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What Is Methadone?

Each year, hundreds of thousands of people take methadone to aid in recovery from opioid addiction. The prescription drug has been used alongside counseling and therapy for decades. Studies show that it increases the chances of staying in treatment and reduces the likelihood of relapse.

The medication usually comes in liquid form at methadone clinics or addiction treatment facilities, but it’s also available in powder and tablet forms. It is usually consumed under the supervision of a physician because of its potential for abuse. Methadone is a man-made opioid that weakens cravings and withdrawal symptoms caused by dependency to other opioids, such as heroin. The term opiate usually refers to naturally occurring drugs derived from opium, such as codeine and morphine. Methadone is made in a lab, so it is not an opiate.

The numbers of clients receiving methadone from certified opioid treatment programs increased from 258,000 in 2006 to 345,000 in 2016, according to the National Survey of Substance Abuse Treatment Services. More than 1,200 drug rehab facilities provided methadone in 2016. If abused, methadone can cause euphoria and relaxation. Frequent abuse can lead to dependency and prescription drug addiction. However, methadone is a long-acting opioid. It takes several hours for the full effects of the drug to kick in, and the effects can last for up to 36 hours.

Most people who misuse opioids to get high prefer drugs that act quickly, such as oxycodone. Getting high on methadone is different from getting high off of other opioids. Methadone doesn’t cause the “rush” that other opioids cause. It’s possible for individuals to become addicted to methadone. Some individuals with opioid use disorders seek methadone from a doctor only when they’re unable to find an illicit opioid, such as heroin. When methadone is taken irregularly and the person isn’t committed to a comprehensive substance abuse treatment plan, recovery from opioid addiction is unlikely.

Methadone must be taken as prescribed by a doctor to be effective. Some people plan on temporarily taking methadone to avoid withdrawal. Once they take the medication, they may realize the drug can help them recover from addiction. With long-term methadone treatment and therapy, people can slowly taper off of opioids and return to regular life.

Methadone Maintenance Therapy

Most people who are addicted to opioids continue to take the drugs because they fear the withdrawal symptoms caused by dependency. Opioid withdrawal lasts for several days and can cause intense sweating, nausea, diarrhea, muscle aches and insomnia. To overcome dependency, individuals have to stop taking opioids. The quickest way to overcome withdrawal is to quit cold turkey. However, quitting cold turkey is risky and can cause a number of health complications. Withdrawal is so intense that very few people successfully quit opioids cold turkey.

Recovery from opioid addiction is more realistic when individuals slowly decrease the amount of opioids that they take. Methadone maintenance therapy replaces heroin or prescription opioids with methadone. The medication is less prone to abuse and lasts longer than other prescription opioids, which usually last for between four and 12 hours. People undergoing methadone maintenance therapy receive methadone once a day at a clinic for at least a year. Some people receive the medication for multiple years. A 2005 review of 52 studies that was published in the Journal of Substance Abuse Treatment found that methadone maintenance therapy was more effective than several other forms of treatment at retaining patients in treatment and reducing heroin use.

Initial Dosing

The initial dose of methadone depends on a person’s history of opioid use and his or her tolerance to opioids. Individuals with an unclear history of opioid use or those with a low tolerance to opioids usually begin with a low dose of methadone. If patients experience cravings or withdrawal symptoms while on methadone, health providers will adjust the methadone dose gradually. The dose is usually adjusted based on how a person feels within two to four hours of receiving methadone. It isn’t adjusted based on when the effects of methadone wear off. Over time, methadone will accumulate in the body and the effects of the drug will last longer.

Steady State

After multiple days of methadone maintenance therapy, levels of methadone in the body reach a steady state. That means methadone leaves the body at a rate similar to the rate at which it enters the body. Individuals may experience some withdrawal symptoms when methadone wears off during the first days of initial dosing. Once the drug reaches steady state in their bodies, they should not feel withdrawal symptoms.

Stabilization

The stabilization phase of methadone therapy refers to the phase of treatment during which patients no longer exhibit drug-seeking behavior. To reach stabilization, methadone levels have to reach a steady state in the blood, and doctors have to determine a dosage of methadone that prevents withdrawal symptoms for 24 hours. Once patients are stabilized, they usually begin intensive counseling and therapy to treat the psychological causes of addiction. They learn healthy stress-relief techniques, coping skills and strategies to avoid relapse.

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