August 1, 2008
NIDA Director, Dr. Nora D. Volkow

Recent reports have highlighted the potential dangers, including death, of the improper use (or abuse) of methadone. Growing accounts of this medication's adverse effects—which likely stem from its increased use for treating pain, along with physician inexperience in prescribing it—should not overshadow methadone's proven benefits. For more than 30 years, methadone has been used safely and effectively to treat people with opioid addiction, particularly heroin.

Methadone is a long-acting synthetic opiate that works at the same receptors in the brain as heroin (the mu opioid receptors). However, unlike heroin, it has a slow onset and long duration of action when taken orally as directed. Properly prescribed, methadone is not intoxicating or sedating and does not interfere with ordinary activities like driving a car. It does effectively suppress opiate withdrawal and relieve the debilitating craving that typically causes people to relapse.

Combined with behavioral therapies or counseling and other supportive services, methadone enables patients to stop using heroin (and other opiates) and return to more stable and productive lives. Methadone has also been shown to reduce addiction-related death, criminal recidivism, and the spread of HIV. The increased incidence of adverse methadone-related consequences demands that we intensify our efforts to mitigate its potential misuse or abuse, starting with physician and patient education. That said, we must not lose sight of methadone's powerful benefits as a therapeutic medication for both pain and addiction.


Nora D. Volkow, M.D.