Methadone

Methadone

Not very may people know exactly what methadone is, what it is used for, and why it is necessary. Addiction is an illness, and there are many substances that enable addiction. People who are addicted to opioids are just like anyone else who has an illness, they are sick. People who are ill need medicine, and methadone is a medicine that is used to treat people who are sick with opioid addiction. Methadone has been used for 35 years in the treatment of opioid addiction and has helped millions of recovering addicts (Methadone and You 4:1) Methadone is a effective way to help opiate and heroin addicts control their addiction, return to normal life and become a contributing person of society,

O'Brien, Roberts and Cohen tell us that methadone is an opioid, a synthetic narcotic analgesic. Opioids are chemically and effectively related to natural endorphins found in the body. In fact, the word "endorphin" literally means "the morphine within." We don't understand all there is to know about endorphins, the natural opioids within the body, but there is evidence they are involved with pain control, body temperature, learning, and other functions (Lindesmith Center-Drug Policy Foundation 8).

Methadone was first introduced during WWII when it was developed by German Chemists (the brand name Dolophine is a tribute to Adolph Hitler) (167-168). The German Scientists developed methadone as a substitute for morphine. Soon, American companies brought Methadone to the United States for use as a painkiller and, later, to help treat persons going through heroin and other opiate withdrawal (Methadone and You 1: 1). Since the 1960's, methadone has primarily been used for addiction treatment. It is also important to know that methadone is not a single product from a single manufacturer, though the active ingredient is always the same: methadone hydrochloride (Lindesmith Center-Drug Policy Foundation 10).

Methadone has a very slow onset compared to other opioid analgesics. Morphine for example has a very quick onset, but relatively quick metabolism. In other words, morphine wears off in about 4-6 hours. Some analgesics are even shorter. Fentanyl, another synthetic opiate, metabolizes in about 2-3 hours. Methadone has a metabolism that averages around 24-36 hours. If you were to use morphine to manage opiate dependency, you would have to dose 4-6 times a day, compared to a daily dose of Methadone. On the other hand, methadone has a slow onset (the time it takes to "kick in") thus making it less effective for pain relief. Methadone also is equidosable with morphine. One milligram of methadone equals one milligram of morphine, making it a very strong narcotic agent. All of the above factors make methadone a prime candidate for opiate addiction management.

Methadone Maintenance Therapy, or MMT for short, is for people who are dependent

on opioid drugs. MMT is not a treatment for people whose problems are with other drugs- such as cocaine, alcohol, benzodiazepines, or cigarettes (The Lindesmith Center-Drug Policy Foundation 6). Methadone is dispensed at clinics that are federally licensed and regulated. These clinics are usually privately owned, though some receive financial sponsorship from government agencies. Clinics providing methadone maintenance treatment have consistently been found to be more successful than other treatment programs in retaining patients, possibly due to methadone's ability to reduce craving for heroin (Incardi and Harrison 174). This is a primary benefit of MMT- the ability to reduce the craving for heroin and other opiates. Methadone also effectively blocks the euphoric effects of heroin by bonding to the same receptors that heroin would use to produce euphoria. Platt teaches that the effectiveness of levels of methadone intended to serve a blocking function for the use of illicit opioids is does related (i.e., greatest at higher dose levels- generally, over 60mg. and up to 100mg. daily) (82). Another problem that MMT takes care of is the removal of withdrawal symptoms. Withdrawal from opiates and especially heroin can be one of the most excruciatingly painful and unpleasant experiences that anyone can go through. At the time of enrollment into a MMT clinic, the addict usually has opiates in his or her system. Methadone also has substantially helped with AIDS cases among heroin users, as those who are in MMT are not likely to use needles.

MMT is dispensed orally three different ways. First is through the use of tablets, which usually contain 40 milligrams of methadone. They are dissolved in water in a small dosing cup and then administered to the patient. The second way is methadone powder, dosed similarly to tablets. This method is seldom used in clinics today. The third and final way is through a liquid that already contains methadone dissolved in it. The liquid is usually flavored cherry to take away the natural bitter taste of methadone. This liquid form is dispensed into a small dosing cup through the use of a computer controlled dosing device that can regulate the dose down to even a milligram. This method is the most popular method of dosing used in clinics today.

For the average person, methadone lasts approximately 24-36 hours. Methadone does not make the addict feel "high" like other opiates, though when methadone is first administered some will feel a mild "glow" that lasts for a few hours. This glow usually is temporary and will subside as the patient attains a stable dose. Patients who are receiving a stable dose will not be notably sedated, show no distortion or affect on perception, feel relief from craving, develop tolerance to euphoric effects of methadone itself, do not withdrawal whatsoever, and will not need increases in doses to maintain these effects (Incardi and Harrison 164).

When a patient is at a stable dose with MMT is when the real miracle of methadone is seen. MMT can literally restore to the addict a normal life. They are able to be consistently employed. Drug seeking activities no longer consume their lives. Criminal activity to acquire drugs is no longer a factor. Methadone is literally a miracle to the addict whose former life revolved around using and seeking heroin and other opiates. In fact, at some of the earliest clinical trials of methadone treatment programs, Platt shows us that "none of the patients remaining in the program became readdicted to heroin, the majority returned to school or employment, and evidenced a significant reduction in arrests in comparison to both preadmission rates and arrest rates of addicts in other treatment programs" (308).

Treatment length with MMT is a crucial factor