Quality Addiction Management Information Resources
METHADONE FACT SHEET - BACK
Methadone was orignally synthesized by chemists
during World War II in Germany as a substitute for the pain reliever
morphine. Methadone has about the same analgesic strength as morphine,
but it is longer acting (25 hours v 2-6 hours). Methadone was first
available commercially in the United States in 1947, and was initially
used as a long-acting pain killer. It was not until the mid-1960's
that Methadone began to be used to treat chronic narcotic addiction.
The main pharmacological properties of methadone
are similar to morphine and other opiate narcotics (Demerol, codeine,
Dilaudid, Oxycontin, Heroin, etc.). Cross tolerance occurs with all
the opiates, that is, the administration of one opiate will eliminate
the withdrawal symptoms of any other opiate. The major difference
among the opiates is the strength, length of action, and most effective
route of use. Methadone is as strong as morphine. Its effects last
24-26 hours, and it is most effective when ingested orally. All methadone
preparations (tablet v liquid) are equally effective at equal doses.
Only the vehicle, the "stuff" which the active medication is added and held together
with, differs. Preference for one form of methadone over another
is merely a matter of personal preference, and has no basis in pharmacology.
Methadone is a tolerance-producing
central nervous system depressant. It produces insensitivity to pain,
sedation, slowing of respirations, lowering of blood pressure, constipation,
slowing of pulse, and nausea. The subjective effects following single
doses in non-addicted individuals are similar to those noted after
morphine or heroin use; feelings of well being, drowsiness and euphoria.
Tolerance develops to the pain-relieving, nauseant,
sedative, euphoric, respiratory and cardiovascular effects. However,
no tolerance develops to methadone's ability to prevent
withdrawal symptoms. Therefore, once the opiate-addicted individual
is stabilized on methadone, she/he can function normally (physically
and psychologically) without requiring ever increasing doses to eliminate
withdrawal symptoms and remain physiologically comfortable. This
occurs regardless of the stabilizing dose of methadone. In some patients,
and at higher doses, methadone may help decrease anxiety although
it is not effective as a potent mood elevator.
The most common side effects of methadone are weight gain, constipation,
increased intake of fluids, increased frequency of urination, tingling
in the hands and feet, increased sweating, skin rash, nausea, and
delayed ejaculation. However, these symptoms are typically mild and
temporary.
Methadone is administered orally and is gradually absorbed into
the body through the intestines and liver. From the liver, it is
released slowly into the blood stream. This slow release into the
blood stream keeps maintenance patients from experiencing a rapid
narcotic high and keeps them above the blood level for experiencing
intense withdrawal symptoms. Methadone can also chemically block
the craving for opiates, even though it does not produce the euphoria
of the short-acting opiates. At doses greater than available in illicit
opiates, methadone produces a "blocking effect" to the high of illicit
opiates. However, methadone does not block the intoxicating effects
of non-opiate drugs, such as alcohol, sedatives, tranquilizers and
stimulants. Use of other intoxicating drugs may produce overdose
and death. Most overdoses occur when methadone maintained individuals
supplement their prescribed methadone with other central nervous
system depressants. Particularly dangerous when used in combination
with methadone are Placidyl, Xanax, Valium, methaqualone, illicit
methadone and large amounts of alcohol.
The character and severity of withdrawal symptoms
that appear when an opiate is discontinued depends on many factors,
particularly the drug itself, dose, duration of use, interval between
doses, health, personality and expectations and motivations of the
patient. The symptoms of abrupt discontinuation of methadone are
insomnia, anxiety, hypertension, irritability, chills, excessive
sweating, "running"
nose and eyes, enlarged pupils, sore, achy joints and muscles, muscle
spasms, abdominal cramps, nausea, vomiting and diarrhea. Symptoms
may appear 24-48 hours after the last dose of methadone and most
major symptoms are minimal by the 14th day. However, general discomfort,
loss of appetite and insomnia may persist for as long as six months.
These symptoms can be drastically reduced and often eliminated by
withdrawing the methadone on a slow, deliberate schedule of dose
decreases managed by a physician. The longer the process, the less
the discomfort during withdrawal.
Methadone maintenance is a long-term treatment for
opiate addiction. The patient must regularly visit the clinic and
receive daily methadone. Many patients lead normal productive lives
by working, caring for their families and enjoying a healthy, active
lifestyle while maintained on methadone. Methadone is not known to
cause any physical or mental deterioration, even after 15 years or
more of use. Since methadone programs are voluntary, the length of
time a patient remains in treatment depends greatly upon the patient.
Studies show that patents are more apt to stay in treatment for relatively
longer periods of time if they are over 30 years old, married, have
dependent children and have spent time in jail during their addiction
to opiates.
Methadone is not a cure for opiate addiction. It is pharmacologic
treatment which suppresses opiate withdrawal symptoms and lessens
the craving for other opiates. Coupled with therapy, methadone facilitates
both interpersonal interactions involved in strengthening motivation,
changing lifestyles and breaking the cycle of life patterns and stress
reactions which underlie relapse.
©QAM inc. - 2011 - BACK