Methadone
meth · green · mixture
What does current UK evidence show?
ONS recorded 584 England and Wales registrations mentioning methadone in 2025, down from 676 in 2024. Methadone was implicated in 338 Scottish drug use deaths in 2025, down over the latest year and from its 2020 peak. It remains prominent in opioid mortality data, but death-certificate mentions do not distinguish prescribed treatment from all other circumstances of exposure.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Opioids · Medicines
- Common names
- meth, green, mixture
- Typical forms
- In UK opioid treatment, principally an oral liquid; tablets and injectable medical formulations also exist for specific indications
- Routes
- In treatment, principally swallowed as an oral medicine
- UK legal classification
- Class ASchedule 2 medicine under the Misuse of Drugs Regulations 2001.Check government source ↗
- Concise pharmacology
- Methadone is a long-acting full mu-opioid receptor agonist. Appropriately prescribed opioid substitution treatment can reduce illicit opioid use and mortality.
Main harms
Concise clinical and polydrug picture
Reduced consciousness and slowed or stopped breathing are the principal overdose risks.
Physical dependence is expected in continuing treatment and is not the same as addiction. Constipation, endocrine and cardiac effects require monitoring; retaining people in effective treatment is protective.
Abrupt interruption can cause prolonged opioid withdrawal and loss of treatment protection; changes in treatment should be clinically planned.
Benzodiazepines, alcohol, gabapentinoids and other sedatives increase respiratory-depression risk.
Unmeasured doses, reduced tolerance, diversion and use outside the prescribed route increase overdose risk. Injecting adds infection and vein-damage risks.
Current intelligence status
Assessment, confidence and direction
ONS recorded 584 England and Wales registrations mentioning methadone in 2025, down from 676 in 2024. Methadone was implicated in 338 Scottish drug use deaths in 2025, down over the latest year and from its 2020 peak. It remains prominent in opioid mortality data, but death-certificate mentions do not distinguish prescribed treatment from all other circumstances of exposure.
Reason: Direct official statistics or confirmed analytical evidence support the defined signal. Interpretation remains limited to each source’s geography, period and method.
Principal source limits: NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant. Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation.
Geography and reference periods are given in each linked source card below. The rating is an editorial evidence judgement, not a probability, clinical risk score or TD priority.The assessment reflects the latest linked evidence and is not a universal severity rating.
Operational implications
Evidence-supported prompts for professional response
Preserve treatment access and continuity while reviewing take-home safety, tolerance change and sedative combinations.
Record substance, sold identity, route, frequency and combinations; review overdose and withdrawal needs.
Prioritise airway and breathing, give naloxone for suspected opioid overdose and continue supportive care.
Triangulate treatment, mortality, testing, hospital and frontline evidence before assigning a local trend.
Related intelligence
Continue into connected platform evidence
Sources & limitations
Direct evidence links, reference periods and status
Drug-related deaths in Scotland, 2025
Published23 Sep 2026Reference period2025 registrations
NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant.Deaths related to drug poisoning in England and Wales: 2025 registrations
Published4 Nov 2026Reference period2025 registrations; 2024 occurrences
Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation.Adult substance misuse treatment statistics
Published04 Dec 2025Reference periodEngland · 2024–25
Treatment contact reflects recorded service need and access in England, not population prevalence.Oral methadone and buprenorphine recommendations
Published27 Dec 2024Reference periodEngland · opioid substitution treatment
Treatment benefits and individual medicine choice require assessment; death mentions do not identify prescribing circumstances.