For generations, methadone has been used to treat people saddled with opioid addiction. Sanctioned drug rehabilitation sites utilize methadone as part of a medication-assisted treatment (MAT) program, along with therapy, to wean people off opioids.
It remains a key medication in the fight against opioid addiction, the deadliest, most confounding drug crisis of our times.
Read on to find out more about the history and pharmacology of methadone and how it is employed in professional addiction treatment.
Methadone is a synthetic opioid that German scientists produced in the 1930s. It was developed because there was a need to create a pain medicine that was less addictive than morphine. Methadone was finally introduced to the United States in 1947 and used as a pain reliever. This was before it was employed to treat narcotic addictions.
Then in 1964, a pilot project established methadone maintenance treatment to fight heroin addiction. Methadone was employed to replace the more potent opioid to get users sober and stabilized. Maintenance therapy was a form of harm reduction rather and not abstinence-based like a 12-step program. This is what made methadone so controversial, especially at this nascent stage of use.
Still, the U.S. Food and Drug Administration (FDA) approved methadone maintenance treatment for heroin addiction in 1972.
Currently, methadone is available only in outpatient treatment programs that have been certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the U.S. Drug Enforcement Administration (DEA). It is administered as a tablet, solution, or dispersible that dissolves in a liquid.
Methadone stimulates the opioid receptors in the brain. However, it acts more slowly and will not produce the euphoria other opioids generate.
Methadone has an exceptionally long half-life (around 15 to 55 hours), which allows it to be used in maintenance programs and weaning during detox. As a maintenance treatment agent, it eliminates opioid withdrawal symptoms and alleviates drug cravings.
Its pain-relieving abilities can last up to eight hours, and it can also prevent a user from experiencing withdrawal symptoms for up to two days.
There is a downside to methadone, however. People abuse it for recreational purposes because it still generates discernible effects and withdrawal symptoms once use stops.
The withdrawal symptoms from methadone feel like the flu, where users experience nausea, vomiting, diarrhea, sweating, and body aches. Additionally, methadone symptoms are reported to be much more severe, which makes it difficult to quit. This is also why, after years of use as a maintenance treatment agent, methadone remains controversial.
A battle rages over the use of methadone and maintenance medications like it in drug treatment.
Opponents decry the logic of people addicted to opioids “taking drugs to quit drugs” and prefer an abstinence-based model. To them, MAT does not qualify as real recovery. Because methadone has its own addictive properties, the belief is that it can become a “crutch” drug on its own.
Tom Price, the former U.S. Health and Human Services Secretary, once criticized the use of MAT in drug treatment, saying, “If we’re just substituting one opioid for another, we’re not moving the dial much.”
He was a proponent for faith-based treatment programs.
Still, a multitude of medical agencies and professionals endorse methadone and other MAT medications like buprenorphine and naltrexone to treat opioid addiction. Proponents of MAT include the World Health Organization (WHO), a specialized agency of the United Nations, which includes methadone on its List of Essential Medicines, as one of the most effective and safe medicines needed in a health system.
The National Institute on Drug Abuse (NIDA) states that methadone and buprenorphine save lives, adding that “they help to stabilize individuals, allowing treatment of their medical, psychological, and other problems so they can contribute effectively as members of families and of society.”
Some professional drug treatment programs employ methadone because of its track record in successfully treating people who are addicted to opioids. It remains a tried-and-true solution to the relentless issue of opioid addiction, particularly heroin.
Heroin is so potent that all it takes is a single dose to set someone off on a course to addiction. NIDA defines addiction as “as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.”
Though it shares the same drug class as methadone, the euphoric effects generated by this natural substance is far more powerful.
The rush provided by heroin is also accompanied by dry mouth, a warm flushing of the skin, and heaviness in the extremities. Users can also experience severe itching, nausea, and vomiting.
Heroin produces dangerous long-term effects as well, such as slowed heart function and breathing.
It is rare that substance users in this country encounter pure heroin. It is far more likely that they will come into contact with the adulterated street variety, which is often “cut” with other illicit drugs such as cocaine or fentanyl, toxic products like lead or strychnine, and/or inert additives like talcum powder or cornstarch.
When someone overdoses, it is likely due to any or a combination of these added substances, along with the heroin. Fentanyl, a primary driver of the current opioid epidemic, greatly heightens the risk of fatal overdose. On its own, a few grains of fentanyl are enough to kill a human being.
Other signs of overdose are when breathing slows or stops completely, decreasing the levels of oxygen needed to reach the brain. Such action can cause brain damage and coma.
Death by overdose occurs when someone stops breathing altogether.
Methadone treatment can greatly diminish the risk of death and overdose, which is why it remains a staple of opioid addiction treatment.
When methadone is carefully administered on a short-term basis, it can minimize heroin withdrawal symptoms. The milder effects it produces allows it to be used to replace heroin in detox. Someone in a sanctioned drug rehabilitation program will then be tapered off methadone as well.
While methadone continues to be prescribed as a maintenance medication for opioid addiction, it has fallen out of use as more medical professionals have turned to Suboxone and naltrexone.
Suboxone and naltrexone have a lower risk of addiction than methadone. What’s more, they are often prescribed in combination with therapy and counseling, a practice known as medication-assisted treatment or MAT.
Suboxone is a combination drug that is comprised of buprenorphine and the anti-overdose medication naloxone. Buprenorphine is a partial opioid agonist, meaning it only partially functions as an opioid and produces far weaker effects than methadone. Unlike methadone, Suboxone can be administered in doctors’ offices rather than at sanctioned and registered clinics.
Naltrexone acts differently from Suboxone and methadone in how it treats opioid addiction. Naltrexone is an opioid antagonist. In other words, it completely blocks the euphoric and sedative sensations that come from opioid use rather than producing partial or limited effects.
The withdrawal symptoms produced by opioids are not considered life-threatening. However, they are painful and uncomfortable enough to compel someone to continue using.
Treatment administered through an MAT program, along with therapy and counseling, can help an addicted person realize sustained recovery.
Professional addiction treatment includes medical detoxification via acute treatment, clinical stabilization services where comprehensive therapy and counseling occurs, outpatient care that provides additional therapy, and aftercare which provides communal support in recovery.
The goal of professional treatment is to rid the body of opioids, get you mentally and physically stabilized, help you get to the root of your addiction, and equip you with effective strategies to avoid relapse.
An opioid addiction does not have to be the end of your story. We can help you locate a drug treatment program that can help you end your addiction.
Call 844-326-4514 anytime, day or evening, for a free consultation with one of our knowledgeable addiction recovery specialists. They can help you find the right treatment option. You can also contact us online for more information.
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National Institute on Drug Abuse. (n.d.). Is the use of medications like methadone and buprenorphine simply replacing one addiction with another? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/use-medications-methadone-buprenorphine
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