What is Methadone and what is it used for?

Methadone is a synthetic opioid that is used primarily for treating narcotic addictions and opiate dependencies on such drugs as heroin, Vicodin®, Percocet®, and Morphine.  Methadone is also used as an analgesic (pain reliever) to manage moderate to severe pain and as an antitussive (cough suppressant).

Is Methadone expensive?

The cost of over-the-counter prescribed Methadone is considered relatively low, but also varies from clinic to clinic.  On average Methadone costs $10/dose.  Methadone clinics in the United States can charge anywhere from $5-$400/week.  The fact that it is fairly affordable classifies Methadone as a drug with a high potential of abuse and physical dependency.

What is Methadone maintenance and what does it do?

Methadone Maintenance Treatment (MMT) is a type of opiate replacement therapy.  It helps to reduce the use of illegal opiates and reduces the criminality associated with illegal drug trafficking.  MMT improves the overall health, safety and social productivity of those who enroll in the program.  Additionally, MMT reduces the risks associated with injection, such as the possible transmission of infectious diseases like hepatitis and HIV.  If used correctly and effectively, MMT programs can lead to Methadone patients reducing or stopping their use of drug substances entirely.

What is an opioid?

An opioid is a drug that has been derived from the opium poppy plant.  These include Opium, Morphine and Codeine.  Synthetic opioids have the same chemical structure but are not naturally occurring drugs.  Some examples of synthetic opioids include Dilaudid®, Methadone and Demerol®.

Are there adverse effects associated with Methadone?

Yes.  The effects of Methadone vary depending on the differences in the physiology and pre-existing health between users, but there are many adverse effects that can occur from taking Methadone.  Adverse effects of Methadone use can include: chronic fatigue, nausea, hallucinations, vomiting, headaches, weight gain, anorexia, memory loss, dry mouth, swelling, blurred vision, insomnia, itchiness, skin rashes, impotence, mood swings, stomach pains, cardiac arrhythmia, low blood pressure, constipation, hypoventilation, perspiration, seizures, overdosing and/or sudden death.  The effects of overdosing can include shallow breathing, convulsions, coma and/or possible death.

Are there any withdrawal symptoms associated with Methadone use?

Much like any narcotic drug used on a regular basis, if a dose of Methadone is skipped or missed the user will start to feel the effects of withdrawal.  If a patient undergoes dosage reduction in their MMT program, withdrawal symptoms may occur.  Methadone tolerance and dependence can develop with repeated doses and is also highly addictive. Physical symptoms of Methadone withdrawal can include: diarrhea, sweating, tremors, aches and pains, elevated pain sensitivity, itching, yawning, sneezing, lightheadedness, nausea, fever, chills and high blood pressure (which can lead to a stroke). Cognitive symptoms of Methadone withdrawal can include: suicide ideation, depression, delirium, anxiety, insomnia, agitation, paranoia, delusions, labored breathing, panic disorders, auditory and visual hallucinations and reduced libido.

Is dosage reduction difficult to handle?

Dosage reduction policies vary from clinic to clinic, but the decision for a patient to undergo Methadone dosage reduction only occurs if it is deemed appropriate to do so by the Methadone clinic itself, as it is their job to adjust the dosages in accordance with their personal evaluation and correct care of each individual patient. Initially the patient is maintained on a high dose of Methadone to deter and prevent the patient from the use of illicit opioids. Once approved for dosage reduction, a patient’s Methadone dosage is reduced slowly so as to minimalize discomfort and reduce the incidence of a relapse. The ultimate goal is to reduce the patient’s dosage gradually until they are able to take the patient off of Methadone completely.  That being said, dosage reduction and the possibility of eliminating the use of Methadone completely vary from patient to patient. Many patients have remained on Methadone for years - in some cases over 20. Adjustments made to a patient’s Methadone dosage are monitored closely on a daily basis, and the rate of reduction is often adjusted based on the patient’s symptomatic response.  As mentioned earlier, withdrawal symptoms may occur.  But in the best case scenario and in accordance with guidelines set by the clinic’s policies, the dosage reduction is so gradual and is observed so closely that withdrawal symptoms would be documented and the dosage would be adjusted as a result, thus relieving the patient of discomfort.

How can Methadone be administered and how long does it last?

Methadone can be taken as an oral solution, oral tablet or injection.  Methadone is a long-acting pain reliever and the effects of a single dose can last anywhere from 24-48 hours in length.  Methadone has very high fat solubility, which makes the effects of the drug last longer within the body than most Morphine-based drugs.  Usually once-a-day oral administrations are required for those undergoing opiate detoxification and/or maintenance programs. In rare cases “split-doses” are taken at 12 hours intervals, as prescribed by a physician.

Can Methadone be taken with other drugs?

No, it is not recommended that any drugs be taken at the same time. Due to its strength, Methadone used in conjunction with other drugs can be extremely life threatening.  Overdosing is very likely if other drugs are used at the same time as Methadone.

Why is Methadone-related mortality so high?

Within a 5-year period between 1999-2004, Methadone-related mortality quadrupled in the United States.   According to the Substance Abuse and Mental Health Services Administration, this significant rise did not result from Methadone use within MMT programs, but rather as a result of illicit distribution of the drug through other alternative channels.  It was not until 2006 that the Food and Drug Administration (the FDA) revised the package insert for Methadone, after realizing that the ‘adult dosage’ instructions and language found on the package insert were inaccurate and potentially deadly.  Outside of MMT programs, the illicit use of Methadone is often uneducated. Countless illicit Methadone-related deaths have been associated with overdosing.  This is not only due to Methadone’s strength alone, but also frequently due to combining its use with other drugs simultaneously, which has deadly consequences.

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