Methadone has been championed as one of the most effective methods of treating opioid addiction.

And it’s true: when used in conjunction with various other treatment methods, using methadone properly can be instrumental in reducing the withdrawal symptoms of opioids, typically regarded as one of the most addictive substances known today.

But as an opioid itself, methadone also carries with it the potential for abuse just like any other opium-based substance. And that means if you’re going to be using methadone in your treatment, you need to first have all the facts.

What is Methadone?

Methadone is an opioid that’s most commonly used in addiction treatment. It’s unique in that it can be used to ward off the withdrawal symptoms of other opioids like heroin and codeine, hence its usefulness in the addiction treatment field.

It can come either in liquid or pill form and is normally distributed by physicians at certified methadone clinics.

When taken properly, methadone can counteract the uncomfortable process of opioid withdrawal since it actually interacts directly with the same receptors in the brain as other opioids, though to a lesser degree.

The problem comes from taking this substance outside of a doctor’s guidelines in order to achieve a methadone high. This can produce feelings of euphoria and pleasure similar to that caused by other opioids.

What’s more, some methadone treatments can be administered at home by the patient themselves. The methadone pills patients receive can be crushed and then snorted, smoked, or injected to increase the potency of the methadone high.

What Are Some Methadone Side Effects?

Like many other powerful drugs, methadone can cause some users to experience a variety of physical and mental side effects such as:

• Stomachache
• Dry mouth
• Sore tongue
• Weight gain
• Headache
• Vision problems
• Erratic mood
• Insomnia

If you are currently taking methadone for opioid addiction and experience any of the following side effects, be sure to contact a doctor immediately:

• Rash, hives, itching, or swelling of the eyes, face, mouth, tongue, or throat
• Difficulty breathing or swallowing
• Hoarseness
• Chest Pain
• Extreme drowsiness
• Agitation or hallucinations
• Fever, sweating, fast heartbeat, shivering or muscle stiffness or twitching
• Nausea, vomiting, weakness, dizziness, or loss of appetite
• Sexual dysfunction, decreased sexual desire, or irregular menstruation

What Role Does Methadone Play in Addiction Treatment?

Methadone is one of the most commonly used substances for treating opioid addiction. Being an opioid itself (though a much less intense one with a longer release timeline), methadone has been shown to be quite effective at reducing the withdrawal symptoms during opioid addiction detox.

It does so by interacting with the same receptors that other opioids stimulate, namely a particular opioid receptor called the mu receptor. In fact, when taken in proper doses, methadone can help to eliminate withdrawal symptoms and cravings entirely, all without producing an actual “high” in the patient.

Using substances such as methadone to counteract the sometimes-unbearable withdrawal symptoms is called medication assisted treatment or MAT. Some other examples of MAT substances include buprenorphine and naloxone for opioids and acamprosate for alcohol.

The National Institute on Drug Abuse reports that MATs have a variety of benefits such as:

• MATs have been shown to decrease opioid use, criminal activity, infectious disease transmission and also help decrease opioid-related overdose deaths as well.
• MATs boost both social functioning as well as retention in treatment centers, leading to lowered rates of relapse.
• MATs improve the outcomes for pregnant mothers with an opioid dependency problem, reducing the symptoms of neonatal abstinence syndrome and the final length of their hospital stay.

What Other Components Are Required for Successful Addiction Treatment?

Medication assisted treatment has been shown to be especially effective in treating opioid addiction by reducing withdrawal symptoms and cravings. What’s more, its relatively few side effects when prescribed and taken appropriately make methadone an incredibly useful part of many opioid use disorder treatment plans.

But the success of any recovery program depends on more than just medication assisted treatment. In fact, if you’re looking for a rehab program that only deals in medication assisted treatment, you may be out of luck.

Many clinics today recognize that successful treatment takes more than just detox and treating the symptoms of withdrawal. Rather, a high-quality facility will craft their program around other evidence-based treatment methods as well.

These techniques and strategies are built on actual scientific evidence, not just conjecture or tradition. And when used in conjunction with MAT programs, these additional services will provide a dramatic decrease in the likelihood of a relapse.

