How Methadone Clinics Work

What is a Methadone Clinic?

A methadone clinic provides medication-assisted treatment to people addicted to opioids, such as prescription painkillers and heroin. Some methadone clinics give patients the brand name version of Dolophine. 

There are private and public clinics located throughout the United States regulated by state and federal laws. According to federal law, all methadone clinics must be SAMHSA-certified, which means they provide a range of services in addition to methadone. These opioid treatment programs also offer assistance with preventing the spread of infectious disease and criminal behavior, which are two things those with an SUD have a significant risk of developing.

How Methadone Clinics Work

Methadone clinics work by providing a less-lethal alternative drug to people with opioid use disorder. It makes the transition off of opioids and heroin easier. Clinics also provide recovery support in addition to methadone treatment.

By law, programs must focus on individual treatment options, including family and work life, ability to function in society, and access to resources for co-occurring conditions. Clinics cannot just administer methadone to treatment center patients without additional resources.

Treatment begins with a complete health evaluation. The evaluation includes a thorough health history review, a blood or urinalysis test, and education about the treatment programs. Patients should understand the guidelines and goals of treatment before they begin.

Once the evaluation and diagnosis are complete, treatment begins. In addition to receiving doctor-monitored methadone, patients also have access to:

• Group, family, and individual therapy
• Behavioral health counseling
• Therapy to address co-occurring disorders
• Assistance dealing with stress and other life challenges

If a clinic offers outpatient treatment, patients must return to the clinic to receive methadone. Local guidelines determine if this occurs daily or not. Some patients in some locations have the option of less frequent clinic visits. Family members can attend outpatient treatment visits with patients.

Methadone clinics provide the following benefits:

• Reduction or elimination of opioid withdrawal symptoms
• Decrease in drug cravings
• Blocked appealing effects of opioids
• Improved ability to function in everyday life
• Support for co-occurring disorders
• Counseling services for loved ones

Who Is Eligible for Methadone Treatment?

Anyone addicted to opioids or heroin and under the supervision of a doctor is eligible for methadone treatment.

People who need detox or maintenance receive treatment. According to a 2011 Substance Abuse and Mental Health Services Administration (SAMHSA) survey, most patients in an opioid treatment program were there for detox. About a quarter of those admitted to treatment were there for methadone maintenance treatment alone. 

Despite its ability to improve the chance of long-term recovery, many people with substance use disorders do not seek methadone treatment for opiate addiction because of the high cost. However, some communities offer low-cost and free alternatives. Some treatment clinics receive financial support from state and federal sources, nonprofit organizations, and government grants. These clinics sometimes offer treatment on a sliding fee scale based on a patient’s income earnings. 

Other resources to help someone with an opioid addiction pay for methadone treatment include:

Medicaid Coverage

Medicaid insurance programs offer low-income individuals many substance abuse treatment options, including methadone treatment. Some clinics also assist patients with applying for Medicaid if they qualify.

Health Insurance Coverage

As of 2008, when the Affordable Care Act became law, all marketplace healthcare plans must provide substance abuse treatment as part of their standard policy offerings. This is true even for plans that are partially or fully funded by employers. 

Additionally, the Mental Health Parity and Addiction Equity Act requires insurers to offer the same coverage benefits for standard medical care and addiction recovery.

Side Effects & Risks of Methadone Treatment

Methadone is safer and less addictive than heroin and prescription opioids, but there are side effects. The most common physical symptoms include:

• Lightheadedness
• Shallow breathing
• Rapid heartbeat
• Chest pain
• Confusion
• Hallucinations
• Nausea/vomiting
• Diarrhea
• Muscle tremors
• Abdominal cramps

Methadone also interacts with other medications. Patients must be upfront about any drugs, prescription or otherwise, that they are using. This is true even if it has been several hours or days since someone last used a drug. Even a trace of a drug in someone’s system triggers potential adverse effects, including overdose.

Methadone must always be used under the direction of a doctor, and dosing instructions followed precisely.

Other cons of using methadone treatment include:

• Potential daily visits to the clinic
• Limited travel
• Low self-esteem
• Positive employment drug test

Additionally, methadone is medication-assisted therapy (MAT). Though much safer and a potential stepping stone to recovery, some 12-step programs and other philosophies on recovery express concerns over this lack of total sobriety. 

In the last decade or so, drug treatment researchers have incorporated the 12-step philosophy into methadone treatment programs with some positive results. 

How Do I Find The Right Methadone Clinic?

Methadone clinics address aspects of opioid addiction that other forms of drug rehab cannot. But this success is only possible if you find the right methadone clinic.

First, consider whether outpatient or inpatient treatment for opiate addiction is best for you. 

Then evaluate:

• Need for monitoring and supervision
• Types of treatment are offered in addition to methadone, including mental health services
• Intensity of the treatment – inpatient treatment programs tend to be more intense
• Cost of treatment
• Location and convenience of traveling to the addiction treatment center