Methadone

 

What is methadone?

This drug was invented by Germany’s Nazi regime in 1941 as a substitute for inadequate morphine supplies. Today methadone is best known as a legal substitute for heroin. In addition to that use in addiction treatment programs, methadone is given to adults and children as a pain reliever for surgery, cancer, burns, and other conditions. The substance is used as a cough suppressant and also has calming qualities. In racehorses the drug can promote running ability and is banned from the sport. A human dose can last for 24 hours, rather long for a drug of this type and class. For pain relief a dose of methadone may be roughly 2.5 to 14.3 times stronger than morphine, depending on how and why the drug is administered.

Methadone is mainly used in the treatment of opioid dependence. It has cross-tolerance with other opioids including heroin and morphine, offering very similar effects and a longer duration of effect. Oral doses of methadone can stabilise patients by mitigating opioid withdrawal syndrome. Higher doses of methadone can block the euphoric effects of heroin, morphine, and similar drugs. As a result, properly dosed methadone patients can reduce or stop altogether their use of these substances.

 

Ways of administration

Methadone comes as a tablet, a dispersible tablet (can be dissolved in liquid), a solution (liquid), and a concentrated solution (liquid that must be diluted before use) to take by mouth. When methadone is used to relieve pain, it may be taken every 4 to 12 hours. If you take methadone as part of a treatment program, your doctor will prescribe the dosing schedule that is best for you.

Your doctor may change your dose of methadone during your treatment. Your doctor may decrease your dose or tell you to take methadone less often as your treatment continues. Ask your doctor or pharmacist if you have any questions about how much methadone you should take or how often you should take the medication.

 

Short-term effects

Withdrawal from opioids can be painful with the worst symptoms occurring within the first 48 to 72 hours following the last dose. Methadone helps reduce these unwanted effects of withdrawal. The Centers for Disease Control and Prevention suggest that methadone blocks the euphoric and sedative effects of the opiates, making relapse less likely and without reward of high. Methadone also blocks the potential effects of future narcotic abuse.

Unwanted effects can include

  • restlessness
  • vomiting
  • nausea
  • constipation
  • slow breathing
  • sweating
  • urinary difficulty
  • pupil contraction
  • restlessness
  • impaired sexual performance

 

Long-term effects

When a person is beginning long-term treatment with methadone, his dose is titrated, or raised incrementally, to a level at which it will stabilize over time. This titration allows the individual receiving treatment to gradually become tolerant to the drug, reducing the occurrence of common physiological and psychological effects such as sedation, nausea, constipation, and altered cognitive function. Dependence is a major effect of long-term methadone use, and its unpleasant counterpart–withdrawal. After long periods of methadone use, a person who suddenly stops taking methadone will begin experiencing withdrawal effects usually 48 hours after the last dose. These effects include sweating, cramps, muscle aches, nausea, chills, runny nose and intense cravings for more methadone.

After taking methadone for periods of one year or longer, reports the National Highway Traffic Safety Administration, most recovering opiate addicts do not report adverse effects. However, lung and breathing problems can still arise after long-term use of methadone, reports the University of Maryland. Methadone, like other opioids, reduces the production of testosterone in both men and women, and can interfere with menstrual cycles in women when used for long periods of time. Additionally, long-term use of methadone can also cause reduced libido and sexual dysfunction in men and women, states the National Cancer Institute. These sorts of effects vary with each individual and dosage amount, yet they have the potential to alter a person’s lifestyle and health, and should be weighed against the therapeutic effect of taking methadone for long periods of time.

In 2000 a study reported significant memory problems in a group of methadone maintenance recipients, but the same group also had confounding conditions such as head injury and alcoholism that may have affected memory test performance. Another 2000 study comparing methadone users to nonusers concluded that life factors other than methadone were the best explanation for differences in scores on thinking tests.

 

Addiction and Treatment

Although methadone is intended to prevent narcotics addiction and dependence along with associated withdrawal symptoms, there is still the possibility of becoming addicted. In fact methadone is an extremely physically addictive drug; however addiction is less likely when under the supervision of a doctor. Tolerance to methadone can also occur with frequent administration, though studies have shown that a user’s tolerance may not increase if prescribed correctly. Withdrawal symptoms occurring from the use of methadone are not as common as they are with heroin; therefore it is possible to maintain an addict on methadone without certain harsh side effects. Psychological and physical dependence can develop with the use of methadone. For instance, use of the drug continues a user’s opioid dependency, but frees them from uncontrolled, compulsive, and disruptive behavior associated with heroin addiction.

Aside from methadone, there are currently at least two alternative options for the treatment of opioid dependence: Bupernorphine and LAAM. But it is still important to remember that outside of a doctor’s care these drugs can be equally as addictive as methadone, resulting in dependence, tolerance, and withdrawal.

 

Popularity of methadone over time


 

References

  1. The Encyclopedia of addictive drugs – Richard Lawrence Miller ISBN: 0–313–31807–7
  2. http://en.wikipedia.org/wiki/Methadone
  3. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682134.html
  4. http://drug-effects.us/methadone-short-term-long-term
  5. http://www.cesar.umd.edu/cesar/drugs/methadone.asp
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