Methadone is an opioid agonist medication that has been used to treat opioid use disorder for 50 years. This medication, which is also used to treat pain, can cause adverse effects, including overdose, if not taken as prescribed. In order to prescribe methadone for treatment of OUD, healthcare providers are required to acquire and maintain certifications issued by SAMHSA.
Related Training Resources
This introductory module is a case-based discussion of the general approach to evaluation and treatment of patients presenting with problematic opioid use. Benefits and limitations of available medications and differences between them are described. An approach to choosing first and second line treatments is also presented.
There is clear evidence of the potential of methadone to increase the QT interval which can result in a lethal arrhythmia, Torsades de Pointes. There however has been controversy as to when and how to screen patients entering methadone treatment. This module will attempt to address this need by presenting the available literature and case studies. Clear guidelines to consider will be established.
Methadone Safety: Clinical Practice Guidelines from the American Pain Society and College on Problems of Drug DependenceRoger Chou, MD | Associate Professor of Medicine, Oregon Health & Science University, Director, the Pacific Northwest Evidence-based Practice Center
This presentation reviews evidence on methadone safety, properties of methadone, and recommendations for safer use, include careful patient assessment, use of alternative opioids and treatments, education and counseling, use of ECG screening and monitoring, careful dose initiation and titration, careful monitoring and follow-up, and use of risk mitigation strategies.
Upon completion of this module, physicians working in MMT will know how to safely induce patients to MMT, how to adjust methadone dosing for maximum effectiveness, how to detect and manage MMT side effects and medication interactions, and how to work within legal/regulatory framework of 42 CFR part 8.