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.

What Are the Requirements for a Methadone Clinic?

To receive the certification required to provide methadone and other treatments, clinics must reach certain federal standards. All methadone clinics must offer a minimum range of services, including:

• Initial examination – Every patient must have a complete physical examination by a physician or a health care expert under a program physician’s supervision. Clinics must provide complete documentation.
• Pregnancy services – Methadone clinics must have policies and procedures set to address pregnant patients' needs. The clinic must offer prenatal care or be able to refer the individual to a suitable service.
• Assessments – Patients accepted for methadone treatment must receive an initial assessment. This includes a treatment plan and reviews during treatment.
• Counseling – Patients must receive enough substance abuse counseling from an expert qualified to evaluate social and psychological backgrounds, help with the treatment plan, and assess patients' progress. If the patient attends a short-term detox treatment, they must receive an initial drug test. Long-term detoxification treatment requires an initial drug test and randomized monthly tests.

These services are the bare minimum a methadone clinic must offer. High-quality methadone clinics go above and beyond these requirements, typically offering various types of counseling and holistic therapies.

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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

How Are Patients Looked After at a Methadone Clinic?

Patients who receive prescribed methadone for opioid addiction do not experience the cravings for opioids or the euphoric rush associated with the drug. Methadone suppresses drug withdrawal symptoms for between 24 to 36 hours.

In addition to methadone treatment, patients also attend counseling sessions. Counseling prevents drug relapse and helps individuals deal with stress, restore personal relationships, and rebuild professional goals.

Group, family, and individual counseling sessions are provided for the recovery of the patient. Some patients see improvements almost immediately, while others take more time.

Benefits of Receiving Treatment at a Methadone Clinic

Patients who were addicted to drugs like heroin or prescription painkillers receive the following benefits when treated with methadone and professional counseling services:

• Termination of opioid withdrawal symptoms
• Reduction in opioid cravings
• The decline of the undesirable effects of opioids
• Cessation of the physical need for opioid substances

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. 

Do Methadone Clinics Offer the Most Effective Treatment Medication for Opioid Dependency?

Methadone is the best-recommended treatment method for opioid dependency by The National Institute on Drug Abuse when combined with other procedures at methadone clinics.

• Medication-assisted treatment (MAT) – When used as prescribed by an expert physician, treatment medications block how opioids affect the brain to stop drug cravings and dependencies. Methadone is the most popular treatment medication because of its effectiveness and affordability. Buprenorphine and Suboxone relieve drug cravings with fewer symptoms and side effects than methadone and are recommended for individuals with a lower dependence on illegal opioids for a shorter period.
• Cognitive-behavioral therapy (CBT) – CBT helps prevent addiction relapse. Patients in CBT learn to identify and correct troublesome behaviors by applying various skills that can help stop drug abuse issues. CBT can also help deal with other problems that typically co-occur with drug abuse. A central part of CBT is anticipating likely issues and improving a patient’s self-control. Patients explore and understand the positive and negative consequences of consistent and continued drug use. They self-monitor to learn of cravings early and identify situations that might put them at risk for use. Patients also develop methods for coping with cravings and avoiding high-risk situations. Research shows that the skills patients learn through CBT often remain following the completion of treatment.
• Recovery support services (RSS) – The services provided by methadone clinics promote a healthy and safe lifestyle to lessen the risk of relapse and help those experiencing opioid use disorder continue recovery. Those who participate in opioid use disorder treatment alongside RSS usually have improved long-term recovery outcomes than those who receive either alone.

What Happens During the First Visit to a Methadone Clinic?

When patients first visit a methadone clinic, they will discuss their overall health and drug use history with a healthcare professional. Patients will receive a blood and urinalysis test.

Medical professionals will review a patient’s health history and condition to develop an individualized treatment plan. Depending on the individual’s case, they may receive treatment medication on their first visit to the clinic.

A patient must display signs of withdrawal to administer the appropriate amount of medication to treat them. Medical staff will inform the patient about their customized treatment plan, set goals, and establish guidelines for their safety and success.

Early on in the treatment, patients must visit the methadone clinic daily to receive their dose of treatment medication and counseling sessions. When a patient displays long-term stability and dependability, they may receive take-home medication privileges and visit the methadone clinic only for periodic check-ups.

Who Is Involved In a Patient’s Recovery at a Methadone Clinic?

Medical professionals such as physicians, nurses, and counselors help patients through recovery at a methadone clinic. Administrative and business staff members will also be available to help with the office's daily operations and functions. Partners, spouses, family members, and friends are encouraged to help individuals throughout treatment.

Family members and friends can accompany a patient to an appointment at any time if the patient agrees to it.

Do Methadone Clinics Have a Bad Reputation?

Many people believe methadone clinics heighten crime and help patients become hooked on drugs. Many individuals think that methadone treatment means switching one addiction to another.

Methadone maintenance treatment is often seen as a scam in some way. However, this attitude is damaging to people in recovery and affects the number of people seeking treatment. Some people undergoing methadone maintenance treatment may also experience stigma.

These perceptions are based on the fact that methadone is an opioid. However, they do not consider the significant differences in potency.

Methadone treatment does not get anyone high when it is consumed as prescribed by a doctor. Instead, it significantly increases the chances of drug addiction recovery. Methadone clinics are there to help people overcome their addictions, not to give them another one.

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

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