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Methadone for Addiction Treatment

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Methadone is a highly effective treatment for opioid use disorder when taken correctly and under the supervision of a medical practitioner.1 Methadone can reduce or eliminate withdrawal symptoms and cravings to use opioids, and studies show it can reduce the risks of opioid overdose and contracting infectious diseases which are often associated with opioid use.1 Many people benefit from taking methadone as part of an individualized opioid use disorder treatment program that may also include behavioral therapy, counseling, social support, and aftercare.1

This article will cover all the information you need to know about methadone, why it’s used, how it works, side effects, symptoms of opioid use disorder, overdose risks and interactions with other medications, and how you can find help near you.


What Is Methadone?

Methadone is a medication used to treat opioid use disorder. It helps reduce the cravings associated with opioid use disorder, giving people the time and ability to make necessary life changes associated with long-term remission and recovery from opioid use disorder.1 It is a long-acting opioid agonist, which means it curbs opioid withdrawal symptoms as well as blunts or blocks the effect of other opioid drugs.2 Approved by the Food and Drug Administration (FDA), methadone is prescribed for opioid use disorders and is also used as a pain medication for certain medical conditions.2

Methadone is a Schedule II-controlled medication and thus requires a prescription and supervision of a medical practitioner.2 Federal regulations restrict the dispensing of methadone to opioid treatment programs. Counseling and drug testing are required in these programs, and some also offer additional services, such as treating co-occurring mental health disorders, peer support, and more.1 Some people prefer to receive medication via their physician’s office, and although your physician may not meet the requirements to prescribe methadone, they may be able to prescribe buprenorphine or naltrexone, which can also be used to effectively treat opioid use disorder.

Even though methadone is an effective treatment, it can also be misused as it is still a narcotic and can cause dependence and withdrawal symptoms.3


Why Methadone Is Used and How Does it Work?

Methadone is among a few medications used as maintenance treatment from more dangerous opioids like heroin and fentanyl.1 Other such medications are naltrexone and buprenorphine.1 However, methadone is considered a highly effective medication as it reduces cravings, blocks the euphoric effects of opioids, and reduces withdrawal symptoms.4 In this way, methadone helps curb the dangerous effects of opioids while gently easing a person away from using opioid drugs like heroin.1

The idea behind using methadone as maintenance treatment is that it acts similar to the opioid but does not produce the associated high.4 Research has shown that medications like methadone are preferable to detoxification as it reduces the risks associated with withdrawal, overdose, criminality, and infections.4 Not only that, maintenance treatment using addiction treatment medications helps improve health and quality of life.4

When using methadone to treat opioid addiction, a medical professional slowly increases the dose to prevent opioid withdrawal symptoms and to block other opioids from reaching the brain’s opioid receptors, which prevents euphoria from other shorter-acting opioids.5

Methadone activates the same receptors that other opioids act on, including inhibition of pain transmission, making it an effective medication for neuropathic pain as well.5 Given that it does not create the euphoria that short-acting opioids induce, it helps curb the addiction and reinforcement mechanism of more dangerous opioids.5

However, since methadone is still an opioid itself, it can be diverted and misused—which is all the more reason to maintain safe and controlled access to proper methadone treatment.1 Nonetheless, the possibility of misuse should not prevent a person from receiving life-sustaining methadone treatment, so a balance of care and control must exist.1

What Is Opioid Use Disorder?

While methadone does not produce the same effects as heroin, it has strong analgesic and sedating effects, which can be addictive.3 The signs and symptoms of methadone addiction are similar to other opioid addictions.

According to the DSM-5 criteria for opioid use disorder, the signs and symptoms may include:6

  • Taking larger doses over a longer period of time.
  • A persistent desire to use and an inability to cut down on use.
  • A lot of effort obtaining, using, and recovering from opioid use.
  • Strong cravings to use.
  • Problems at home, work, or with other important life activities.
  • Repeated use despite significant social problems and/or giving up social activities to use.
  • Repeated use even in hazardous situations.
  • Repeated use despite physical or psychological problems associated with use.
  • Evidence of tolerance.
  • Evidence of withdrawal.

