Methadone treatment programs should ensure that HIV positive patients have access to specialist HIV medical care so that the patient's overall health may be monitored and appropriate treatment provided as required.

In general, patients who are HIV positive are able to comply with the requirements and conditions of the program, however, the medical, psychological and social implications of HIV infection may necessitate the provision of additional services.

Methadone doses must be monitored due to the potential for interactions between methadone and HIV medications and the effects of related illnesses.

  • Higher methadone doses may be necessary if HIV medications increase methadone metabolism (see also Appendix 1).
Flexibility in dosing arrangements may be needed if patients are unable to attend for daily dosing due to illness. This may need to be negotiated with the responsible jurisdictional authority. Options include:
  • Collection of daily methadone dose by a responsible adult;
  • Home deliveries;
  • Takeaway doses.
In the terminal stages of HIV-AIDS, methadone service providers may need to work with hospice services in managing methadone treatment and AIDS conditions.