When taken as prescribed, methadone can help reduce opioid cravings and prevent withdrawal symptoms. When misused, however, it can have deadly consequences.

Article at a Glance:

  • Methadone should only be taken orally, as directed by a physician.
  • Methadone misuse increases the risks of addiction and potentially fatal side effects.
  • Methadone is an effective treatment for opioid use disorder, but misusing it can lead to expulsion from treatment programs.

Methadone Risks

For decades, methadone has been used in replacement therapy for people who are seeking to stop using other opioids. The drug can also be used as a pain relief medication. Although methadone works effectively for pain and opioid cessation, using the drug in ways other than prescribed can lead to dependence, addiction and even overdose.

Methadone was designed to be taken orally. However, someone who uses methadone recreationally may inject, snort or smoke the drug to increase how quickly it works in the body. These delivery methods are dangerous and have led to countless overdoses (See More: Methadone Overdose).

Why You Shouldn’t Shoot Methadone Pills

Methadone is designed to be taken by mouth for the treatment of long-term pain or opioid use disorder. Injecting methadone tablets or liquid greatly increases the risk of overdose and death because too much of the drug is entering the body at one time. Intravenous drug use also increases the risk of skin and heart infections (endocarditis).

Can You Inject Methadone? Is It Safe?

Injecting any form of methadone, including liquid methadone, creates an increased risk of overdose; a methadone overdose is a medical emergency that can have fatal consequences. In addition, intravenous methadone use can lead to other serious side effects. Injecting a foreign substance like methadone into the bloodstream can introduce bacteria and other materials that damage a person’s veins, arteries, heart and lungs. An infection of the heart, called endocarditis, is common among people who abuse substances via injection.

Can You Snort and Smoke Methadone? Is It Safe?

Smoking and snorting methadone is nearly as risky as injecting it into the veins. Additives can enter the lungs or sinuses just as they would enter the bloodstream. Prolonged lung damage due to smoking the drug is a common side effect. People who regularly snort methadone may develop sinus damage, holes in the septum, nasal sores and inflammation.

Is Methadone Effective?

When used appropriately, methadone is very effective at treating opioid use disorder. It is a long-acting opioid that does not create the same amount of euphoria as other opioids. However, misuse can lead people who are struggling with opioid addiction to become addicted to methadone itself.

There is a high risk of overdose for those who use methadone recreationally, and using a non-oral delivery method increases that risk even further. In addition, if someone is caught misusing methadone, they may be expelled from their treatment program.

Methadone Pills in Replacement Therapy

When used in replacement therapy, methadone is effective as an opioid blocker due to its long duration in the body’s system. Methadone stays active for 24 to 36 hours, allowing for controlled, daily doses that help a person function without feeling cravings or withdrawal symptoms.

While the drug remains active in the system for an extended time, the pain relief effects do not last for nearly as long. This can lead to people who use methadone as a pain reliever becoming dependent on the drug and then taking more than the prescribed dose.

Despite the risks of misusing methadone, it is still an effective option for people seeking to treat opioid addiction. If you or a loved one is struggling with opioid use or addiction, methadone treatment is available at The Recovery Village. Contact us today to learn more about our full continuum of care and how it can help you begin the path to a healthier, drug-free future.

Jonathan Strum
Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
Conor Sheehy
Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Roxane Laboratories, Inc. “Dolophine Hydrochloride: Methadone Hydrochloride Tablets.” U.S. Food and Drug Administration, October 2006. Accessed August 16, 2021.

Substance Abuse and Mental Health Services Administration. “Methadone.” June 8, 2021. Accessed August 16, 2021.

Lavender, Thomas and McCarron, Brendan. “Acute infections in intravenous drug users.” Royal College of Physicians: Clinical Medicine, October 2013. Accessed August 16, 2021.

Peyrière, Hélène et. al. “Necrosis of the intranasal structures and soft palate as a result of heroin snorting: a case series.” Substance Abuse Case Reports, 2013. Accessed August 16, 2021.

U.S. National Library of Medicine. “Endocarditis.” MedlinePlus, August 5, 2021. Accessed August 16, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.