The correct dose of methadone is a popular topic among patients on opioid treatment programs. What is the ideal dose to treat a person’s opioid dependence? Best answer for this question:

The lowest dose that is effective in reversing the symptoms of opioid withdrawal in a person.

The purpose of using opioid substitution therapy includes eliminating the uncomfortable daily withdrawal that prevents a person from functioning normally. The degree of opioid withdrawal varies from person to person, as does the severity of each person’s opioid dependence.

There are several factors that affect how a person responds to different doses of methadone:

  • Number of years of opioid dependence
  • Number and type of opioids used
  • Type of administration (injection, inhalation or oral administration)
  • Frequency of use
  • General health of the person, including liver function

As a person develops tolerance and dependence on opioids over time, they find they need larger amounts of opioids or stronger opioids to overcome withdrawal symptoms.

How will the center decide how much methadone is needed?

An induction is a regimen carefully followed by the center’s clinical staff to gradually help a new patient become accustomed to methadone. Patients usually start on a safe dose of methadone that poses a low risk of overdose, and then increase the dose every few days until the person reaches a dose that successfully manages opioid withdrawal symptoms.

Historically, in methadone treatment centers it is during this introductory phase that a person is at greater risk of accidental overdose. Because of this, reputable centers start their patients on a safe dose and gradually increase the drug levels as the person gets used to the drug.

If a patient starts on a high dose of methadone, or if the dose is increased too quickly, they may be at risk of accidental overdose. Well-managed, high-quality centers will closely monitor their patients during treatment initiation and work with them to get them on the right dosage as quickly as possible, but without unnecessary risk.

The Clinical Opiate Withdrawal Scale (COWS) is a scoring tool used to measure a person’s degree of opioid withdrawal. The opioid risk assessment tools assesses the severity and presence of various withdrawal symptoms (such as restlessness, tremors, sweating, chills, nausea, etc.). This helps healthcare providers decide if a booster dose is needed and how much to offer.

What is the average dose for most patients?

The average dose of methadone for most people is 80 to 120 mg. It is important to note that there are a significant number of people who are comfortable with a dose of less than 80 milligrams, and many patients who may need more than 120 milligrams. The dosage is very individual. What works best for one person may not work for another.

The correct therapeutic dose of methadone is one that eliminates opioid cravings and withdrawal symptoms and allows the patient to focus back on their goals and life.

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