Methadone treatment for opiate addiction
How methadone works, what going to an opioid treatment program is like, and how take-home doses are earned.
Find treatment near youUpdated October 2026. Sources are linked on this page.
The short answer
- What it is
- A long-acting opioid medicine, taken once a day, that stops withdrawal and cravings and is given through certified clinics.
- How long
- At least a year is the usual advice. Some people stay on it for many years.
- What it costs
- Covered by every state Medicaid program and by Medicare. Many private plans cover it too.
How methadone works
Methadone is a full opioid, like the drugs it replaces, but it acts slowly and lasts a long time. One dose a day keeps withdrawal away and takes the edge off cravings. It also blunts the effect of other opioids if you use them.
At a steady dose, taken as prescribed, it does not produce the rush that heroin or fentanyl does. People on a stable dose hold jobs, raise families and think clearly.
It has a strong record. In a study funded by the National Institutes of Health, people who received methadone after surviving an overdose had 59% fewer opioid overdose deaths over the next year.
For a side-by-side look at all three medicines, see our overview of medication treatment.
How an opioid treatment program works
You cannot pick up methadone for addiction at a regular pharmacy. By law it is given only through opioid treatment programs certified by SAMHSA. People often call them methadone clinics.
The first weeks
Your first visit includes a health history and an exam. The starting dose is kept low on purpose, then raised step by step until you feel steady through the whole day. Early on, most people go to the clinic every day or nearly every day and take the dose in front of a nurse. It often comes as a liquid you drink.
Take-home doses
Federal rules updated in 2024 gave clinics more room to send doses home. A program may allow up to 7 take-home doses during your first 14 days, up to 14 from day 15, and up to 28 from day 31. These are upper limits. The clinic decides what is safe for you, and your state may set tighter rules.
What else the program offers
Programs must offer counseling along with medical and other support services. Under the federal rules you cannot be refused medication because you choose not to take part in counseling. Some programs run mobile units that bring dosing closer to home.
Who methadone tends to suit
There is no single right medicine. Methadone may be a good fit if:
- you tried buprenorphine and cravings or withdrawal kept breaking through
- a daily visit and regular contact with staff would help you stay on track
- you are pregnant, since methadone and buprenorphine are the recommended treatments in pregnancy
- there is a program you can reach most days
The daily trip is the hard part, mostly in the first weeks. If no program is within reach, buprenorphine from a doctor’s office or by video may be more realistic. You can switch from one medicine to the other with your prescriber’s help.
To look for programs near you, find treatment in your state.
Staying safe on methadone
Methadone is safe and effective when taken as prescribed. The risks come from how long it stays in the body.
The effect you feel wears off before the medicine has left your system. Taking extra because a dose “is not working” can build up to an overdose. Breathing problems are most likely in the first few days and after a dose increase. If your dose does not hold you, tell the clinic instead of adding to it yourself.
Alcohol, benzodiazepines and other sedating drugs raise the danger. Some medicines taken with methadone can affect heart rhythm, so give the clinic a full list of what you take.
Keep take-home doses in a locked box. Liquid methadone can look like fruit juice, and a small amount can kill a child.
Call 911 if someone is not breathing or cannot be woken. It is worth keeping naloxone at home.
Worries people have about methadone clinics
“I will be tied to the clinic forever.” The daily visits are heaviest at the start. Take-home doses can now begin much earlier than they once did.
“People will find out.” Federal law, 42 CFR Part 2, gives substance use treatment records extra protection. In most cases a program cannot share them without your written consent. Our page on whether your job will find out has the details.
“I will be on it for life.” Guidance says at least 12 months, and some people stay much longer. If you want to come off, the dose is lowered slowly with your clinic to avoid withdrawal. Stopping suddenly is risky.
What methadone treatment costs
With Medicaid
Every state Medicaid program must cover medications for opioid use disorder. That includes methadone.
See your options: With MedicaidWith private insurance
Many plans cover opioid treatment programs. Ask if the program is in your network.
See your options: With private insuranceWith no insurance
Programs set their own fees. Ask about a sliding scale or state-funded places.
See your options: With no insuranceFind methadone in your state
Real, licensed facilities from public records. No paid placements.
Questions people ask us
Do I have to go to the methadone clinic every day?
At first, usually yes or close to it. Federal rules now let programs give up to 7 take-home doses in the first 14 days, up to 14 from day 15 and up to 28 from day 31, when the clinic judges it safe. Your state and your program may be stricter, so ask what their policy is.
Is methadone stronger than buprenorphine?
They work differently. Methadone switches opioid receptors on fully, while buprenorphine does so partway. Some people whose cravings are not controlled on buprenorphine do better on methadone. Neither is better for everyone. A prescriber can help you weigh them, and our medication overview compares the two.
Can I get methadone from my regular doctor?
Not for addiction. Methadone for opioid use disorder can only be given through an opioid treatment program certified by SAMHSA. A regular doctor can prescribe buprenorphine or naltrexone instead, or refer you to a program.
Does Medicare cover methadone treatment?
Yes. Medicare Part B covers treatment at opioid treatment programs that are enrolled in Medicare, including methadone, counseling and drug testing. Medicare says you will not have a copayment at those programs, though the Part B deductible applies. See our page on Medicare and treatment costs.
Sources
- SAMHSA: Methadone
- SAMHSA: 42 CFR Part 8 final rule, expanding access and flexibility for patients
- SAMHSA: 42 CFR Part 8 final rule, frequently asked questions
- MedlinePlus: Methadone
- NIH: Methadone and buprenorphine reduce risk of death after opioid overdose
- Medicare.gov: Opioid use disorder treatment services
This page is general information, not medical advice. Talk with a clinician about your own situation.