For years, people have used methadone to end their heroin use, particularly those who have relapsed repeatedly when attempting to quit the drug. Users who participate in medication-assisted programs have reported optimal results after receiving methadone maintenance in addition to counseling and support.
Methadone has been used to treat heroin addiction in the U.S. for more than 40 years, according to the National Institute on Drug Abuse (NIDA), which says the drug has the following benefits:
- Blocks opioid cravings that are a major factor in relapse
- Suppresses opioid withdrawal symptoms for 24 to 36 hours
- Blocks the effects of heroin use
- Does not cause users to feel euphoria, intoxication, or sedation
Though buprenorphine is slowly becoming the primary treatment approach for people who want to end opioid dependence and addiction, some health care professionals still use methadone to taper opiate users off the drugs they have been using gradually. This method allows the body time to recover from long-term opiate use without the potency of stronger opioids, such as codeine, heroin, and oxycodone (OxyContin).
Methadone is also used to treat people who manage pain from a chronic illness as well as those who have had surgery or sustained an injury. It can linger in the body anywhere from 24 to 36 hours, which can offer relief around the clock for some users. Even so, the safety of using methadone for pain-based ailments is a topic of debate. Past data show that methadone was involved in nearly a third of deaths linked to prescription drug overdoses, making some medical professionals highly cautious about prescribing it.
George D. Comerci Jr., MD, FACP, told the ACP Internist that methadone is probably most appropriate to treat neuropathic pain because it blocks the opioid mu receptor and the NMDA receptor,” which is often activated in chronic neuropathic pain,” the health site writes.
It goes on to say, “Methadone should not be used to treat pain conditions such as fibromyalgia, chronic migraine, or chronic tension headache, and other pain conditions best treated with adjuvant medications.” Also, according to the site, physicians are advised to monitor the patient’s chronic pain to see if methadone treatment is actually helping to alleviate it.
Methadone use is managed and monitored in a controlled setting when administered by a medical professional. However, because the medication is a full opioid agonist, it is highly addictive and dangerous when misused and abused.
What is Methadone and What Does It Do?
Methadone is a synthetic (manmade) opioid medication that changes how the brain and body respond to pain. This is why users feel relief after taking it. World War II-era chemists in Germany created the drug in response to the country’s shortage of opium. But research on the drug was halted upon the realization that it had potentially dangerous side effects.
Once the United States Department of Commerce got a hold of the research, it determined that the studies had value, and commercial use eventually followed. The U.S. pharmaceutical company Eli-Lilly began making methadone under the brand name Dolophine in the late 1940s.
The medication is legally available in only two ways. Users either have to a) visit a certified methadone center that requires a daily visit to receive a therapeutic dose, or b) be given a take-home dose that is scheduled to last one day or one week before they can visit the center for another dose. Users who take the medication at home must first meet strict federal eligibility criteria before they can take maintenance medication at home.
How Does Methadone Work?
According to WebMD, methadone works similarly to morphine, a more potent drug in the opioid class of medications. It can be taken as an oral tablet, a liquid, or a wafer once a day for 12 months at a minimum, though some people may need it for longer than a year.
“Even if a patient feels that they are ready to stop methadone treatment, it must be stopped gradually to prevent withdrawal. Such a decision should be supervised by a doctor,” SAMHSA writes.
The dosing of the medication will vary according to the patient, and a doctor will determine how long a person will receive methadone treatment.
When taken orally, a person can begin to feel the effects of methadone within 30 minutes to an hour after one dose. According to the Substance Abuse and Mental Health Administration (SAMHSA), one dose offers pain relief for four to eight hours.
However, it can take anywhere between eight and 59 hours for the drug to fully clear from one’s system, according to the U.S. Food and Drug Administration (FDA). This makes it easy to take more of the drug than directed, a practice that can be habit-forming. It is very possible for people to take more methadone when they feel the pain relief fade without realizing their bodies haven’t cleared the first dose.
Though methadone’s effects are milder than some other opioids, the body can adapt to regular use. If you or someone you know is taking more methadone to experience the same initial results, than that indicates that your tolerance is higher, which could mean you’ll use more of the drug than you should. There are short- and long-term effects of methadone use to watch for.
