Methadone is a synthetic opioid drug developed in Germany in WWII as an analgesic. Today it is most commonly used to treat dependence (addiction) of other opiates, for example codeine, oxycodone, hydromorphone, meperidine, morphine and heroin. Its benefit in addiction treatment was first discovered in the 1960’s but the use has become more widespread since the 1990’s. It is not useful in treating an addiction to cocaine, methamphetamine, MDMA (ecstasy), benzodiazepines (valium and others), marijuana or alcohol.
Methadone is effective in
reducing the craving to use opiates and the symptoms of opiate withdrawal. Patients
get a chance to get their lives back on track because they no longer have to
spend considerable time and resources to locate drugs. They now have an opportunity
to separate themselves from the people and environments that promote drug use
and other harmful activities. Methadone can be effective whether you inject,
snort or swallow opiates. Several scientific studies have proven that addicts
on a methadone program are less likely to have legal or medical problems and
are more likely to hold down a job, stay in school and keep their family together.
Only specially licensed physicians are able to prescribe methadone for Methadone
Maintenance Treatment (MMT). Each patient may only be registered with one methadone
clinic.
How is methadone taken?
Methadone is prepared in a liquid (usually orange drink) and taken once a day. Initially patients must go to a pharmacy every day to get their dose. The pharmacist will witness the doses being taken. As they progress in the treatment program they may be allowed to take doses home to take on their own. Likewise, initially they attend clinic twice per week. As they progress they attend clinic less often.
Effects and side effects
Euphoria (feeling high) or sedation is possible if too high a dose of methadone is taken. Typically patients feel no effect except a decreased need for opiates - a low dose is started for safety reasons. During the stabilization phase some patients experience withdrawal and may decide to continue using to prevent these symptoms. Once stabilized patients do not get “high” and they do not suffer withdrawal or craving for opiates. Patients usually do not get high if they take other opiates because methadone maintenance blocks the euphoric effects of these drugs – this helps to decrease the desire to use opiates.
Methadone is useful to prevent withdrawal because it has a long duration of action. For most people a single dose prevents withdrawal for 24 hours. By slowly decreasing the dose over months patients can become opiate free without having to go through withdrawal. Patients that are compliant with their treatment contract are never forced to go off MMT – some stay on indefinitely.
Most people get some side effects. Most common are constipation (typical of all opiates), sweating and weight gain (due to better health and appetite), and libido changes (increased or decreased).
Taken as directed, methadone is very safe and does not cause long-term damage to organs, even after several years. However, it is a powerful drug and a typical dose for an addict can be fatal to someone that has not developed tolerance.
Will I become addicted to Methadone
Patients taking methadone
do become physically dependent on it – stopping it will cause the uncomfortable
physical symptoms of withdrawal. However, by definition these patients are not
addicted to methadone - addiction involves not only a physical need for the
drug (dependence) but several undesirable behaviors that a person develops to
help them get the drug. These behaviors might include spending money that should
go to your children, lying to your loved ones about where you are going, missing
work, breaking the law, avoiding your friends and family etc. Patients on MMT
have a steady supply of medication which blocks the need and desire for opiates
therefore the patient has no reason to continue with these behaviors –
many of which the patient is ashamed of or otherwise wants to stop. Patients
start to reform the self respect they have lost as a result of the addiction.
They are free at any time to stop the MMT if they want to or to slowly decrease
their dose of methadone which is the recommended approach as it is a more successful
method of staying totally off opiates. Many scientific studies have shown that
Methadone Maintenance remains the most successful treatment currently available
for opiate addiction.