Initial methadone dose in treating opiate addiction

Intramuscular administration of naloxone was used to precipitate the narcotic withdrawal syndrome in opiate-dependent patients. Objective signs of withdrawal were rated according to a previously developed scale. Based upon naloxone-induced withdrawal scores, 76 patients were given a dose of methadone, either low, medium, or high, in a randomized double-blind manner on 2 consecutive days. The adequacy of the methadone dose was evaluated by assessing the patients' physical responses after each treatment. Results indicate that the medium dose of methadone in each naloxone-induced withdrawal score range provides optimal control of narcotic deprivation. It is concluded that a correct initial dose of methadone can be administered when the degree of opiate dependence is established by the naloxone test.