One of the most common concerns I hear from people considering medication-assisted treatment is this: If I start the program, will I still be able to work?

It is a fair question. And the honest answer is yes, in most cases. But there are details worth understanding before you make that decision.

I am Dr. Okechukwu Obua, Chief Medical Officer at CORAS Wellness. I have spent over 17 years practicing addiction medicine, and a large portion of my patients are employed or actively looking for work when they start treatment. Here is what I tell them.

If you are still deciding between medications, our guide to methadone vs. Suboxone covers how we choose the right fit for each patient.

Our Clinics Open at 5 AM for a Reason

CORAS Wellness clinics open at 5:00 in the morning. That is not an accident.

We have patients who are working, who are stable, who have construction jobs that start at 6:00 AM. They come by at 5:00, get their medication, and go straight to work. The program does not have to disrupt employment.

For many patients, the daily clinic visit is actually less disruptive than the time they were spending managing active addiction. When you are not using, you are not spending hours every day finding drugs, recovering from them, or dealing with the consequences.

How Quickly Can You Earn Take-Home Doses?

In the past, earning take-home privileges under federal guidelines required meeting eight criteria over many months. The first three months, you would receive weekend take-homes only. The next three months, two more. After a full year, you might qualify for six take-homes per week.

That structure made sense in a different era of opioid treatment. But it created real problems for people trying to hold down a job.

The Substance Abuse and Mental Health Services Administration has updated its guidelines, and we now have much more flexibility. Under current SAMHSA guidance, patients who are testing negative and attending consistently can begin receiving take-home doses within a week or two of starting treatment. That means far fewer required clinic visits much earlier in the process.

This matters because the patient does not have to pay for transportation to come every day, and they can get a job quicker. We have not seen bad outcomes from this approach. The evidence supports it.

Does Methadone Affect Your Ability to Work?

This is where I want to be straightforward with you, because there is a real answer and a nuanced one.

The common standard in addiction medicine is that methadone at therapeutic doses should not impair a patient’s ability to carry on activities of daily living. That includes working.

When a patient is stable on their dose, meaning they are not sedated, not impaired, functioning normally, they should be able to do any job assigned to them.

I have patients in construction, in healthcare, in transportation. They are working and they are stable.

That said, there are a few specific situations worth knowing about.

The First Few Days of Treatment

During induction, when we are still finding your correct dose, you may not know exactly how you will feel on methadone. I would not expect a patient to start cleaning high-rise windows on day one. Give yourself a few days to stabilize before taking on high-risk physical work.

Commercial Driver’s Licenses

Federal law includes a specific restriction: patients on methadone treatment are not permitted to drive commercial motor vehicles. If you hold a CDL and are starting MAT, this is something to discuss with your treatment team before you begin.

Workplace Drug Testing

Here is something many patients do not know: standard workplace drug tests typically do not include methadone. The regular drug screen used by most employers in the United States does not include methadone in its panel. It will not show up.

For employers that use more comprehensive testing, the process is handled through a Medical Review Officer. If a result comes back that requires explanation, the MRO contacts the physician of record. I would receive a letter asking whether I am prescribing methadone for that patient. If I confirm that I am, the result is recorded as negative for workplace purposes.

In more than 17 years of practice, I have not seen a patient lose their job because of methadone treatment.

A Note on Patient Honesty with Employers

You are not required to tell your employer that you are in a methadone program. Your treatment is protected health information under federal law.

If you choose to disclose, that is your decision. But many patients keep this private, maintain their employment without issue, and their employer never knows.

Frequently Asked Questions

Will methadone show up on my job’s drug test?

In most cases, no. Standard workplace drug panels do not include methadone. If your employer uses extended testing, a Medical Review Officer handles any follow-up, and a confirmed prescription resolves the result without affecting your employment record.

Can I drive to work while on methadone?

Yes, for personal vehicles. Federal regulations prohibit patients on methadone from operating commercial motor vehicles (CDL-required jobs). For all other driving, there is no federal restriction. Talk to your doctor about your individual situation during the stabilization period.

How early are CORAS clinics open?

ORAS Wellness clinics in Newark, Dover, Millsboro, and Harrington open at 5:00 AM to accommodate patients who work early shifts.

How long will I have to come to the clinic every day?

Under current SAMHSA guidelines, patients who are testing negative and attending consistently can begin receiving take-home doses within one to two weeks. Daily visits are not a permanent requirement.

Does methadone affect job performance?

At therapeutic doses, methadone should not impair your ability to work. Patients who are stable on their dose function normally. There is a short adjustment period at the start of treatment while your dose is being set.

What if my probation officer or the courts are involved?

Some probation officers recommend specific medications. If you receive a recommendation that does not match what your physician considers medically appropriate for you, your doctor can communicate directly with the probation office. Medical decisions belong with the treating physician, not the court system.

Does counseling still happen if I am working?

Yes. Counseling is a required part of the MAT program and is scheduled around your availability. To understand why it matters, read our article on why counseling matters in opioid addiction treatment.

Ready to Start Treatment?

If you or someone you love is struggling with opioid use disorder, CORAS Wellness is here to help. Our MAT program is available at five locations across Delaware, with early morning hours designed to fit around your life.

Call us at 833-886-2277 or visit coraswellness.org/contact to speak with a treatment consultant. Same-day intake appointments are available.

About the Author

Dr. Okechukwu Ernest Obua serves as Chief Medical Officer at CORAS Wellness & Behavioral Health, where he oversees medical care for all patients across the organization’s methadone, detox, and rehabilitation programs. Dr. Obua trained in family medicine at Henry Ford Hospital in Detroit, where he developed a deep interest in addiction medicine after witnessing the confusion and inconsistency in how opioid prescriptions were handled. Since completing his residency in 2009, Dr. Obua has practiced addiction medicine exclusively, specializing in running methadone clinics as a medical director.

Dr. Obua holds the following board certifications and credentials:

• Diplomate, American Board of Family Medicine
• Diplomate, American Board of Addiction Medicine
• Diplomate, American Board of Preventive Medicine (Addiction)
• Fellow, American Society of Addiction Medicine

He attends the annual ASAM conference to stay current on new developments in substance use disorder treatment and evidence-based practices.