What is Methadone?
Methadone is a long-acting, full opioid agonist medication that has been used since the 1960’s to help stabilize the lives of people who are dependent on opioids. As a full agonist, it activates the receptors of the brain in the same way illicit opioids do, but at a medically managed, therapeutic dose. Dosing is individualized for each patient, adjusted during the initial treatment phase until a patient is no longer experiencing withdrawal symptoms or feeling of euphoria or a “high”.
Methadone is an effective treatment for those who are addicted to any type of opioids including prescriptions such as hydrocodone, OxyContin®, Percocet® and Vicodin®, as well as heroin and fentanyl.
How does Methadone work?
Methadone is part of a long-term and comprehensive maintenance program for opioid dependent clients.
Methadone directly attaches to the opiate receptors in the body, activating them at a therapeutic level. To obtain the full benefit of the medication, it is best if patients abstain from the use of other opioids, otherwise the effects of Methadone diminish. Taking illicit opioids along with Methadone will not produce the euphoria or “high” that many patients are accustomed to experiencing. Additionally, it increases the risk of overdose.
The ultimate goal of Methadone treatment is to stabilize the body physically so that changes can be made in other areas of life, taking full advantage of a “drug-free” lifestyle.
How is Methadone taken?
Methadone is taken orally, typically in liquid form, and is diluted with either water or juice. When patients begin a Methadone Maintenance Program, they drink the medication at the pharmacy daily. This provides much needed structure early in recovery and allows the CARE team to frequently assess how the patient is doing.
As patients progress in their recovery and stop using street drugs, they earn take-home medication doses or “carries” allowing them more personal flexibility.
Medication taken at home should be stored safely and refrigerated. It is the patient’s responsibility to ensure the medication is stored safely and is not taken by anyone else. Methadone can be particularly dangerous, even lethal, for a child or a non-opioid dependent person.
How long do I have to stay on Methadone,
and how do I taper off?
The length of a Methadone maintenance program is different for each person. Significant research indicates that patients tend to have better outcomes when participating in treatment for a year or longer. Key factors that often indicate a person is ready to successfully taper and will maintain a “drug-free” lifestyle include:
- In good mental and physical health
- Abstinent from illicit drugs
- Stable employment
- Supportive social network
- Free of legal challenges
When the time is right, the decision to taper is made by the patient with support of the treating physician. The Methadone dose is then typically tapered by approximately 10% of the daily dose, at weekly or biweekly intervals. This is only a guide, as each patient’s best plan of action will be determined by working closely with their treating physician.
Does Methadone have any side effects?
Most people experience few, if any, side effects. Once the dose is stabilized, Methadone is usually a very well tolerated medication and a dosage adjustment may resolve minor side effects.
A few of the most common side effects include:
- Weight gain
- Dry mouth
- Cold or flu-like symptoms
- Sleep disturbances
- Mood swings
Methadone should not be taken with benzodiazepines or alcohol as there is danger of significant respiratory depression. If a patient takes benzodiazepines, or other medications, they should speak to their medical provider before starting a Methadone Treatment Program.
Can Methadone be used during pregnancy?
Methadone is the recommended medication for opioid addiction treatment during pregnancy. The medication has been well tested and proven to be safe for pregnant women and their unborn children. In addition, it is far safer than detoxing without assistance or continuing to use opioids illicitly. When managed by a medical provider, Methadone reduces the risk of miscarriage and physical stress on the infant, as well as preventing premature labour. Withdrawal symptoms after birth may be present, but are often much milder than they would be if illicit opioids were used during the pregnancy. These too can be managed and treated with no long-term negative effects on the child. CATC have several expert physicians who specialize in the treatment of Opioid Use Disorder during pregnancy.