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Methadone TabletsCareFirst (Caremark)

Detoxification treatment of opioid addiction (heroin or other morphine-like drugs)

Initial criteria

  • Reserve for use only in patients for whom alternative analgesic treatment options (non-opioid analgesics or opioid combination products or immediate-release opioid analgesics) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain
  • Not indicated as an as-needed (prn) analgesic
  • For detoxification or maintenance treatment of opioid addiction, must comply with conditions for distribution and use required under 42 CFR 8.12