Category - Methadone Maintenance for Opiate Addiction

In the United States, an average of 44 people die every day from opiate overdoses. These drugs – such as Percocet, Vicodin, Morphine, and Codeine contribute to the deterioration of brain’s function in recognizing pain. Beginning in the 1970s, Methadone maintenance for opiate addiction has been introduced to assist in addiction treatments. According to UCLA Dual Diagnosis Program, methadone is a better choice for patients who have severe opiate addictions. It keeps the patients from getting high on other opiates, such as prescription painkillers or Heroin.

Medication-Assisted Treatment

When continuously being used, physical dependence toward the drugs will often take place. If the drug is stopped, withdrawal symptoms may occur. Opiate prescription painkillers will also cause a high, the reason why most people become addicted to the use of these drugs. An addiction to opiate painkillers is considered one of the biggest risk factors for an addiction to Heroin. The experts at Yale’s Schools of Medicine and of Public Health have created a three-year strategic plan on fighting the opiate epidemic in late 2016. These strategies focus on preventing and treating the addiction to an opiate.

A medication-assisted treatment such a Methadone maintenance will be able to control a patient’s addiction. Although politically methadone maintenance for opiate addiction is still considered controversial, scientifically it proves that it is a better addiction treatment for both drug and alcohol.  On estimation, there are:

  • 25 percent of patients become abstinent
  • 25 percent of patients continue to take the drug
  • 50 percent of patients go on and off on methadone maintenance repeatedly

According to studies, patients who are medically-treated with methadone become less depressed, less likely to contract HIV or hepatitis and less likely to commit crimes. They are also more able to maintain a better social life and hold a job. As patients begin to feel healthier than before, a majority of them will self-refer themselves to social service agencies. This is to help them to get back on their feet.

Methadone Maintenance Around the World

In Indonesia, the methadone maintenance program has been established in the prisons in 2005. This program was created in order to help HIV-positive prisoners to be free of drugs they have abused. Patients who are positive of HIV also receive antiretroviral treatment for free. The distribution of condoms and bleach to clean used syringes and needles are also considered as part of the strategy’s components. Since the beginning of the program, 31 percent of prisons (around 139 prisons) in Indonesia have now provided voluntary counseling and HIV testing (VCT). Around 10 percent of prisons (40 prisons) are currently offering antiretroviral therapy (ART) to the prisoners. The Methadone Maintenance Treatment (MMT) in Indonesia has produced great level of success rate.  This is considered a great start for a country like Indonesia where information on medically-assisted treatment is still aggressively needed to educate the addicts.

Methadone maintenance for opiate addiction in Hong Kong has been established since the 1980s. As a response to the increasing numbers in drug abuse, methadone maintenance program was started to deal with addictions. Some of the most important characteristics of Hong Kong methadone clinics include:

  • Non-judgmental approach which often includes the distribution of condoms and providing information
  • Each of the clinic attendance is affordable and will only cost around 12 cents
  • Open from early in the morning to midnight and seven days per week

According to a research, patients who are involved in methadone maintenance program in Hong Kong tend to show reduced levels of HIV risk behaviors and drug injections. Those who receive doses of methadone more than 60mg per day show they will less likely use or inject opiate drugs compared to those who take lesser than 60mg per day.

How Does Methadone Maintenance Actually Work?

It is often called as the agonist drug. The way Methadone works are by binding to the body’s opiate receptors. This will activate the receptions as what opiate drugs would usually do. In order to get Methadone medication-assisted treatment, a patient has to go to a certified treatment facility. Only doctors who are certified will be able to supervise methadone doses taken by a patient.

Methadone is usually offered in liquid, pill and wafer forms. It can be taken once a day and most of the time, the patient will be required to go to the clinic on a daily basis. A dose of Methadone will be able to provide pain relief of about four to 8 hours. For Heroin addicts, Methadone treatment is effectively working in higher doses. This helps them to stay in the addiction treatment programs longer. Every patient who is using methadone maintenance for opiate addiction must receive the medication under a physician’s supervision. Between the clinical visits, the patients may be allowed by the physician to take Methadone at home.

According to a publication Principles of Drug Addiction Treatment: A Research-Based Guide – 2012 by the National Institute on Drug Abuse, the length of time in Methadone treatment varies from patient to patient. The minimum length is usually 12 months. Some patients may be required to use Methadone maintenance for years until they are completely opiate-free. To stop the Methadone treatment, a doctor will supervise the decision based on the patient’s continuous results. Even if a patient is certain that Methadone is no longer needed, the process has to be stopped gradually. This is to prevent symptoms of withdrawal.

The Advantages of Methadone Maintenance

The benefits of using methadone are far greater than other types of addiction treatment. Most of the time, patients are reported to have better success in Methadone treatment programs. Some of the benefits of Methadone maintenance for opiate addiction include:

  • An improvement in the quality of life especially related to work, study and family
  • A better improvement in social functioning
  • Reduction in activities related to crimes due to no longer using illicit drugs
  • Better chance at the success of a long-term recovery
  • Reduction in infectious diseases such as HIV and hepatitis due to no longer using injection drug abuse

Since there are no withdrawal symptoms when using methadone, the participation in the addiction treatment will become better too. There will be no distractions and the patient’s focus will only be on getting better and free from opiate addiction. Some treatment programs will allow the patients to take home certain dosages. Patients will usually be required to account for every dosage they have taken and to keep methadone in a locked container.

The Disadvantages of Methadone Maintenance

Even though Methadone maintenance for opiate addiction is highly recommended, they are a few side effects of taking the medication. These side effects tend to be mild and short-term. If you are experiencing any of these side-effects, you need to talk to the doctor who prescribed you immediately. Some of the side effects include:

  • Stomach ache
  • Constipation
  • Sweating
  • Nausea
  • Vomiting
  • Slowed breathing
  • Restlessness
  • Sexual dysfunction
  • Itchy skin

Methadone dosages are usually able to be adjusted according to your needs and situation. However, it is still possible for patients to develop certain long-time side effects such as lung and respiratory problems. The Center for Substance Abuse Research (CESAR) at the University of Maryland also advised the side effects that can happen to women such as:

  • The changes or lapse in menstrual cycles
  • Pregnancy complications, especially for users who reduce the dosages upon finding out that they are pregnant

Even though Methadone is intended to treat an opiate addiction, the possibility of the patients to become dependent on Methadone still exist. An addiction to methadone is less likely to happen if the patient is continuously supervised by a doctor.

Patients who are allowed to take home dosages of Methadone have to comply with the rules stated by their doctors. This is to avoid them from becoming addicted to Methadone. Even though patients are prescribed correctly by physicians, there have been cases where patients developed tolerance to methadone. If this happens, it is recommended for the patients to consult the doctor who prescribed methadone immediately.

Defining Success in Methadone Maintenance for Opiate Addiction

Although Methadone still remains as a controversial approach toward treating opiate addiction, the successful rate of the treatment is still considerably higher than others. Many treatment centers in the United States and around the world still prefer to use methadone as a short-term detox drug. Unlike heroin, methadone is a long-acting opioid. The Western Journal of Medicine has explained in their article how methadone maintenance is still favored by most in treating opiate addictions.

The controversies come from the fact that some patients begin developing tolerance and dependence on methadone after using it for a long-term. For this reason, it is best for the patients to be prescribed with methadone only for a short-term period. As soon as the patients are considered opiate-free, the process of using methadone should be gradually stopped – as not to create another unhealthy withdrawal symptoms from methadone dependence.