The documents listed below provide information on regulations and guidelines regarding methadone dosing and safety. You can search them easily for specific information about the safety of methadone.
Substance Abuse and Mental Health Services Administration. Federal Guidelines for Opioid Treatment Programs. HHS Publication No. (SMA) XX-XXXX. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. https://store.samhsa.gov/system/files/pep15-fedguideotp.pdf
U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016. https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf
Medication-Assisted Treatment (MAT), SAMHSA, updated 9/2019. https://www.samhsa.gov/medication-assisted-treatment
ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use, June 1, 2015. https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf
Below find specific information on dosing, cardiac concerns, drug interactions, and overdoses.
Dosing
Dosing and Take-Homes (see Federal Guidelines for Opioid Treatment Programs, SAMHSA, January 2015, p.10.) https://store.samhsa.golistev/system/files/pep15-fedguideotp.pdf
AATOD Guidelines for Guest Medication. http://www.aatod.org/policies/policy-statements/aatod-guidelines-for-guest-medication/
ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use, June 1, 2015, p.30.) https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf
Cardiac Concerns
No Evidence to Support QTc-Interval Screening in Methadone Maintenance Treatment: Cochrane Review, July 2013, Addiction Treatment Forum. https://staging3.atforum.com/2013/07/no-evidence-to-support-qtc-interval-screening-in-methadone-maintenance-treatment-cochrane-review/
Drug Interactions
McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine, and other frequently prescribed medications: a review. Am J Addict. 2010; Jan-Feb;19(1):4-16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334287/ doi:10.1111/j.1521-0391.2009.00005.x.
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (December 18, 2014). The DAWN Report: Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes. Rockville, MD. https://www.samhsa.gov/data/sites/default/files/DAWN-SR192-BenzoCombos-2014/DAWN-SR192-BenzoCombos-2014.pdf
FDA Drug Safety Communication: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants; careful medication management can reduce risks, September 20, 2017. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-urges-caution-about-withholding-opioid-addiction-medications
Substance Abuse and Mental Health Services Administration. Federal Guidelines for Opioid Treatment Programs. HHS Publication No. (SMA) XX-XXXX. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. https://store.samhsa.gov/system/files/pep15-fedguideotp.pdf
SAMHSA Dear Colleague Letter on State Prescription Drug Monitoring Programs (PDMPs), September 27, 2011. https://www.samhsa.gov/sites/default/files/programs_campaigns/medication_assisted/dear_colleague_letters/2011-colleague-letter-state-prescription-drug-monitoring-programs.pdf
Overdoses
During the early 2000s, methadone maintenance treatment was incorrectly blamed by the media and politicians for overdoses. Investigations found that these cases involved methadone prescribed for pain, not methadone dispensed by opioid treatment programs. See Methadone-Associated Overdose Deaths: Factors Contributing to Increased Deaths and Efforts to Prevent Them, GAO-09-341, published in a GAO Report to Congressional Requestors, March 2009. https://www.gao.gov/new.items/d09341.pdf
5 Minutes Is All It Takes To Identify and Reverse an Overdose. Harm Reduction Coalition, 2015. https://harmreduction.org/overdose-prevention/5-minutes-is-all-it-takes/
