Replacement Therapy: Methadone

Opiates, derived from the opium poppy, are a class of drugs that include illegal drugs such as heroin, as well as painkillers such as hydrocodone, oxycodone, morphine, fentanyl, codeine and many others. All opiate drugs have a tremendous potential for misuse and addiction.

Opiate addiction has reached epidemic proportions in the United States and globally. NIDA (The National Institute on Drug Abuse), estimates that opiates are abused by between 26 and 34 million people around the world. The number of deaths due to unintentional overdose has soared. Methadone is a treatment option that offers hope for many addicted individuals.

What is Methadone and how is it Used?

Although methadone is a synthetic drug that shares many of the characteristics of morphine and other opioid drugs, it affects the body very differently by blocking certain receptors in the brain. As a result, users don’t experience the typical, intense rush of euphoria. Detox occurs more gradually, cravings are reduced and afflicted people are able to avoid the extremely uncomfortable withdrawal process.

Methadone is administered daily and effects last 24 to 36 hours. The drug, which is rigidly controlled in the United States, is available primarily at special methadone clinics. It is available in pill or liquid form; it is not used intravenously.

Methadone isn’t a short-term solution, and long-term methadone maintenance tends to result in the best outcomes. NIDA recommends at least a full year of methadone maintenance. In some cases, methadone maintenance is required for several years, or as long as potential for relapse remains.

Several decades of research by entities such as the Center for Disease Control (CDC), The Substance Abuse and Mental Health Services Administration (SAMHSA), The National Institute on Drug Abuse (NIDA), the World Health Organization (WHO), and many others have indicated that methadone replacement therapy is an effective treatment for opiate addiction. Methadone maintenance is most effective when coupled with addiction counseling.

However, the subject remains highly controversial and not all addiction professionals view methadone treatment in a positive light.

The Controversy

Because methadone carries a potential for abuse, some people believe that methadone therapy is simply trading one dangerous drug for another, thus perpetuating the addiction. However, proponents of methadone maintenance argue that a potentially deadly opiate addiction is swapped for a safe, medically-supervised drug, greatly minimizing crime and the risk of death due to overdose. The problem, they say, is that the severity of withdrawal symptoms is too difficult for many addicts. As a result, preventing addicts from receiving methadone prevents opportunities for them to get well.

Weighing the Pros and Cons

Methadone maintenance isn’t best for all addicts and the decision shouldn’t be taken lightly. However, it can be a light at the end of a tunnel for many individuals who have long struggled with addiction to heroin or other opiate drugs. It’s important to weigh the pros and cons and to consider individual needs and treatment goals. Here are a few things to consider:

  • Daily visits to a methadone clinic provide much-needed structure for many people. However, committing to regular visits can be difficult for busy individuals with packed schedules.
  • Regular methadone therapy helps many addicted people to develop much-needed accountability.
  • Most addicted people who enter methadone treatment report better health and an improved ability to cope with life’s stresses. Many benefit from counseling, which is offered at most methadone treatment clinics.
  • Methadone usually costs less than heroin or other opioid drugs.
  • Like most drugs, methadone is associated with a variety of side effects, including sweating, weight gain, constipation, nausea, drowsiness, frequent urination and changes in libido. However, symptoms tend to be relatively mild and short-lived when the drug is taken properly. Severe side effects are usually an indication that a change in dosage is needed.

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