Methadone Addiction and Abuse
Methadone has been used for decades as a primary treatment and maintenance support for long-term opiate addiction recovery. It’s efficient and effective for preventing relapse when used in a monitored, supervised program.
But, what happens when the “cure” becomes the problem?
Methadone addiction and abuse are becoming an increasing concern in the rehabilitation community. Because it’s an opioid, many people misunderstand its effectiveness toward helping people recover from opiate addictions.
What is Methadone?
Methadone hydrochloride is a synthetic opiate that was originally indicated as a pain reliever in Germany during the second world war. Pain relief is still one of methadone uses. However, it’s most commonly prescribed for recovering opiate addicts, who can receive daily doses at a methadone clinic as part of a medical maintenance plan during recovery. The methadone half-life is relatively long compared to other drugs. However, it can vary from patient to patient. The half-life of a drug is how long 50 percent of an effective dose remains in the bloodstream.
It’s chemically similar to morphine and classified as a Schedule II drug, meaning it has medicinal value but a high potential for abuse. Methadone is only legal when prescribed by a doctor as part of a SAMSHA-approved opioid treatment program or for pain management. As an opioid agonist, it’s effective for reducing drug cravings without causing the same intoxicating effect that makes drug use so attractive to some. Opioid agonists are drugs that affect the same part of the brain that’s activated by stronger opioids but in a more controllable manner. It’s an important component in medically assisted treatment (MAT).
According to methadone abuse statistics, the main cause of addiction and overdose death is due to a return to prescribing the drug for its pain-relieving properties although it’s considered safer than other opiates.
How Does Methadone Work in Drug Addiction Treatment?
Among the uses of methadone, it’s indications for drug treatment are the best-known. It works by changing the message the brain receives about pain and altering its response. Users will receive the pain blocking effect and experience a reduction in withdrawal symptoms without feeling the pleasure and euphoria that’s common with the onset of opiate abuse. Because it’s a milder opioid, it’s considered more manageable and safe under controlled conditions such as dispensing from a methadone clinic.
The drug is available as a time-released pill, a liquid, or a wafer that’s administered to control opioid cravings and prevent relapse. Originally, recovering addicts had to visit their clinic three times a day to receive their dosage, but newer formulations allow the drug to remain effective for up to 24 hours. This enables those in recovery to resume a normal life without disruption or temptation to return to heroin and other narcotic opiates.
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Misunderstanding Methadone Uses
Critics claim that using methadone in drug rehab and recovery is just trading one addiction for another, and they point to statistics reporting the rise in mortality to prove their case. Using liquid methadone and other formulations has a proven track record of success. Medically assisted treatment programs (MATs) are responsible for reducing the number of treatment re-admissions for heroin addiction to 28 percent.
In addition, methadone treatment may:
- Reduce relapse rates
- Improve patient mortality
- Decrease illegal opiate use and overdoses rates
- Allow recovering addicts to gain employment and build a new life
- Improve birth rates and infant health for pregnant women in recovery
Treatment with liquid methadone or wafers is indicated for a minimum of one year before the drug is tapered off and discontinued. A lower methadone dosage is administered in stages until the brain is able to function normally on its own and other recovery mechanisms like therapy and peer counseling take hold. At that time, all substances are stopped.
The drug remains effective for up to 24 hours, but the main effects may begin to wear off at around 20 hours after ingestion. The long methadone half-life and milder effects are what makes methadone the preferred treatment option in rehab settings.
The drug can remain in the system for up to 60 hours or as few as eight hours. The duration depends on the buildup of drugs in the body, the duration and severity of use, and the person’s size and metabolism.
Is Methadone Addictive?
Since methadone is an opioid agonist, it has the same potential for abuse and dependence as any other opioid. What keeps it safe under monitored doctor’s supervision is the relatively low methadone dosage, strict criteria to participate in programs, and doctor oversight. However, the long methadone half-life leaves substance abusers with a higher incidence of overdose if alcohol, other opiates, or depressants are abused during treatment.
Methadone Abuse Statistics
According to the most recently available statistics, the rise in methadone abuse isn’t entirely due to its use in drug treatment programs. The drug was originally developed and patented to treat severe pain, and there has been an upsurge in prescribing it to manage pain. This may be because the continuing opioid crisis has made doctors hesitant to prescribe stronger drugs.
According to a study performed by Substance Abuse and Mental Health Services (SAMHSA), there were 2,452 deaths attributed to methadone overdose in 2004, which was nearly four times the number of 623 reported in 1999. This is believed to be due to three factors:
- High levels of opioid toxicity from heavy or long-term use prior to detox with methadone.
- Diversion to those with low opioid tolerance.
- Additive effects of those also using alcohol, benzodiazepines, or heroin while detoxing with methadone; this is especially true with those who are opioid naive or tolerant.
As of 2006, methadone-related deaths rose to 5,420. In 2008, more than 750,000 prescriptions were written for methadone to treat pain. These two statistics are believed to be related. Methadone has been found as the primary cause of death in more than one-third of opiate overdoses.
Luckily, there is help for those who have developed a dependence on, or addiction to, methadone.