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Category - Methadone as a Short-Term Detox Drug
Drug abuse and addiction are major problems in the United States, with millions of people affected by the vicious grip of illegal substances, both directly and indirectly.
The heroin epidemic is especially horrendous, with more than 15,469 deaths from heroin-related overdose in the U.S. alone in 2016. Drug overdoses are now the leading cause of death for Americans under 50, with the nation’s mortality from drug overdoses rising by 21 percent in 2016.
Abundance of Addiction
With drug use on the rise, officials and advocates are scrambling for solutions to a problem that affects people of all ages.
We have roughly two groups of Americans that are getting addicted,” said Dr. Andrew Kolodny, director of opioid policy research at Brandeis University. “We have an older group that is overdosing on pain medicine, and we have a younger group that is overdosing on black market opioids.”
Those struggling with opioid addiction are increasingly at risk due to the growing practice of mixing heroin with fentanyl, an opioid drug that is used with other medications for anesthesia. In many cases, heroin is laced with fentanyl, and users inadvertently take a deadly dose. Because Fentanyl is 50 to 100 times more concentrated than morphine, it is nearly impossible for people to know how much they are actually injecting or control their dose of this extremely powerful opioid.
Heroin, fentanyl and other opioids are respiratory depressants, meaning they interfere with a person’s ability to breathe properly. Combined with other substances such as alcohol or sleeping pills, and these opioids are a recipe for overdose and death.
The opioid epidemic in the United States has worsened to the point that President Trump declared it a “public health emergency.” Families and friends of drug addicts are urging loved ones to seek help before it’s too late. Those that do go through the detox and rehabilitation process to recover from heroin addiction may be treated, despite ongoing controversy and debate, with another opioid medication called Methadone.
What is Methadone?
Methadone is an opioid medication, sometimes referred to as a narcotic, that reduces withdrawal symptoms and relieves pain in individuals addicted to heroin or other opioids. Methadone does not cause the high associated with opioid addiction, so many doctors use it to help patients as they wean themselves off their deadly drug habit.
Methadone is marketed under the brand name Dolophine and is available only from certified pharmacies. This medication is used in maintenance therapy and addiction programs throughout the country, but it remains under discussion as critics raise concerns about its effectiveness in combating opioid-related overdoses and deaths.
Many medical professionals choose methadone as a detox drug because it’s a long-acting opioid, unlike heroin, which is a short-acting opioid.. Like other opioids, methadone can slow bowel activities, lower blood pressure, help with pain, and produce sedation and respiratory depression.
Detox is a process that saves lives, but also causes turmoil for individuals who are addicted to powerful substances and suddenly have to cope without that cherished high. Many doctors choose methadone for its painkilling element, which helps both with the treatment of chronic pain and drug detox, specifically for heroin. Heroin addicted people experience many uncomfortable side effects that methadone, as an opioid, helps to alleviate.
For example, diarrhea is a common withdrawal symptom that can be reduced with methadone’s tendency to slow bowel activity. Many people suffering from addiction experience anxiety and depression during withdrawal, and the sedative property of methadone will help ease their mental and emotional distress. In addition, the high blood pressure that results from heroin withdrawal can be balanced with the low blood pressure that comes from methadone use.
When taken properly, methadone can work wonders for those struggling with tough withdrawal symptoms caused by suddenly stopping heroin use. As part of a methadone-based treatment program, doctors will administer small, carefully measured doses of methadone hydrochloride to patients hooked on heroin. Typically, doses begin around 10-20 mg and are upped by increments of 10 mg until the heroin withdrawal symptoms are more manageable. Doctors are careful to prescribe a low initial dose to ensure to make certain the addition of a new opioid into the patient’s body will not cause irreversible damage. Once the person adjusts to the dose, doctors can begin increasing the amount.
The goal is to prevent the withdrawal symptoms as much as possible, and then slowly decrease the doses until the client is completely off both methadone and heroin. The Center for Substance Abuse Research points out that the exact amount of the dose will vary based on each individual’s age, weight, mental health and medical history. All these facts are closely evaluated and considered before the treatment program commences.
In order for this treatment to work successfully, doses must be taken regularly. Any deviations in consumption may cause the body to lose the ability to properly process the methadone. This, in turn, will raise tolerance for the drug and force the patient to start replacement therapy all over again. In addition, it is important that consumption is always supervised by a doctor, pharmacist or other medical professional. These experienced experts must ensure the liquid dose is exactly the right amount to make the weaning and withdrawal stages as easy as possible.
Although it usually takes between two and four hours for methadone to reach its peak effect, the drug builds up in the body, so the patient may feel a stronger effect over a few days even if the dosage hasn’t increased. Like many things in life, it’s all about finding the right balance, and doctors need to explore the best option based on how the body responds to methadone and how much heroin it was used to consuming.
Each person has an ideal dose that can only be achieved through trial and error. Because methadone is meant to replace heroin consumption, patients may experience some withdrawal symptoms at the beginning, because the optimal dose of opioids is still being discovered.
Through it all, doctors aim for minimal discomfort, which, for most people, can be achieved with a daily dosage of 40 mg. This manages pain and withdrawal symptoms, and most people stay on this dose for 2-3 days before it is slowly reduced every day or every other day. Although 10-20 percent is a standard reduction, each person’s responses and physiology must be evaluated before deciding.
Sometimes, the reduction rate may be too high, and clients may experience withdrawal symptoms that tempt them into relapsing. In situations like this, the supervising doctor can try upping the dose, slowing the reduction process, or a combination of both. Because withdrawal symptoms may not present themselves for up to three days after the last methadone dose, it’s important for doctors to always keep an eye on the patient and observe their reactions closely.
Risks Associated with Methadone
The benefits of methadone are often weighed against the risks of using a potentially addictive substance to treat an already-existing addiction. The controversy continues as some critics worry about the possibility of users developing a tolerance and dependence on methadone. Trying to quit methadone after becoming reliant on it can cause its own withdrawal symptoms, including chills, fever, vomiting, runny nose, crying, and rapid heart rate.
For this reason, it is best to prescribe methadone just for the short-term—long enough to help the person get through the most difficult parts of heroin withdrawal, but not so long as to form an unhealthy dependence on methadone. The Western Journal of Medicine acknowledges the potential problem of giving an opioid to a patient trying to sever an opioid addiction, but notes that the withdrawal symptoms are “less severe than that of a shorter-acting opiate such as heroin.”
A Better Life
Doctors use methadone as a temporary detox drug in a form of maintenance therapy. Patients who are physically and psychologically dependent on short-acting opiates are given methadone as a substitute for the heroin or other drugs they are addicted to.
Methadone maintenance therapy reduces, and sometimes even completely blocks the most painful withdrawal symptoms from heroin. With time, methadone also diminishes the euphoric high of a heroin hit, eliminating cravings for the illicit substance. This allows patients a supervised rest from the constant desire to obtain and consume heroin.
Looking ahead to the future, this maintenance therapy gives people a path for eventual reintroduction into a normal life without drugs.