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In most situations (dependant on state laws and institutional policies), methadone-maintained patients enrolled in a drug abuse program are best managed by continuing methadone at the usual maintenance levels with once-a-day oral administration.
Pearl: In the event the methadone clinic is closed and/or the dose cannot be verified, 30-40 mg (10-20 mg IM) is generally enough to prevent withdrawal in most patients.
This is only a short-term measure and some patients may require additional methadone. Full doses of methadone should be reinstituted as soon as possible.
References
Fultz JM, et al. Guidelines for the management of hospitalized narcotic addicts. Ann Intern Med 1975;82(6):815-8. [PMID 1138596]
Alford DP, et al. Acute pain management for patients receiving maintenance methadone or buprenorpine therapy. Ann Intern Med 2006;144(2):127-34. [PMID 16418412]
Freedman DX, et al. Methadone treatment of heroin addiction. Annu Rev Med 1973;24:153-64. [PMID 4575849]
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