that the person considers using opioids.

If you are ready to commit to recovery, start by consulting your healthcare provider for recommendations.

Friends and family may also be able to provide suggestions.

Beyond this, try searching online for “methadone clinic near me” and you should yield plenty of suitable options.