Methadone Program

Methadone is a long acting opioid drug used to replace the shorter-acting opioids that someone may be addicted to, such as heroin, oxycodone, fentanyl or hydromorphone. Long-acting means that the drug acts more slowly in the body, for a longer period of time. The effects of methadone last for 24 to 36 hours. In contrast, a person who uses short-acting opioids to avoid withdrawal must use three to four times a day.

When taken at the correct dose, methadone prevents withdrawal symptoms and reduces drug cravings without causing the person to feel high (euphoric) or sleepy. This lowers the harms associated with opioid misuse and gives people who are addicted to opioids a chance to stabilize their lives. 

Methadone maintenance is a long-term treatment. The length of treatment varies from one or two years to 20 years or more. However, if the person taking methadone and their doctor agree to end treatment, the methadone dose is tapered down gradually over many weeks or months, easing the process of withdrawal.

Learn more about methadone.

Methadone is usually prescribed by doctors to help you with opioid addiction to drugs like codeine, heroin, and fentanyl. Long-term clinical studies have shown not only the benefits of this treatment but also the affordability of the program. Our Methadone maintenance program also supports you with counselling, social work, and family therapy. 

Methadone as a first-line treatment when Suboxone is not preferred. Your doctor may decide that methadone is the best treatment option based on your needs, circumstances, and preferences.

Methadone is a full opioid agonist that has been used to treat opioid addiction for several decades. Unlike Suboxone, methadone does not have a ceiling effect, which means the risks of sedation and respiratory depression increase at higher doses. Methadone is also metabolized very slowly — on average, it takes five days for methadone to build up to a steady level in the body after a person’s daily dose is increased. For these reasons, when people start taking methadone, their dose is adjusted slowly and prescribers monitor patients carefully for signs that their dose is too high (sedation, respiratory depression) or unsafe. It usually takes several weeks to months for patients to reach their optimal dose.

Methadone is available in either a liquid or powder form and is taken orally. The length of treatment and dosage will be individual to your needs and will be closely monitored by your doctor. 

You would benefit more from long-term Methadone if:

• You have been using opioids for a long time, in high doses, developing a strong tolerance.
• You have engaged in high-risk/reward behaviours such as IV injection of drugs and mixing drugs.
• You are without a support structure or stable housing.
• You have failed suboxone treatment in the past.

It’s easier to start Methadone than Suboxone® since you don’t have to stop using opioids before your treatment. Some studies show people are more likely to stay on Methadone, and that it controls pain better than Suboxone.

If you are not content with your initial decision you can switch between methadone and suboxone quite easily. Using the Suboxone® micro-dosing protocol you may slowly reduce the prescribed methadone dose while simultaneously increasing Suboxone® in micro-dose amounts over the span of 7-10 days. Similarly, you may transfer to methadone from Suboxone® under physician guidance.

The tapering process is a slow one and should be carefully thought-out with the help of your doctor. Current guidelines recommend tapering slowly over a year or more (likely no more than 10% of your daily dose every two weeks, often less). 

You may experience withdrawal symptoms during tapering, which is why you should be honest with your doctor about your symptoms. If you feel overwhelmed, it would be better to move at a slower pace. Tapering too fast can lead to relapse. Your personal life and your support system must be stable and strong to give yourself a better chance of recovery.

Clinic visits with the doctor are fully paid for if you have a valid OHIP card.

In general, costs of medications may be covered under government plans such as Ontario Drug Benefits (ODB) or Non-Insured Health Benefits (NHIB), a private medical plan, or Trillium Drug Plan (TDP). Your pharmacist may try to assist you if you are having difficulty with payment.

Set up an intake appointment by contacting us by telephone or on-line as shown below. You can also drop by a RTR clinic and present your OHIP card. An initial appointment will be scheduled as soon as possible.

To become a patient you must:

• Be 18 years of age or older
• Have valid photo identification, including a valid OHIP number
• Opioid use disorder evidence must be present as per DSM-V criteria
• Agree to follow program policies & procedures
• Give full consent prior to starting medication assisted treatment (to be agreed upon and signed by the patient)
• A urine sample will be obtained periodically to assess for recent drug use 

Common side effects of methadone use can include:

• constipation
• excessive sweating
• dry mouth
• changes in sex drive
• drowsiness
• light-headedness
• nausea and vomiting
• weight gain

Learn more about the short-term and long-term effects of methadone.

Both methadone and Suboxone® are recommended for the treatment for pregnant women with opioid use disorders. Despite helping the mother with an opioid use disorder, and being relatively safe for her unborn child, children born to women who have been taking methadone or
Suboxone® can develop neonatal abstinence syndrome (NAS). When a baby is born with opioids in their system, they may require extended hospitalization and experience symptoms of withdrawal, including tremors, excessive crying, poor sleep and feeding. NAS is an expected, common, and treatable condition. Sublocade® is not recommended to treat opioid use disorder in pregnant women.