Bradbury believes methadone blood levels should be used routinely, bringing respectability to methadone dosing practices just as with other medications. "You wouldn't give somebody insulin and say, 'Let me know when the dose feels OK."'[6] Byrne compared methadone dosing to lithium, digoxin, and anticonvulsant therapy where blood levels are critical for clinical management. [7]

As for the economics of blood level testing, Byrne indicates that the test is relatively inexpensive compared to the "cost" of giving someone inadequate doses of a drug for months or years. "Unfortunately," he says, "the doctor who is disinclined to order a test may also be disinclined to order a higher dose. Patients should never be denied the right dose because of a doctor's ignorance, bias, or prejudice."[6]

At the same time, Byrne cautions, "We must never make the mistake of treating the test but ignoring the patient." Still, as the limited research on blood level testing demonstrates, there is no way of prescribing a single best dose to achieve a specific blood level as a "gold standard" for all patients. Providing effective treatment and comfort for patients by making flexible dosing decisions supported by appropriate laboratory procedures can be crucial. This also supports the premise that setting methadone doses by policy or regulation alone is simply not good science.