Differences between Short-Acting Opioids and Methadone​

From: Chapter 3: The Fundamentals of Methadone Maintenance Treatment, in Methadone Maintenance: A Counsellor's Guide to Treatment (© 2003).

In contrast to short-acting opioids such as heroin, methadone:

• is more effective orally; taken orally, methadone is slower acting than injected heroin (30 minutes for effect vs. immediate effect)
• does not cause a "high" or drowsiness (in stabilized clients)
• does not cause impairment in thinking, behaviour or functioning
• does not dull normal emotions and physical sensations
• diminishes opioid craving
• reduces the likelihood of a heroin-induced "high," should the client use heroin
• will continue to be effective with long-term use without dose increases
• is medically safe
• is longer acting than heroin (24 to 36 hours vs. three to six hours) and is administered less often (once a day vs. three or more times a day)
• decreases drug-seeking behaviour (U.S. Department of Health and Human Services, 1995).