When a patient begins a comprehensive narcotic treatment program, what must the first day's dose of methadone generally not exceed?

The starting dose for a patient beginning a comprehensive narcotic treatment program with methadone is typically set at a maximum of 40 mg on the first day. This limit is established based on guidelines that aim to ensure patient safety by minimizing the risk of overdose. Methadone is a long-acting opioid, and initial doses that are too high may lead to respiratory depression and other serious complications.

Although higher dosages may be appropriate in subsequent days after careful assessment of the patient's response to treatment, the initial 40 mg cap helps to establish a baseline for tolerance and individual response without overwhelming the patient’s system. The practice emphasizes caution, particularly since many patients may have varying levels of opioid dependence and tolerance. This standard is supported by recommendations from authorities in addiction treatment to ensure that patients are initiated onto methadone in a manner that promotes safety and effectively manages their withdrawal symptoms.