Methadone was first used as a treatment for heroin dependence in Vancouver in 1959 and was subsequently introduced into Australia for the same purpose in 1969. Methadone Maintenance Treatment (MMT) was endorsed by State, Territory and Commonwealth Governments as an appropriate and useful treatment for heroin dependence at the launch of the National Campaign Against Drug Abuse in 1985. Since that time there has been substantial growth in the number of individuals receiving methadone treatment in most jurisdictions of Australia.

The aims of Methadone Maintenance Treatment are to:

  • Reduce or eliminate illicit heroin and other drug use by those in treatment.

  • Improve the health and well-being of those in treatment.

  • Facilitate the social rehabilitation of those in treatment.

  • Reduce the spread of blood borne diseases associated with injecting opioid use.

  • Reduce the risk of death associated with opioid use.

  • Reduce level of involvement in crime associated with opioid use.
These clinical guidelines have been prepared to aid authorised medical practitioners in the selection and management of patients seeking methadone maintenance treatment for opioid dependence. The content has been designed to complement the National Policy on Methadone Treatment and local jurisdictional policies and requirements for methadone prescribing.

These guidelines were prepared under the auspices of the National Expert Advisory Committee on Illicit Drugs (NEACID) in collaboration with the National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) project, the Royal Australian College of General Practitioners (RACGP) and the Australian Professional Society on Alcohol and Other Drugs (APSAD), and are funded by the Commonwealth Department of Health and Ageing.

The clinical guidelines are based on national and international research literature, previously published guidelines and clinical experience with the use of methadone in Australia. They have undergone a rigorous process of review and have been formally endorsed by the RACGP and APSAD.Top of page

The authors gratefully acknowledge the contribution of a number of individuals and organisations in the drafting and review of these guidelines. Mr Andrew Preston generously gave permission for material from his book The New Zealand Methadone Briefing to be included in the guidelines. Dr Tony Gill and the Drug Programs Bureau, NSW Health Department gave valuable feedback and allowed us to reproduce sections of the NSW Methadone Maintenance Treatment Clinical Practice Guidelines in the appendices. Dr Hendree Jones, Director of Research at the Centre for Addiction and Pregnancy in the USA, provided valuable comments on the sections on Pregnancy and Lactation. We are indebted to Dr Michael Farrell and the UK Department of Health for permission to use the table of drug interactions which appears at Appendix 1. To all those who patiently reviewed and commented on successive drafts of the document – our grateful thanks.