10 Methadone Facts

  1. Where does methadone come from?

Methadone was created by chemists in Germany in WWII. Its intention was to take the place of the scarcely available morphine to work as a painkiller. It was offered as a pain medication for surgical and cancer patients in the U.S. in 1947. It was known as Dolophine at the time. In 1950, it was first used for short-term use to minimize withdrawal symptoms by addicts of heroin and morphine.

  1. How is it different than morphine?

Morphine subdues pain for an average of 5-6 hours whereas methadone subdues pain for up to 24 hours.

  1. How should one take methadone if prescribed it for treatment?

Methadone is most effective when taken orally and the effects last 24-36 hours – It is as strong as morphine.  Methadone (white or orange tablets) and methadose (liquid suspension) are equally effective at equal doses.  Only the “binder,” the “stuff” which the active medication is added to and held together with, differs.  Preference for one form over the other is merely a matter of personal preference and experience and has no basis in pharmacology.

  1. How does methadone affect the body as an opiate?

It’s an addictive central nervous system depressant.  It produces analgesia or insensitivity to pain, sedation, slowing of respiration, lowering of blood pressure, constipation, slowing of pulse, and nausea.  The subjective effects following single doses in non-addicted individuals are similar to those noted after morphine or heroin use, feelings of well-being, drowsiness, and euphoria.

  1. How does one build up a tolerance to methadone to be used as treatment?

Tolerance (the body’s ability to develop counteracting and re-stabilizing effects) develops to the pain killing, nauseating, sedative, euphoric, respiratory, and cardiovascular effects.  However, no tolerance develops to the drug’s ability to stave off withdrawal symptoms.  Therefore, once an addict is stabilized on methadone he or she can function normally – physically and psychologically – without requiring more and more doses to eliminate withdrawal symptoms and remain physiologically “comfortable.”  This occurs regardless of the stabilizing dose (the dose required to suppress withdrawal symptoms and the dose the patient is equivalently tolerant to in illicit opiates).  In some patients, and at higher doses, methadone may help decrease anxiety although it is not effective as a potent mood elevator.

  1. What are common side effects of methadone?

Weight gain, constipation, increased intake of fluids, increased frequency of urination, tingling in the hands and feet, increased sweating, skin rash, nausea, and delayed ejaculation.  However, the symptoms may be slight and temporary.

  1. How does the body absorb methadone?

Methadone is administered orally and gradually absorbed into the system through the intestines and liver.  From the liver it is released slowly into the patient’s blood stream.  This slow release into the blood stream keeps maintenance patients from experiencing a rapid narcotic high and keeps them above the blood level for experiencing intense withdrawal symptoms.  Methadone can also chemically block the craving for heroin even though it does not produce or mimic heroin’s warm, euphoric “rush”.  At doses greater than available in illicit opiates, it produces a “blocking effect” to the high of the illicit opiate.  This means that if an addict uses heroin while in methadone treatment, he or she will experience little to no effect from the heroin.  However, methadone does not block the intoxicating effects of non-opiate drugs (sedatives, tranquilizers, stimulants, alcohol, etc.).  That is why some patients may die of an overdose.  Most overdoses occur when addicts in treatment supplement their prescribed methadone with other central nervous system depressants.  Particularly dangerous when used in combination with methadone are placidyl, valium, methaqualone, illicit methadone, and large amounts of alcohol.

  1. What happens if a patient abruptly stops taking methadone for treatment?

The character and severity of withdrawal symptoms that appear when a narcotic is discontinued depends upon many factors, particularly what the drug is, the dose he or she is given, duration of use, interval between doses, health, personality, and expectations and motivations of the patient.  The symptoms of abrupt withdrawal from methadone (complete discontinuation of the drug) are insomnia, anxiety, hypertension, irritability, chills, excessive perspiration, “runny” nose and eyes, enlarged pupils, sore and aching joints, muscle spasms, abdominal cramps, nausea, and diarrhea.  Symptoms appear 24-48 hours after the last dose and most major symptoms are minimal by the 14th day.  However, general discomfort, loss of appetite, and insomnia may persist for as long as six months.  These symptoms can be drastically reduced and often eliminated by withdrawing the patient according to a slow deliberate schedule of dose decreases managed by a physician.  The longer the process – the less the symptomology.

  1. Can methadone be used short-term or long-term as treatment?

Methadone maintenance is a long-term treatment for opiate addiction.  The patient must regularly visit the clinic and receive his/her daily medication.  Many patients lead normal, productive lives by working, caring for their families and enjoying an active, healthy lifestyle.  According to a federal 15 year follow-up study, methadone does not cause any physical deterioration even after 15 years of use or more.  Since methadone programs are voluntary, the length of time a patient remains in treatment depends greatly upon the patient.  Studies show that patients are more apt to stay in treatment for relatively longer periods of time if they are over 30 years old, married, have dependent children, and have spent time in jail during their addiction to heroin.  All these factors tend to strengthen the patient’s determination to overcome his or her heroin problem and become a more productive, social being.

  1. Can methadone cure opiate addiction?

Methadone is not a cure for opiate addiction.  It is a pharmacologic tool which suppresses withdrawal symptoms, lessens the craving for heroin and coupled with therapy facilitates those interpersonal interactions involved in strengthening motivation, changing lifestyles and breaking the cycle of life patterns and stress reactions which underlie relapse.

This entry was posted in Blog. Bookmark the permalink.