By 1976, methadone clinics had opened in cities including Chicago, New York, and New Haven, with some 38,000 patients treated in New York City alone. Society and culture
Brand names
Brand names include Dolophine, Symoron, Amidone, Methadose, Physeptone, Metadon, Metadol, Metadol-D, Heptanon and Heptadon among others. Cost
In the US, generic methadone tablets are inexpensive, with retail prices ranging from $0.25 to $2.50 per defined daily dose. Brand-name methadone tablets may cost much more. Methadone maintenance clinics in the US may be covered by private insurances, Medicaid, or Medicare. Medicare covers methadone under the prescription drug benefit, Medicare Part D, when it is prescribed for pain, but not when it is used for opioid dependence treatment because it cannot be dispensed in a retail pharmacy for this purpose. In California methadone maintenance treatment is covered under the medical benefit. Patients eligibility for methadone maintenance treatment is most often contingent on them being enrolled in substance abuse counseling. People on methadone maintenance in the US either have to pay cash or if covered by insurance must complete a pre-determined number of hours per month in therapeutic groups or counseling. The United States Department of Veterans Affairs (VA) Alcohol and Drug Dependence Rehabilitation Program offers methadone services to eligible veterans enrolled in the VA health care system.Methadone maintenance treatment (MMT) cost analyses often compare the cost of clinic visits versus the overall societal costs of illicit opioid use.
Black box warning
Methadone has the following US FDA black box warning:
Risk of addiction and abuse
Potentially fatal respiratory depression
Lethal overdose in accidental ingestion
QT prolongation
Neonatal opioid withdrawal syndrome in children of pregnant women
CYP450 drug interactions
Risks when used with benzodiazepines and other CNS depressants, including alcohol. A certified opioid treatment program is required under federal law (42 CFR 8.12) when dispensing methadone for the treatment of opioid addiction or detoxification. Overdose
Most people who overdose on methadone show some of the following symptoms:

Miosis (constricted pupils)
Vomiting
Spasms of the stomach and intestines
Hypoventilation (breathing that is too slow/shallow)
Drowsiness, sleepiness, disorientation, sedation, unresponsiveness
Skin that is cool, clammy (damp), and pale
Blue fingernails and lips
Limp muscles, trouble staying awake, nausea
Unconsciousness and comaThe respiratory depression of an overdose can be treated with naloxone. Naloxone is preferred to the newer, longer-acting antagonist naltrexone. Despite methadones much longer duration of action compared to either heroin and other shorter-acting agonists and the need for repeat doses of the antagonist naloxone, it is still used for overdose therapy. As naltrexone has a longer half-life, it is more difficult to titrate. If too large a dose of the opioid antagonist is given to a dependent person, it will result in withdrawal symptoms (possibly severe). When using naloxone, the naloxone will be quickly eliminated and the withdrawal will be short-lived. Doses of naltrexone take longer to be eliminated from the persons system.