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Methadone is used for the treatment of opioid dependency. It may be used as a long-term maintenance therapy or in shorter periods for detoxification without withdrawal symptoms.

A 2009 Cochrane review found methadone was effective in retaining people in treatment and in the reduction or cessation of heroin use as measured by self-report and urine/hair analysis but did not affect criminal activity or risk of death.

The treatment of opioid-dependent persons with methadone will follow one of two routes. Methadone maintenance therapy (MMT) usually takes place as an outpatient. It is prescribed once or twice daily for those who wish to abstain from illicit drug use.

The duration of methadone treatment ranges from a few months to several years, or even lifelong. Methadone reduction, called detoxification, are suitable for persons who wish to completely stop using drugs. The length of time a person remains in treatment depends on a number of factors. The starting dose depends on the type and quantity of drugs being used at onset of treatment. It also depends on how long the person has been using the drug(s) and the method (i.e. oral, inhaled, or injected).

In addition, enrolment in methadone maintenance has the potential to reduce the transmission of infectious diseases associated with opiate injection, such as hepatitis B and C, and/or HIV. The principal goals of methadone maintenance are to relieve opioid cravings, suppress the abstinence syndrome, and block the euphoric effects associated with opioids.

Both methadone abuse and lawfully prescribed use will eventually lead to dependence.

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