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How Does Methadone Treatment Work?
Methadone is a narcotic drug used to treat chronic pain and opiate addiction. Originally developed in Germany, during World War II, the drug was first introduced to the United States in 1947. Methadone was first used as a long-acting painkiller in both surgical and cancer patients. It wasn’t until after 1950 that methadone found use as a withdrawal treatment for heroin and morphine 1.
Unlike heroin and morphine, methadone is not made from opium poppies, but is synthesized in a lab. It has pain-killing properties, similar to opiates but is much longer-lasting--natural opiates last two to four hours, versus 24 hours for methadone 1.
About Opiate Addiction and Withdrawal
Opiates, like heroin and morphine, are highly addictive because of the way they interact with the body. The human body actually makes its own opiate-like chemicals in the form of endorphins. These endorphins sit on special receptors in the brain and block pain signals. Endorphins can also create a euphoric rush, or high. Opiates fit into the same receptors as the endorphins but they have a much more intense effect. Many addicts describe an opiate high as a rush of warmth--like sinking into a hot bath--followed by a relaxed euphoric feeling and numbness.
The first dose is often considered the most intense and many addicts will continue using in an effort to recreate that first high. After prolonged use, addicts form a tolerance to the drug and need to use higher doses to get high. Additionally, the high doesn’t last as long so the addict has to use more often. If the addict stops using, or misses a dose, he will begin to experience withdrawal. During withdrawal an addict may experience nausea and diarrhea as well as joint and muscle pain, anxiety and depression. An addict can experience withdrawal within hours of his last dose. Withdrawal from opiates is often painful but not dangerous.
- Opiates, like heroin and morphine, are highly addictive because of the way they interact with the body.
- After prolonged use, addicts form a tolerance to the drug and need to use higher doses to get high.
Methadone and Opiates
Suboxone Withdrawal Symptoms
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Methadone fits into the same receptors as opiates and can relieve many of the symptoms of opiate withdrawal. The difference between methadone and opiates is that methadone does not cause that euphoric high. Additionally, methadone can actually block the effects of opiate drugs--preventing someone from getting high if they do relapse. Methadone is not a cure for opiate addiction and is actually addictive, in and of itself 1. What methadone does is prevent the addict from going into opiate withdrawal so he can avoid using the opiate drugs and start the road to recovery.
- Methadone fits into the same receptors as opiates and can relieve many of the symptoms of opiate withdrawal.
Methadone Treatments
Methadone is administered orally in either pill or liquid form and the addict may either go to a clinic to receive each dose, or take home a prescription. How it is administered depends on the facility, the level of addiction and the addict’s history. The most effective methadone treatment program is one that combines the drug with some form of counseling.
Issues With Methadone Treatment
List of Opiate Antagonists
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Methadone is effective in treating opiate withdrawal but it is not without its drawbacks. Opiate addicts have been known to exchange their methadone for opiates, and continue using 1. There is also the danger of overdose if the addicts combine methadone with other drugs, such as alcohol. While methadone actually blocks the opiate high, addict may still combine opiates and methadone with deadly results.
- Methadone is effective in treating opiate withdrawal but it is not without its drawbacks.
- There is also the danger of overdose if the addicts combine methadone with other drugs, such as alcohol.
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References
- Medline Plus for methadone information
- National Institute on Drug Abuse
- Medline Plus for information about heroin
- Bell J. Pharmacological maintenance treatments of opiate addiction. Br J Clin Pharmacol. 2014;77(2):253-263. doi:10.1111/bcp.12051
- Grissinger M. Keeping Patients Safe From Methadone Overdoses. P T. 2011;36(8):462-466.
- U.S. Food & Drug Administration. Roxane Laboratories, Inc. Methadone Hydrochloride Cl Tablets USP 5mg, 10mg. (Dolophine HCl CII). Updated October 2006.
- MedlinePlus. Methadone. Updated September 28, 2020.
- Sameed M, Teague H. Use of nebulized naloxone to reverse methadone overdose - A case report and review of literature. J Community Hosp Intern Med Perspect. 2019;9(5):422-424. doi:10.1080/20009666.2019.1659664
- American College of Medical Toxicology. ACMT Position Statement: The Use of Methadone as an Analgesic. J Med Toxicol. 2016;12(2):213-215. doi:10.1007/s13181-015-0532-6
- Modesto-lowe V, Brooks D, Petry N. Methadone Deaths: Risk Factors in Pain and Addicted Populations. J Gen Intern Med. 2010;25(4):305-309. doi:10.1007/s11606-009-1225-0
- Centers for Disease Control and Prevention. Vital Signs: Risk for Overdose from Methadone Used for Pain Relief — United States, 1999–2010. Morbidity and Mortality Weekly Report (MMWR). 2012;61(26);493-497.
- Kharasch ED. Current Concepts in Methadone Metabolism and Transport. Clin Pharmacol Drug Dev. 2017;6(2):125-134. doi:10.1002/cpdd.326
- American Addiction Centers. How Long Does Methadone Stay in Your System? Updated June 10, 2019.
- Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2006.
- Sources:
Writer Bio
Julia Michelle has been writing professionally since January 2009. Her specialties include massage therapy, computer tech support, land and aquatic personal training, aquatic group fitness and Reiki. She has an Associate in Applied Science from Cincinnati State Technical and Community College in integrative medical massage therapy.