Methadone has been used for more than 30 years as a treatment for heroin addicts. Doctors have all along struggled to find the best doses to help patients overcome their heroin cravings without getting them used to higher levels of methadone (itself an dependence-forming substance) than necessary.
A new study by Jodie Trafton and colleagues (from the VA Palo Alto Health Care System) provides strong support for the notion that there is no one dose that fits all.
Current guidelines recommend methadone doses of at least 60 milligrams (per kilogram bodyweight). However, doctors in methadone clinics report a wide range of doses that are effective, and quite a few clinics treat patients with starting doses that are lower or higher than the recommended amount. Trafton and colleagues studied 222 heroin addicted volunteers who started methadone treatment at 8 different clinics and followed them for up to a year. They examined the range of methadone doses which helped patients achieve heroin abstinence and the factors that influenced whether a particular patient needed a higher or a lower dose.