Expert: Dr.Paul Skett - 8/3/2009

Question
QUESTION: I have a friend whose methadone level on her last drug test was 3614.  Is this a high level?  Is there a formal for determining levels of methadone in your system?

ANSWER: Hi, LaDonna,

Can you give me the units for this measurement?

Paul



---------- FOLLOW-UP ----------

QUESTION: Yes.  The units are 3615 ng/ml.

ANSWER: Hi, LaDonna,

This is a high and potentially life-threatening level (depending on the tolerance of the individual). Toxicity regularly seen above 1000 ng/ml.

There is no easy formula for calculating methadone levels from doses as methadone is so long lasting that it can build up in the body.

Paul



---------- FOLLOW-UP ----------

QUESTION: Is Methadone supposed to be used long term?  If not, how long should it be used?  When should a doctor start to decrease the dosage for a patient?

Thank you so much for your help.

Answer
Hi, LaDonna,

Methadone can be (and is) used long-term - it is used in Scotland for years at a time and the user may never get off it.

However, the dose can be reduced gradually to wean the user off - this may take months to years to achieve. When and if this is done is down to discussion betwen doctor and patient and may be modified as the patient sees withdrawal effects.

Best wishes,

Paul