What is methadone treatment?

Methadone Treatment – Yes Or No?

During the 1960s, methadone was introduced as a treatment for opiate addiction. Since then, it has become one of the most popular forms of treatment available. It is particularly good at helping people to manage their withdrawal symptoms, thereby allowing patients to avoid relapse.

How Methadone Treatment Works

On paper, methadone sounds like a wonder drug. However, there are some significant disadvantages to it as well. Some of these are so significant, in fact, that many people choose not to make use of this treatment. It is important to take a fair and unbiased view and thereby be more empowered to make a decision in terms of which treatment is most appropriate for each individual. After all, one of the principles of effective treatment is that every addiction story and treatment have to be considered as unique.

“No single treatment is right for everyone.”

Key Benefits of Methadone Replacement Therapy

Most people who suffer from an addiction to an opiate, particularly heroin, will be offered methadone as a form of treatment. While almost everybody has heard of the synthetic drug, few people truly understand how it works. Very simply put, it is capable of reducing heroin dependency, thereby decreasing usage of the drug, making patients more receptive to other elements of treatment.

“Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs.”

Heroin and methadone are both opioids, meaning they affect the same brain receptors. However, methadone does not lead to a euphoric high, which is what people are aiming for when they use heroin. Instead, it stabilizes them, returning them to a sense of “normalcy”.

Methadone is usually administered orally in a drink that does not work if injected intravenously. Those who have used heroin for long periods of time are believed to have a metabolic deficiency, which can be corrected through continued use of synthetic opioids, such as methadone. If methadone is administered properly, and that is the key, it can be effective for 24 hours, meaning those who are addicted to opioids will not experience the need to seek more heroin, so that they can engage instead in rehabilitation.

The Functions of Methadone

It is undeniable that methadone can be hugely beneficial in terms of getting people into therapy. Indeed, it has three key functions:

1. It replaces heroin and its actions, thereby avoiding heroin’s withdrawal effects. This can be done in a controlled environment, during which time patients can be encouraged to seek further help.
2. It stabilizes those who want help. Because they no longer need to seek out heroin or face intense cravings, they can focus instead on learning new coping strategies, allowing them to enter the road to recovery. Indeed, various studies have shown a link between methadone treatment and positive outcomes.

“With regard to methadone, research has shown that it is useful in increasing retention in treatment, physical and mental health levels, functioning and quality of life, and in decreasing the use of illicit drugs and HIV risk behaviors. In fact, in 2009, the World Health Organization Guidelines recommended methadone and buprenorphine as first line agents for agonist maintenance treatment.”

3. It reduces drug use. There are two schools of thought when it comes to methadone. One advocates it for short term detox, meaning it is used for no longer than a week. Others prefer maintenance programs, in which people can continue to use methadone for years. As it is a legally available drug on prescription, it is possible to continue this type of treatment safely for a long time as long as the patient is properly monitored.

Methadone Treatment Has a Potential Drawback

Nothing in the world is perfect and everything has its pros and cons. The same is true for methadone treatment. Methadone is an opiate, albeit a synthetic one, and that means it can be addictive. Anything that is addictive can lead to withdrawal symptoms. Most patients who are addicted to opiates use drugs because they want to experience a “high”, and they want to avoid the withdrawal symptoms and this is what has led to them having a full dependency in the first place.

There are other significant drawbacks to consider in relation to methadone treatment, including the fact that:

• It does not give the patients control over their treatment and recovery.
• It means patients must attend methadone clinics on a daily basis, which can prevent them from being productive members of society.
• It does not stop patients from using other opioids and drugs.
• It can lead to an overdose, particularly when abused.

“Overdose from methadone is a major concern and continues to be problematic. Mixing methadone with other substances that slow the body like alcohol and benzodiazepines increases the risk of breathing problems and death.”

• It shows up during drug tests, thereby potentially preventing patients from accessing education or employment.
• Many patients feel ashamed about using it, something that is often not properly addressed in treatment. Indeed, many users try to keep their methadone treatment a secret.
• Patients receiving methadone treatment are still addicted, which can be noticed when a dosage is missed, for instance.

The reality is that there are downsides associated with methadone treatment. These can affect the psychological, emotional, and physical well-being of patients. It is also for this reason that methadone must be dispensed under strict controls and only while a patient is monitored by a physician.

Replacing Replacement Therapy

If you are currently in the grips of an opiate addiction, it is likely that methadone replacement therapy will be offered to you. It is very important that you consider the pros and cons as described above before deciding whether or not it is right for you. There are other options available as well. One of them is short term methadone detox, as described earlier. Other options include going cold turkey, which is rarely recommended; medically assisted detox; long term inpatient rehabilitation; intensive outpatient rehabilitation; and more. It is vital to see addiction for what it is, which is a multi-faceted disease that requires a multi-faceted treatment approach rather than a one size fits all solution.

About the author

Dr. Michael Carlton, MD.

Leading addictionologist, Michael Carlton, M.D. has over 25 years of experience as a medical practitioner. He earned a bachelor’s degree in Mechanical Engineering and returned for his MD from the College of Medicine at the University of Arizona in 1990. He completed his dual residency in Internal Medicine and Pediatrics and his Fellowship in Toxicology at Good Samaritan Regional Medical Center and Phoenix Children’s Hospital.

He has published articles in the fields of toxicology and biomedicine, crafted articles for WebMD, and lectured to his peers on medication-assisted treatment. Dr. Carlton was a medical director of Community Bridges and medically supervised the medical detoxification of over 30,000 chemically dependent patients annually.

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