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For methadone-maintained patients with marked QT prolongation of 500ms or more, strong consideration should be given to adopting a risk minimisation strategy, such as reducing the methadone dose, eliminating other contributing factors, transitioning the patient to an alternative treatment such as buprenorphine, or discontinuing methadone treatment. Methadone-related cardiac risk should be mentioned in the informed consent document presented to patients at intake, and patients should receive plain-language educational materials explaining this risk. Medical staff too should be educated about the risks posed by a prolonged QT interval and trained in assessing patients for risk of torsades de pointes and other cardiac problems.]