Considerations in methadone dosing for opioid addiction

Introduction: Methadone has been an essential medication in the treatment of opioid addiction worldwide. Aim: To discuss dosing considerations related to different methadone programs. Method: A search was performed the Ovid (all resources) including: Medline, Cochrane, and EMBASE databases using the following terms: methadone dose, methadone optimization, and methadone adequacy. We compared and assessed the eligible studies with respect to the global guidelines for methadone dosing. Result: 103 different resources have been discussed and presented in the context of methadone dosing. Types of related concerns included: impact of dose on type of the program, dose induction, maintenance dose, dose in case of adverse events, doses in patients with different ethnicities, doses in males and females and dose and compliance. Conclusion: Although there is no global consensus on methadone dosing, there is a good similarity amongst the guidelines and published data on the general practical dosing regimens. Go-Slow is the most commonly used technique, and described to be the safest, too.