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Opioid Use Disorder Treatment  ·  Medically Assisted Treatment (MAT)

Methadone

Also known as: Physeptone, Dolophine

A medically supervised treatment for opioid use disorder, one of the most evidence-backed interventions available, reducing overdose deaths, HIV transmission, and supporting recovery.

ATC CodeN07BC02
Kenya EML 2023Listed
Level of UseLevel 5-6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Controlled Medicine: MAT Programmes Only

Available exclusively through licensed Medically Assisted Treatment programmes in Kenya.

What it treats

Which conditions is Methadone used for?

Opioid Use Disorder

Overview

What is Methadone?

Methadone is a medicine used in the treatment of opioid use disorder. It is provided through structured, supervised medical programmes rather than through ordinary pharmacies, and is taken daily in a clinical setting, particularly in the early stages of treatment.

When used in this way, it is one of the most effective and well-studied interventions for opioid use disorder in the world. It reduces the physical craving and withdrawal that drive continued opioid use.

It is listed in Kenya's Essential Medicines List 2023. Methadone programmes in Kenya are managed in partnership with NACADA and the Ministry of Health.

How it works

What does it do in the brain?

Methadone acts on the same receptors in the brain that opioids like heroin target, but it does so in a sustained, steady way rather than producing the sharp highs and lows of heroin use. At the right therapeutic level, it removes the cycle of craving and withdrawal without producing intoxication.

Formulations in Kenya

How is it available?

Oral solution
Available in MAT clinics
Taken by mouth, supervised
MAT programme facilities only

Availability across Africa

Where is it available in Africa and what is it called?

Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
CountryCommon Brand Name(s)Notes
UgandaMethadone (generic)MAT programmes operational in Kampala at Mulago Hospital and select clinics.
TanzaniaMethadone (generic)MAT programmes active in Dar es Salaam and Zanzibar; significant HIV-linked opioid use context.
South AfricaPhyseptone, Methadone (generic)MAT programmes operational in Cape Town, Durban, and Johannesburg under health authority oversight.
NigeriaMethadone (generic)MAT pilot programmes established in Lagos; expanding under Federal Ministry of Health guidance.
EthiopiaMethadone (generic)MAT programmes in Addis Ababa under Ministry of Health oversight.
MauritiusMethadone (generic)One of the most established MAT programmes in Africa; long-running national programme for heroin use disorder.

Side effects

What might you feel while taking it?

These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.

  • Constipation, very common and needs to be actively managed
  • Sweating
  • Sedation, particularly in the early weeks
  • Nausea, especially at the start
  • Dry mouth
  • Changes in sexual function
Go to a doctor or emergency room straight away if you notice any of the following.
  • Heart rhythm changes, a heart tracing (ECG) is done before starting treatment and periodically during it
  • Breathing difficulty. The risk is highest if other substances, particularly alcohol or benzodiazepines, are used at the same time

Who should not take it

Important warnings before starting

Tell your doctor about all your medical conditions, allergies, and other medicines before starting Methadone.
  • Severe liver disease
  • Significant heart rhythm disorder
  • Currently taking certain other medicines. Your MAT team will review these

Special care needed

Situations that need extra attention

  • Never share methadone with anyone else. It can be fatal to someone who is not opioid-tolerant
  • Avoid alcohol and benzodiazepines during treatment
  • Tell your MAT team about all other medicines, including HIV medicines
  • If you become pregnant during treatment, tell your team immediately
Pregnancy
Continuing methadone treatment during pregnancy is strongly recommended over attempting withdrawal. Stopping opioids abruptly in pregnancy carries significant risks. Specialist perinatal management should be sought as early as possible.
Breastfeeding
Breastfeeding is generally encouraged in stable patients on methadone programmes. The benefits of breastfeeding outweigh the minimal transfer through milk.

Other medicines

Medicines and substances that can interact with it

Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
  • Alcohol and benzodiazepines: A significantly increased risk of breathing problems and overdose. Must be avoided.
  • Certain HIV antiretroviral medicines: Some ARVs affect methadone levels significantly. Your HIV doctor and MAT team must communicate.
  • Rifampicin (TB treatment): Reduces methadone levels substantially, which can trigger withdrawal. TB treatment must be coordinated with your MAT team.

Tests and follow-up

What your doctor will monitor

  • Regular attendance at the MAT clinic for supervised dispensing
  • Heart tracing (ECG) at baseline and during treatment
  • Testing for HIV, hepatitis B and C at enrolment
  • Ongoing assessment of wellbeing at every clinic attendance

Stopping this medicine

What happens if you stop taking it?

Stopping methadone should only be done gradually and with full support from the MAT team. Abrupt stopping leads to withdrawal and dramatically increases the risk of returning to opioid use and of overdose.

In Kenya

What you should know about this medicine in Kenya

Kenya has established MAT programmes in Nairobi, Mombasa, Malindi, Kilifi, and other towns, reflecting the significant heroin use problem along the East African coastline.

Opioid use disorder and HIV are closely linked in Kenya. MAT substantially reduces needle sharing and therefore HIV risk. Integrating MAT and HIV care services produces better outcomes.

Stigma towards people with opioid use disorder remains significant in Kenya. People seeking MAT deserve respectful, compassionate care.

Sources

References

  1. Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
  2. Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
  3. World Health Organization. (2009). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva: WHO.
  4. World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.
  5. NACADA. (2017). National Guidelines for Medically Assisted Treatment in Kenya. Nairobi: NACADA/Ministry of Health.