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METHADONE ADDICTION

photo of prescription bottle of methadone oral solution

First introduced in 1947 in the United States, methadone is a widely prescribed opiate and narcotic for the management of chronic pain that can unfortunately also lead to methadone addiction. Although it is sometimes administered intravenously in a hospital setting, most methadone is prescribed in pill form for oral use. In addition to its use for pain management, methadone is also used as a replacement therapy for heroin addiction and as a detox medication for withdrawal from other opiates. [1]

Methadone’s Use in Detox and Heroin Replacement Therapy

Because methadone is a very long-acting opioid and does not produce as much euphoria (a sense of elation) as other opiates, it is a good medication for long-term maintenance therapy as well as for opiate detoxification. Used in this way, methadone can reduce withdrawal symptoms from those attempting to quit drugs such as heroin, potentially making success more achievable. However, because methadone is still an opiate as well, individuals can become addicted to it in much the same way as their previous opiate of choice. Many substance abuse professionals see this as “trading one poison for another,” rather than genuinely treating the core addiction. These professionals view this approach as a sort of Faustian bargain where methadone addiction is the end result, instead of sobriety.

Why Prescribe Methadone?

One other benefit of using methadone for inpatient opiate detox and for opiate maintenance therapy is that it has a very strong affinity (attraction) for opiate receptors in the brain. This means that if a person who is receiving methadone maintenance therapy uses a different opiate (oxys, morphine, heroin, hydrocodone), in conjunction with the methadone, the methadone will most likely displace the other opiate from the receptor, preventing an extreme “high.” Although this effect is seen as a positive by those prescribing methadone, it can also have an unintended consequence. Individuals who develop a methadone addiction may feel that they have all the drawbacks of addiction without getting the “benefits” of a high from the experience, causing them to switch back to other drugs such as heroin.

Pregnant Women and Methadone Prescription

For those women who are addicted to opiates, methadone has often been used for maintenance until delivery, at which point both the mother and child undergo drug detox. It is recommended that opiate-addicted pregnant women not undergo detox, but be maintained on another opioid like methadone or buprenorphine (Subutex) because of the risk of miscarriage. However, after giving birth, the new mother need to begin drug treatment immediately or risk a range of problems related to methadone addiction. [2]

Methadone Diversion and Street Sales

When so many former “street drug” addicts have access to methadone, it is no surprise when they begin to trade or sell the pills on the street to their former dealers. This may be done to gain access to their old drugs of choice or simply for monetary reasons. However, this behavior then creates a new avenue for individuals to acquire methadone from drug dealers within their communities. Individuals who buy methadone in this way may be seeking to fight off withdrawal symptoms from other drugs or simply looking to maintain a methadone addiction that was acquired in a medical environment that has since ceased to provide the pills entirely or in the greater amount that their building tolerance makes necessary. This methadone carries with it the added risk of adulteration with other dangerous substances such as the increasingly available fentanyl, whose potency makes it a constant risk for deadly overdose.

Side Effects of Methadone Use

The side-effects of methadone are similar to that of other opioids and include nausea, vomiting, constipation, sedation, and respiratory and cardiac suppression. One important note is that anyone beginning on methadone therapy will likely have an EKG pre- and post-treatment. This is because methadone has the side-effect of changing the heart’s electrical impulses, which can change the cardiac rhythm and lead to a full arrest.

Heroin Addiction Withdrawal Symptoms

  • Restlessness
  • Vomiting
  • Nausea
  • Slowed breathing
  • Itchy skin
  • Pupil contraction
  • Severe sweating
  • Constipation
  • Sexual Dysfunction
  • Death

The Threat of Overdose

Although methadone overdose is less common than overdose from other opiates, it can still occur. And, due to the nature of the drug, it can often have its own unique issues. Oftentimes, an overdose on methadone can occur rapidly and go unnoticed, as the slowed respirations and heart rate may not be recognized by the user. Although the user may be experiencing an opiate overdose, he/she may remain awake and not recognize the symptoms of an impending overdose until full collapse. Because of this, methadone carries with it very specific dosing and monitoring guidelines. Methadone should always be titrated up in dosage, starting with a low dose and gradually increasing it. This allows the prescriber to closely monitor the patient for effectiveness as well as any signs of overdose. It goes without saying that “street” use of methadone does not have any of these safeguards in place.

Methadone Addiction Withdrawal

Methadone addiction may not progress as quickly as that of other prescription pain pill addictions, but it is certainly a severe addiction because of the long-acting nature of methadone. Because of this, the detoxification from considerable amounts of methadone may take weeks or even months. For anyone seeking to overcome a methadone addiction, the only safe course of action is to contact an inpatient or residential drug detox and seek professional advice. Usually after the opiate detox, additional drug rehab treatment will be recommended.

Methadone Addiction Detox

For those who are addicted to methadone, it is critical that they be tapered down to a low level, such as less than 60 mg per day of methadone before entering an inpatient or residential drug detox. The same applies to those who are on methadone maintenance and wish to be completely detoxified. This is because the maximum dose that can be given, by law, in a drug treatment center is 30 mg in a single dose and an additional 10 mg on a given day, when required. That being said, some addicts and methadone maintenance patients are on upwards of 240 mg per day. The dosage span between 40 mg and 240 mg, for example, is too great and the symptoms will be intolerable and potentially lead to medical complications.

Methadone Addiction Treatment

After detox is complete, a methadone addict or former methadone maintenance patient needs to seek treatment in a drug rehab immediately or risk relapsing into methadone addiction or addiction to another opiate such as heroin. For the best chance of long-term success, a residential rehab such as Behavioral Wellness and Recovery is highly recommended. At BWR, the patient will be monitored 24 hours a day, 7 days a week and receive intensive therapy and life skills training. In addition, physically (and psychologically) removing the addict from his/her environment is oftentimes key to establishing long-term recovery.

photo of medical doctor reviewing chart with detox nurse

Get Off the Methadone Treadmill Today

If you or a loved one are tired running in place on the treadmill of daily methadone usage, there is hope to kick your methadone addiction, once and for all. It all starts with a call to BWR at 800-683-4457. Our operators are on-call 24/7 to help you get the help you need.

Sources:

[1] Center for Substance Abuse Research, http://www.cesar.umd.edu/cesar/drugs/methadone.asp
[2] The Canadian Journal of Hospital Pharmacy, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477836/
[3] Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/data/sites/default/files/report_2724/ShortReport-2724.html

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