What is methadone?

Methadone is an opioid medicine that is only available with a prescription from your doctor.

How does methadone work?

When methadone is used to replace another opioid, it helps to lessen the effects of withdrawal and reduces the harm associated with opioid drug use. In this way, methadone makes it easier for people to stop their harmful drug use.

Methadone also works to reduce feelings of pain by interrupting the way nerves signal pain between the brain and the body.

What is methadone used for?

Methadone is prescribed for the medical treatment of heroin and other opioid dependencies.

Methadone can also be prescribed to help manage severe pain caused by certain conditions.

Because of the challenges of opioid use, methadone should only be used for pain relief in people who are not able to take non-opioid pain relief medicines, or when pain cannot be managed with other options.

What forms of methadone are available?

Methadone is available in syrup, injection and tablet forms.

The syrup is generally used for treating opioid dependence, and the other forms are used for treating severe chronic pain.

What are the possible side effects of taking methadone?

As with all opioid medicines, methadone can cause life-threatening breathing problems. The chance of these is higher:

• when you first take methadone
• after a dosage increase
• if you are older
• if you have an existing lung problem

Other common side effects of methadone include:

• constipation
• headache or dizziness
• fatigue or drowsiness (especially soon after a dose)
• loss of appetite, nausea and vomiting

Methadone affects everyone differently. Your chance of experiencing side effects may depend on:

• if you regularly use methadone
• if you take methadone while also taking other drugs or medicines
• your dosage
• your weight
• your general health

If you experience side effects while taking methadone, or you are concerned about your drug use, speak with your doctor.

Always take medicines exactly as prescribed by your doctor.

What are the risks associated with methadone?

Methadone is an opioid medicine and can cause life-threatening breathing problems.

Methadone may make it difficult for you to drive or operate heavy machinery. If you have recently started taking an opioid medicine, or changed the dosage, you may be more likely to have an accident. Ask your doctor whether it is legal for you to drive while taking methadone. Also contact your car insurer, as you may not be covered for accidents that occur while you are taking methadone.

If you have kidney or liver problems, your doctor will need to adjust your dosage of methadone.

Other factors that may limit your use of methadone include:

• older age
• alcohol use
• taking other medicines that can cause drowsiness, such as benzodiazepines

Your doctor is the best person to advise you on whether methadone is the right medicine for you, how much you need and how long to take it for. Your doctor can also guide you on when and how to stop taking methadone.

Opioid tolerance and dependence

You can develop tolerance when you take methadone. This means you need to take larger amounts of the opioid to get the same effect. As the dosage increases, so does the chance of side effects.

If you take methadone regularly, you may become dependent on this medicine, even if you take it exactly as prescribed and only for a short time. Your doctor will monitor how you use methadone to reduce your chance of harm.

You may have been prescribed methadone to treat heroin or opioid dependency. This is because your doctor thinks that the benefits of methadone outweigh the problems of long-term use. If you are concerned about the risks of methadone, speak to your doctor. You can also call the National Alcohol and Other Drug Hotline (1800 250 015) for 24/7 support and treatment information.

Opioid overdose

Methadone is a very potent opioid medicine that is slowly released over time. Overdosing on this medicine even in small amounts is dangerous. If you or someone you know has overdosed on methadone, visit your nearest emergency department.

If you take too much methadone (known as an overdose), it's important to get immediate medical attention. Overdose of opioid medicines can cause you to stop breathing.

Symptoms of overdose include:

• feeling sleepy
• difficulty breathing
• loss of consciousness
• pinpoint (very small) pupils

Access to overdose-reversing medication

Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. The Australian Government is offering this medication free of charge and without a prescription to people who may experience, or witness, an opioid overdose.

Learn more about the Take Home Naloxone program.

How do I take methadone?

Methadone is available at select pharmacies. Visit the Find A Pharmacy website to find a methadone dispensing pharmacy near you.

For opioid dependence, your methadone dose is given at the pharmacy, and you take it with supervision from your pharmacist. You may get approval for takeaway doses of methadone syrup. Take these as prescribed by your doctor.

It takes a few days for a dose of methadone to reach full effect. During this time, avoid taking opioids, alcohol or benzodiazepines, as this increases the chance of overdose. Your pharmacist will not give you your methadone dose if you are intoxicated.

If you are prescribed methadone for your pain, your pain specialist will guide you on how to take it.

Always take medicines exactly as prescribed by your doctor. Never give someone else a medicine prescribed for you, or take a medicine prescribed for someone else.

How do I dispose of medicines safely?

It's important that you dispose of unwanted opioid medicines safely. Unused medicines can be returned to any pharmacy. Don't keep unused methadone 'just in case', as this can lead to dangerous or inappropriate use.

Keep methadone out of reach of children and pets. Never throw medicines into a garbage bin or flush them down the toilet, as this is dangerous to others and harmful to the environment.

Are there any alternatives to methadone?

Both methadone and buprenorphine are used to help treat opioid dependence or misuse. Your doctor will work with you to decide the best treatment for you.

Methadone is only rarely used to treat severe pain when other treatments do not work or cannot be tolerated. Everyone's pain is unique. Your doctor may recommend different pain-relief medicines in different circumstances. If you have been prescribed methadone and have concerns or are experiencing side effects, speak with your doctor about other ways you can manage your pain.

If you have chronic (long-term) pain, your doctor might suggest lifestyle changes to help manage the discomfort. This may include:

• improving your physical fitness
• activity pacing
• social activities
• relaxation techniques
• overall health management

Find out more about options for managing chronic pain.

When should I see my doctor?

Always check with your doctor before adjusting your dosage either up or down — do not change your dose without checking first.

See your doctor if you experience any unexpected or unwanted side effects.

If you stop taking methadone suddenly, you may experience withdrawal symptoms. Your doctor can advise you on the best way to reduce your dosage of methadone to minimise the impact of withdrawal effects.

Resources and support

Asking about your treatment or medicine is important to help you understand your options. Here's a guide to questions you should ask your pharmacist or doctor before taking any medicine.

Find a pharmacy near you that is involved with the Opioid Dependency Treatment program.

See also this list of medicines that contain methadone to read the Consumer Medicines Information (CMI) leaflet for the brand prescribed, or:

• If you are struggling with addiction to alcohol or other drugs, call the National Alcohol and Other Drug Hotline (1800 250 015) for 24/7 support and treatment information.
• Call 1300 MEDICINE (1300 633 424) to talk about the medicines you are taking for your pain.
• Learn more about prescription opioids on the Choosing Wisely
• For answers to your questions and for practical advice, call the Alcohol and Drug Foundation (1300 85 85 84).
• For confidential alcohol and drug counselling, visit CounsellingONLINE.

Other languages

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Visit Positive Choices for an overview of drug services and resources for Aboriginal and Torres Strait Islander people and communities.
• Your Room is a website with resources and information about drugs, and has information for Aboriginal and/or Torres Strait Islander people.