Methadone Prescribing Patterns at a Single Institution: A Retrospective Study and Clinical Implications

Background

Methadone is a long-acting opioid utilized in the management of chronic pain and opioid dependency. Given its unique pharmacokinetics and potential for both therapeutic benefit and risk, understanding prescribing patterns is essential. This study aimed to evaluate methadone utilization at a single academic university over a one-year period as well as discuss important considerations of methadone pharmacology.

Methods

A retrospective review was conducted using electronic medical records to assess the number of methadone prescriptions issued across the institution between January 1, 2024, and December 31, 2024. The total number of prescriptions was analyzed and categorized into four quarters. In Q1 (January–March), 96 prescriptions were issued, followed by 109 in Q2 (April–June), 120 in Q3 (July–September), and 145 in Q4 (October–December).

Results

A total of 470 methadone prescriptions were issued during the study period, demonstrating a steady increase over the year. The percentage increase in methadone prescriptions from Q1 to Q4 was approximately 51%. Notably, this analysis did not differentiate between prescriptions for chronic pain versus opioid dependency treatment. The rise likely reflects prescribing for pain management, as methadone for OUD is typically dispensed through regulated clinics not captured in this data. However, some prescriptions may reflect dual management by addiction medicine providers within our institution.

Conclusions

This study highlights a consistent rise in methadone prescriptions at this particular institution, underscoring the need for further investigation into prescribing patterns, patient demographics, and clinical indications. Future research should stratify prescriptions by primary indication to better understand the drivers of methadone utilization and its impact on patient outcomes.