Methadone hydrochloride is an opioid medication used in substitution therapy for addiction and in the treatment of severe pain. The drug is available in syrup form with a concentration of 0.1% for pain management and substitution therapy, and a concentration of 0.5% for substitution therapy only.

Methadone hydrochloride shows: ten times greater affinity than morphine for mu receptors, five times greater affinity for delta receptors, and has an antagonistic action on NMDA receptors, in addition to inhibiting serotonin reuptake in the posterior horns of the spinal cord. Consequently, it is a more effective medication than morphine in the treatment of severe pain. Patients who do not respond to high doses of morphine can be successfully treated with methadone hydrochloride. Furthermore, thanks to its action on NMDA receptors, the drug reduces the need for co-analgesics. Due to its versatile action, methadone hydrochloride is particularly effective in pain with a neuropathic component.

Methadone hydrochloride in a concentration of 1 mg/ml (0.1%) is included in the list of reimbursable medications for the treatment of “malignant tumors” at a fixed cost. The coverage applies to packages of 10, 20, and 100 ml*.

Methadone hydrochloride is also included in the list of free medications for seniors over the age of 65.

*Based on the decree of the Minister of Health concerning the list of reimbursable medications, special medical-purpose foods, and medical devices, effective from April 1, 2024.

Methadone hydrochloride is the main drug used in substitution therapy. It allows patients with severe addiction to stop substance abuse, begin rehabilitation, and treat coexisting illnesses, including HCV and HIV infections. Patients treated with methadone hydrochloride within substitution therapy programs also benefit from psychological support, which facilitates their return to acceptable social relationships.