Methadone is an opioid agonist. Since the 1960s, it has been the most widely used medication for opioid use disorders. Methadone is available only at licensed clinics—ideally, along with access to other clinical services. In the context of treatment for opioid use disorders, methadone offers some advantages. When taken daily, it can reduce cravings, decrease withdrawal symptoms, promote abstinence from other opioids, and help people remain functional in daily life. Methadone can meet the needs of certain systems and the audiences that they serve. However, methadone use also introduces some risks. Because methadone is a full opioid agonist, it is possible for users to get intoxicated. Methadone has considerable street value along with a history of being diverted for nonprescription use. In deciding whether to include methadone in your Medication Assisted-Treatment (MAT) program for opioid use disorders, it may be useful to consider Hazelden Betty Ford Foundation’s experience. Marvin D. Seppala, MD, chief medical officer for the Hazelden Betty Ford Foundation, explains why the organization decided against methadone use: We chose to provide buprenorphine (also known as suboxone) for treatment of opioid use disorders rather than methadone for a number of reasons. We found that buprenorphine was a better medication for our patient population and our goals of transitional use of MAT versus long-term medication maintenance. While methadone is very effective and useful for certain populations, most people in methadone maintenance programs commonly don't have an abstinence orientation, which can result in continued use of benzodiazepines, cocaine, alcohol, marijuana, and other drugs. This is not in keeping with our abstinence-based, Twelve Step model, and it would have been difficult to gain approval in our system for its use. Plus, the regulatory limitations with methadone are onerous, which makes buprenorphine a much easier, more convenient decision for our patients. Excerpted from Integrating the Twelve Steps with Medication-Assisted Treatment for Opioid Use Disorder: Best Practices for Professionals, a guide for administrators, clinicians, doctors, and nurses for implementing Hazelden Betty Ford Foundation's groundbreaking program, COR-12™, to treat patients with opioid use disorders in residential and outpatient addiction rehab centers.