The appropriate methadone dosage is a popular topic among patients in opioid treatment programs. What is the best dose to treat someone’s opioid addiction? The most accurate answer to that question is:

The lowest dose that will effectively eliminate a patient’s opioid withdrawal symptoms.

The goal in using opioid replacement therapy is to remove the uncomfortable daily withdrawal that interferes with a person’s ability to function normally. The degree of opiate withdrawal sickness varies from person to person as does the overall severity of each person’s opioid addiction.

There are numerous factors that influence how a person will respond to varying methadone dosages:

• the number of years they have been addicted to opioids
  
• the type of opioids used and the amount
• the frequency of use
• method of use (oral, inhalation, or injection)
• as well as the person’s general state of health including liver functioning
• and other factors.

As a person’s dependency & tolerance to opioids builds over time, they find that they need greater amounts of opioids or stronger opioids in order to eliminate their withdrawal symptoms.

 So How Does The Clinic Determine How Much Methadone I Need?

The Process of Induction: Induction is a procedure that is carefully followed by the clinic’s medical staff to gradually help a new patient adjust to their methadone medication. Patients are typically started on a safe dose of methadone that presents a low risk of overdose, and their dose is then raised every few days until the patient arrives at a dosage level which successfully eliminates their opioid withdrawal symptoms.

Historically in methadone clinics, it is during this time of induction when a patient is at increased risk of accidental overdose. For this reason, reputable clinics start their patients on a safe dose and then increase the medication level gradually as the patient gets adjusted to the medication.

Starting a patient on a relatively high dose of methadone or increasing the dosage too quickly can place the patient in jeopardy of accidental overdose. High quality, well-managed clinics will carefully monitor their patients during induction and work with them to get them to a comfortable dosage level as soon as possible, but without taking unnecessary risks.

COWS: The COWS (Clinical Opiate Withdrawal Scale) is an assessment tool that is used by ADS to measure the extent of a patient’s withdrawal from opioids. The COWS evaluates the presence & severity of various withdrawal symptoms (like nausea, chills, sweating, tremor, restlessness, etc). The COWS aids ADS medical staff in determining the need for a medication increase and the amount of increase that should be provided.

 What’s The Average Methadone Dose For Most People?

Answer: The average dose is 80 mg to 120 mg for the majority of people. Importantly, there are a significant number of patients who are quite comfortable below 80 mg, and a number of patients who may need more than 120 mg. Dosing is highly individualized. What works best for one patient may not work well for another. Consequently, ADS tailors the dosage to the individual patient and strives for comfort, effectiveness, and safety in all situations.

The right dose is that which eliminates withdrawal sickness and opioid craving, and which allows the patient to refocus on their life & goals.

For more on ADS’ Opioid Treatment Program