What to Expect at a Methadone Clinic

A methadone clinic is a type of medical facility that specializes in treating substance use disorder. These clinics dispense medications that are used to treat opioid use disorders. Methadone is commonly prescribed, but other medications, such as buprenorphine and naltrexone, may also be dispensed.

The prevalence of opioid use disorders has exploded since the late 1990s. More than three-quarters of a million people in the U.S. have died of opioid-related drug overdoses since the opioid epidemic began. Methadone clinics play an important role in helping people access medically-assisted treatments for opioid addiction.

What Is Methadone?

Methadone is a medication approved by the FDA to treat opioid use disorder (OUD), a condition that affects 2.1 million Americans. Methadone can also be used to manage pain. Due to the high regulation of this drug, its use is only permitted under the supervision of a practitioner, most often in clinics.

Since methadone’s actions occur more gradually when compared to other opioids, it doesn't lead to the same feelings of euphoria in an opioid-dependent individual. 

Background of Opioid Use Disorders

In the late 1990s, pharmaceutical companies were confident that opioids, when prescribed for pain, would not lead to addiction. As a result, healthcare practitioners prescribed them without hesitation, which led to widespread misuse.

Medication-assisted treatment has become an important factor in treating those with opioid use disorders, so they can attain recovery and achieve a higher quality of life. Since the mid-1960s, methadone has been an effective treatment for opioid addiction, and has since been widely available for this purpose. As of 2020, there were 1,698 facilities that provided methadone in the U.S.  

What to Expect at a Methadone Clinic 

Raghu Appasani, MD, Addiction Psychiatry Fellow at UCSF, says treatment protocols for OUDs vary from patient to patient. "We start with a thorough psychiatric evaluation to figure out what’s contributing to an individual’s substance abuse," says Dr. Appasani. Practitioners in the clinic aim to get a comprehensive picture of the individual's life—psychosocial factors, community support, history with addiction and substance abuse, and other mental health factors, such as trauma. 

Though medication is a foundational aspect of these clinics, Dr. Appasani underscores the importance of therapy. "Many people may stay on methadone for a long time but don't necessarily need to. Therapy can be valuable in helping a person rebuild their social structure and re-enter the workforce."

Methadone Clinic Protocols

Patients typically come to methadone clinics in the morning, says Dr. Appasani, emphasizing the need for structure as they navigate recovery. 

Furthermore, these clinics are typically staffed with various medical and mental health professionals— MDs, therapists, nurses, pharmacists, and a clinic director (either an MD or a social worker). Each professional plays a particular role in patients’ treatment plans, and serves as support to the patient as they navigate recovery. 

Methadone clinics' regimented protocols can be especially beneficial for certain patient subsets. "Someone who has issues taking the medication regularly, or is at risk of having it stolen or lost—homeless individuals, for instance—are more often prescribed methadone." This ensures that these patients come into the clinic on a regular schedule in the beginning until they’re stabilized. 

Benefits of Methadone Clinics

Methadone, when taken as prescribed and for the duration intended, can be effective in treating opioid addiction. However, as Dr. Appasani and the researchers point out, treatment outcomes aren't dependent on medication alone.

One study found that when medication was coupled with psychotherapy, patient outcomes were even more positive. Additionally, when strong social networks and nourishing interpersonal relationships were cultivated as part of individuals’ substance abuse treatment, reaching and maintaining abstinence were more likely. 

Treatment Can Prevent Violence

And impacts at the societal level are noticeable, as well. A 2018 study found that methadone maintenance treatment led to lower rates of violent and nonviolent crimes among a Canadian cohort.

Drawbacks of Methadone Clinics for Treating Opioid Addiction

Though methadone clinics have been highly effective in helping individuals achieve and sustain recovery, they aren’t free from criticism.

Methadone Clinics Can Be Crowded

One study pointed out that these clinics often have crowded rooms and long lines, which can increase the risk of disease transmission. In the wake of COVID-19, many clinics across the U.S. implemented take-home policies for qualifying patients, which can allow them to feel more empowered with their treatment and their lives.

Further studies on at-home methadone treatments are required to determine their efficacy on patient outcomes. 

Methadone Clinics Are Less Available in Rural Areas

Disparities exist at the geographic level, with methadone treatment being harder to access in rural areas, where rates of OUDs tend to be more prevalent.

Racial Bias Is Evident

And furthermore, studies have pointed out racial inequalities when it comes to dosages of methadone administered to White patients versus patients of color. One finding pointed out that Black women of color were given 67% of the dose that White women received, indicating how provider bias plays out in OUD treatment.  

Getting Help

Since 1999, over 760,000 individuals have died from a drug overdose. In 2018, two-thirds of overdose-related deaths involved an opioid.

Recovery can look different from person to person, and there’s no one-size-fits-all treatment plan. 

It’s essential to seek help for OUD to avoid long-term effects on your social, physical, and emotional well-being. You may want to join Narcotics Anonymous (NA) to find support, which uses a 12-step program to help participants overcome drug addictions. To locate a meeting in your area, you can go to their website’s directory. Your physician can also refer you to an appropriate treatment program or specialist so that you receive adequate care.