Methadone Side Effects

As mentioned above, methadone is a type of opioid medication used to treat opioid use disorder. It is, however, still an opioid, and has side effects similar to other opioids.

The following are the most common side effects associated with methadone use:1

  • Constipation
  • Dizziness
  • Sedation
  • Sweating
  • Vomiting

The side effects of methadone, when taken in the correct dose under supervision, should not be life-threatening.7 Under medical supervision, the dose is tailored to each person depending on their history, health, and previous drug use.7

Strict supervision ensures that doses can be changed according to the patient’s opioid tolerance and also takes into account side effects, which is why it’s important to use this medication as prescribed.8 However, one should report all side effects, especially if they persist or become distressing, as it could indicate a potentially dangerous reaction.7


Methadone Overdose

Methadone is associated with a decreased risk of deadly overdose. Once an individual stabilizes, they usually discontinue illicit drug use completely. While some individuals may continue to use illicit drugs, these occurrences are less frequent or the drug is used in smaller amounts.1

The effects of methadone can last between 4­–8 hours and can vary significantly depending on the person.7 For this reason, it’s important never to take more methadone than what is prescribed, even if the effects seem to subside quickly.8

Taking more methadone to achieve the same effects as it previously did is one of the main reasons people overdose.7 Other reasons that overdoses occur are not understanding the directions of use, taking methadone with other medications or drugs, having certain health conditions, and deliberately increasing the dose.7

Common signs of opiate overdose are:8

  • Small pupils that look like “pinpoints.”
  • Loss of consciousness or falling into a deep sleep.
  • Very slow and shallow breathing.
  • Choking or making a gurgling sound.
  • Limpness or extreme weakness.
  • Blue lips or nose or very pale skin.

It’s imperative to act on an overdose quickly to prevent death. Since death from opioid overdose usually happens through severe respiratory depression, it can happen quickly since our brains cannot live without oxygen for more than a few minutes.8

Currently, the best treatment for opioid overdose lies in medications like naloxone. This medication counteracts the effects of the opioid and thus eliminates the associated respiratory depression.9 Studies show a significant decrease in opioid-related deaths once naloxone laws were put in place and the medication was made more accessible to the general public.9


Methadone Interaction With Other Drugs

An important area for education and harm reduction is the potential for methadone to interact with other drugs and medications. Many times, those who take methadone will understand the importance of taking only what’s been prescribed. However, methadone can interact with over-the-counter medications as well as those used for other health conditions, and the individual may not be entirely aware of all potential interactions.

Unfortunately, many of these medications can increase the effect of methadone, putting a person at risk for serious side effects and overdose.7 This is also true when combining methadone with other recreational or illicit drugs.7 It’s essential that you speak with your doctor about any other medications or drugs you may take so they can adjust the dose of methadone and provide life-saving education.7

Those taking methadone should be especially careful with central nervous system depressants such as alcohol, benzodiazepines, sleeping pills, tranquilizers, other opiates, and any medication that can cause drowsiness.7 Also, antihistamines, blood pressure pills, diuretics, HIV medicines, and MAO inhibitors can interact with methadone.7 Since methadone can also cause heart rhythm issues, it’s also important not to mix anti-arrhythmia medications with methadone.7 Over-the-counter medications such as cold medication may often contain some of the above ingredients.7


Find Treatment and Rehab Centers Near Me

To find an addiction treatment center near you visit our treatment directory. You can also verify your insurance to see how addiction treatment services are covered under your health insurance plan.

Although it’s hard to face an issue as profound as opiate addiction, treatment using methadone as a key tool can provide much-needed relief and prevent the more serious consequences of opiate use. Research has shown that methadone can save lives and provide an enhanced quality of life.2 There is help available for opioid use disorder. Call .


Resources, Articles, and More Information

Additional articles on the subject include the following:

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NREMT
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series of in-depth articles on Community Paramedicine programs across the country that go beyond transporting patients to emergency rooms and connects specific patients, such as repeat system users, the homeless and others with behavioral health issues and substance use disorders, to definitive long-term care and treatment. In his current capacity as Medical Editor for American Addiction Centers, Ryan works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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