TL;DR:
- Missing a single dose of methadone or Suboxone is usually not a major issue, but it’s important to know the correct steps to take. Do not take an extra dose to “catch up.”
- The most important thing to do is to go to your clinic at your next regularly scheduled time. Our walk-in clinics make this easy.
- If you miss several days in a row, your dose may need to be lowered for safety reasons when you restart. This is a standard safety protocol to protect you.
- Life happens. Missing a dose is not a failure, and you will never be punished or shamed for it at Arrow Medical. Our only concern is your safety.
Table of Contents
- Don’t Panic: What to Do Immediately After Missing a Dose
- What Happens if You Miss One Day?
- What Happens if You Miss Several Days? (The Safety Protocol)
- Why You Should NEVER Use Street Drugs to “Cover” a Missed Dose
- Frequently Asked Questions
Life is unpredictable. You might oversleep, get stuck in traffic, feel unwell, or have an emergency come up. Whatever the reason, you may find yourself in a situation where you’ve missed your daily dose of methadone or Suboxone.
The first feeling you might have is panic, followed by shame or worry about getting in trouble at the clinic. At Arrow Medical, we want to replace that fear with clear, safe information. Missing a dose is something that can happen, and we have a process in place to get you back on track safely and without judgment. This guide explains exactly what to do.
Don’t Panic: What to Do Immediately After Missing a Dose
If you realize you’ve missed your dose for the day, follow these simple steps:
- Do NOT Take an Extra Dose: Never take two doses at once or take a dose from one of your “carries” to make up for the one you missed. This can be dangerous.
- Call Your Clinic (If You Can): If you have a moment, give your clinic a call to let them know what happened. This isn’t required, but it can be helpful.
- Go to the Clinic at Your Next Scheduled Time: The most important step is to simply return to the clinic for your next regular dose. Because all Arrow Medical clinics are walk-in, you don’t need to worry about making a special appointment. Just come in during our regular hours.
What Happens if You Miss One Day?
Methadone and Suboxone are long-acting medications. This means they stay in your system for a while.
If you miss only one dose, you will likely be fine. You might start to feel some mild withdrawal symptoms toward the end of the 48-hour period, but many people don’t notice much of a difference. When you return to the clinic the next day, you can receive your regular dose and get right back on track. It’s a simple and straightforward process.
What Happens if You Miss Several Days? (The Safety Protocol)
This is where safety becomes the top priority. If you miss four or more consecutive days of your medication, your body’s tolerance to the medication begins to decrease.
Returning to your regular, full dose after several missed days could be dangerous and might lead to over-sedation. To prevent this, clinics in Ontario follow a standard safety protocol.
What to Expect:
- You Will Need to See the Doctor: When you return to the clinic, you will need to meet with the doctor before you can get your dose.
- Your Dose Will Likely Be Reduced: The doctor will assess you and will likely restart your medication at a lower dose.
- Your Dose Will Be Gradually Increased: Over the next few days, your dose will be safely and gradually increased back up to your normal stable dose.
This is not a punishment. It is a critical safety measure designed to protect you. Our only goal is to get you back to your stable dose without any risks. This is the same reason we start new patients on a low dose during their first week on methadone.
Why You Should NEVER Use Street Drugs to “Cover” a Missed Dose
If you miss a dose and start to feel withdrawal, you might be tempted to use street drugs to feel better. This is the most dangerous thing you can do.
Your tolerance is lowered after missing even a couple of days of treatment. Using street drugs, which are contaminated with unpredictable amounts of fentanyl and now xylazine, puts you at an extremely high risk of a fatal overdose.
It is always safer to feel a bit of discomfort from withdrawal than to risk your life with street drugs. Come back to the clinic. We will get you your medication and help you feel better safely.
Frequently Asked Questions
Q: Will I be in trouble or lose my carries if I miss a dose?
Missing a single dose due to a simple life event will generally not affect your take-home privileges. However, if missing doses become a regular pattern, your doctor will want to have a conversation with you. It might be a sign that you’re struggling, and we may need to adjust your treatment plan to better support you. It’s about support, not punishment.
Q: I missed my dose and I feel really sick. What can I do?
If you feel unwell, focus on comfort measures: drink fluids, rest, and use over-the-counter pain relievers like Tylenol or Advil for body aches. Remind yourself that the feeling is temporary and you will be able to get your dose the next day. If you feel seriously ill, seek medical attention.
Q: What if the clinic is closed for a holiday and I run out of medication?
Your clinic and pharmacy will plan ahead for statutory holidays. They will typically provide you with your take-home doses in advance to cover any days the clinic is closed. Always pay attention to signs posted in the clinic about holiday hours.
At Arrow Medical, we understand that life happens. Our non-judgmental, walk-in model is designed to make it easy for you to get back on track. If you miss a dose, just come see us. Your health and safety are our only priorities.