As with most drugs, the effects of methadone use vary depending on factors that are unique to each person, such as how much of the drug is taken, how it is consumed, and how long it has been used. Short-term effects of methadone include:
- Pain relief
- Relaxed feelings
Methadone users can also experience physical side effects from methadone use. These include:
- Chest pain
- Pupil contraction
- Itchy skin
- Shallow or slowed breathing
- Severe sweating
- Sexual dysfunction
SAMHSA writes that a rapid or pounding heartbeat is a side effect of methadone use as well as hives or a rash, and swelling of the face, lips, tongue, or throat. Users may also feel lightheaded or faint, or they may experience hallucinations or confusion.
Regular and prolonged use of methadone can harm the body. WebMD writes that using methadone for a long time can lead to lung and breathing problems. Women users may notice a change in their menstrual cycles, and using it while pregnant can lead to complications.
Drugs.com reports that repeated dosing can cause methadone to build up in the liver, which releases the drug slowly over time. Such a buildup can increase the drug’s potency and prolong the duration of its potential toxicity, it says.
According to the results of one study, rats used in research on the effects of long-term methadone use found that the animals had a reduced attention span when they had methadone in their bodies as well as after they had excreted the drug from their system. While the results needed further analysis before conclusions could be made, they suggested that the longtime methadone use may affect users’ mental functions as well as learning capacity and memory.
Methadone Misuse Can Lead to Overdose
Taking more methadone than prescribed is only one way to misuse or abuse the drug. Some people also ingest other substances when using it, a practice known as polydrug use or polydrug abuse. People who engage in this practice may use other opioid pain relievers, such as oxycodone (OxyContin), hydrocodone (Vicodin), or morphine.
Some people also seek out alcohol, another central nervous system depressant, to intensify the effects of the opioid drugs they are withdrawing from. This is a dangerous combination that can result in loss of consciousness, coma, or death.
Methadone overdoses have increased in past years, according to data reported from the U.S. Centers for Disease Control and Prevention (CDC). In a July 2012 report, it shared that more than 30 percent of overdose deaths linked to prescription pain relievers involved methadone, “even though only 2 percent of painkiller prescriptions are for this drug. Six times as many people died of methadone overdoses in 2009 than a decade before.”
According to the agency, pain prescriptions for methadone increased, with more than 4 million written for patients in 2009 alone. Illegally sold prescriptions for the drug as well as people using the medication for nonmedical reasons also contributed to the increase in overdose deaths.
It is important to keep in mind that methadone takes considerable time to clear the body, which is one reason it is recommended that users do not take more than directed. Also, the window between a therapeutic dose and a dangerous one is small. Ingesting more methadone than the body can handle sets the stage for an overdose, which can result in injury or death.
Signs of methadone overdose, per WebMD, include:
- Cold, clammy skin
- Severe drowsiness
- Slow breathing
- Slow heart rate
- Small pupils
- Weak muscles
If you suspect someone has overdosed on methadone, call 911 for immediate medical help. With slow or stopped breathing, the person is at risk of suffering from oxygen deprivation, which can harm the brain and body, and result in death.
Once emergency responders arrive on the scene, they may administer several doses of naloxone, the overdose reversal medication, as well as other medical attention. Stay with the person until medical help arrives and try to have as much information about the person and how much of the drug they took as well as any other substances taken so that professionals know how to best help the person.
Addiction Treatment is Available
Taking methadone at doses that are too high can result in dependence and addiction. In a hospital or other medical facility, methadone users are monitored while receiving the medication, and their dosage is adjusted as needed by medical professionals.
However, outside of a controlled setting, methadone users are at high risk of taking too much of the drug, sometimes without realizing it.
Methadone does not bring with it the euphoric high that is experienced with other opiates, so users increase their use and risk overdosing on the drug, which can lead to death.
If you or someone you know has been misusing methadone, it is time to get help at a professional facility that specializes in addiction treatment.
A medication-assisted program (MAT) that begins with a medical detox is recommended to jump-starting your journey on the road to recovery.
At New Perspectives, our doctors and staff are dedicated to helping you or your loved one get on the path to lasting sobriety.
We offer the complete continuum of care, from detox to ongoing treatment in our outpatient program.
Call now for a free and confidential consultation with one of our specialists, who can help answer your questions or concerns. You can also reach us online for more information.