In the US, at the clinic I attended for 10 years in California, they did random UA's and tested for the presence of Methadone, as well as about 10-12 other drugs.
They test for three reasons - to assure that the patient that has take homes doses isn't diverting their meds, to see if the patient is a fast metabolizer, and of course to determine if the patient is using other drugs.
When I was on a lower dose, I would often have UA results come back with "No Methadone metabolites detected" but the Dr. and staff knew that I was a fast metabolizer and on a low dose, so it wasn't an issue.
The "fast metabolizer" was determined by a "Peak and Trough" test where they test your blood level for Methadone before you dose and then 2-3 hours after you dose.
My pre-dose blood test showed very low levels of Methadone, so once I earned my "take homes" I would split my doses - half in the AM and the other half in the PM
And my clinic did do "observed" UA's during the first year or so, at random, to assure I was giving the UA sample and not using someone else's piss.
They also check the temperature of the sample as well.
And they differentiate between Methadone and Methamphetamine.
Your UA is sent to a lab for testing, and they test for just about everything, including Methadone.
The Methadone clinic knows every trick in the book as they have been dealing with thousands of clients over many years trying to game the system in one way or another, including UA's.
Until you've built up a few years of trust with squeaky clean UA's, strict adherence to clinic rules, etc...then you can get enough take homes so you only need to visit the clinic once a week or in some states, once a month.
If you're on maintenance and your still using opiates or other drugs, you'll eventually piss dirty or if you get caught using someone else's piss, they will never trust you after that and getting take homes will be unlikely and they'll revoke any you may have.
And any issue that comes up, you'll never get the benefit of the doubt.
They just assume all addicts are liars, especially if you piss dirty, fail to give a UA, or worse, use someone else's urine.
Just another reason why I'm on Subutex these days as my MMT clinic won't even allow me to take Ambien for sleep issues.
If you're on MMT, either play by their rules, or get on Subs (You'll still be UA'd on Subs) but many Sub Dr.'s will allow you to take other prescribed meds if needed if they are not harmful in combination with Subs.
My Sub Dr. prescribes me 2 x 10 mg. Ambien per night, while my Methadone clinic strictly forbade the use of Ambien and threatened to kick me out of the clinic if I continued to use it, even with low doses of Methadone, as most Methadone deaths are caused by a combination of Methadone and other drugs.
Usually Benzo's.
I heard someone from my clinic OD'd on Methadone and Benzo's, so they became super-strict about people using other drugs in combination with Methadone, but most clinics are like that anyway.