• Dual Diagnosis Treatment – Individuals with a drug use disorder have been shown to be as much as 20% more likely to have a mental disorder compared to non-drug users. And since drug and mental disorders can exacerbate each other, both must be treated in order to increase the probability of recovery.
• Behavioral Therapy – Staying clean requires more than just flushing your body of the substance in question. You’ll also need to be equipped with strategies that help you deal with cravings should any temptations arise (because they will). Behavioral therapy does just that and is integral to every successful program.
• Counseling – Many substance abusers use drugs like opioids and alcohol to cope with problems in their lives. It could be social anxiety, lack of confidence, or past trauma like growing up with an alcoholic parent. Counseling will help you identify the root cause of your addiction so you can deal with it in a healthier way.
• Aftercare – A strong recovery program will include and enforce a variety of aftercare programs such as continued group therapy and regular check-ins. Overcoming an addiction can be a long process that doesn’t end when you walk out the doors of rehab. It can take months or even years longer. Aftercare can help keep you dedicated to your sobriety.

Can You Become Addicted to Methadone?

As an opioid itself, methadone can in fact become the source of a separate addiction. This, unfortunately, is the case with many substances that are used for medication assisted treatment programs.

There is, unsurprisingly then, quite a bit of conflict regarding whether or not MATs should be encouraged. On the one hand, this type of treatment program has been shown to be incredibly beneficial during the recovery process, as mentioned above.

On the other hand, though, some people believe that all substance use disorders should be treated solely through non-medical means like counseling and group therapy.

There is also a prevailing public opinion that substance addiction is a type of moral failure rather than an actual disease, meaning that if someone is unable to stop using, they simply aren’t putting in enough effort.

This view of addiction is one of the most common misconceptions about substance abuse. In fact, changing the way we think about addiction over the past several decades has led to increased rates of recovery and fewer relapses across the country.

What Does Methadone Addiction Look Like?

Methadone addiction typically only occurs when it’s been taken outside the prescribing doctor’s guidelines. What’s more, some methadone treatments can be administered at home without a presiding physician overseeing the treatment, making methadone more susceptible to abuse.

One of the most obvious signs of methadone addiction is the presence of methadone withdrawal symptoms. These can include:

• Chills
• Anxiety
• Nausea or vomiting
• Irritability
• Diarrhea
• Sweating
• Depression

If you or someone you know is experiencing any of these symptoms during methadone treatment, it’s critical that you talk to your doctor about the possibility of adjusting your dosage. Otherwise, you may be tempted to fall back into opioid abuse.

It’s also important that you’re able to identify the signs of methadone overdose when dealing with methadone abuse. Symptoms of a methadone overdose include:

• Pinpoint pupils
• Constipation
• Nausea and vomiting
• Stomach or intestine spasms
• Low blood pressure or weak pulse
• Irregular breathing or no breathing
• Blue fingernails and lips
• Fatigue
• Weakness
• Disorientation
• Coma
• Muscle twitches

If you suspect someone is having a methadone overdose, seek help immediately by contacting the national Poison Help hotline at (1-800-222-1222) or by calling 911.

Can You Get Methadone at Any Clinic?

Due to the addictive nature of methadone and its potential for being abused, not every clinic is licensed to distribute methadone as an opioid addiction treatment. In fact, there are a number of safeguards in place to ensure that the substance is only given to those who need it and is administered in a safe and effective way.

In order to qualify for methadone distribution, a clinic must offer a Substance Abuse and Mental Health Services Administration (SAMHSA) certified opioid treatment program (OTP). These programs must be accredited by the Division of Pharmacologic Therapies (DPT) as well.

By law, such programs must offer a variety of other services to anyone being treated beyond just MAT. These services include medical, vocational, education, and counseling services. Such regulations have come about in part as a result of further research being conducted on the effectiveness of a holistic treatment approach rather than using medication assisted treatment alone.

It’s important, then, that when searching for a successful addiction treatment approach you enquire whether each facility is a designated methadone clinic. Simply assuming they are might be setting yourself up for relapse.  

What Is a Healthy Methadone Dosage?

If you’re enrolled in an opioid treatment program, you and your doctor will be working closely to figure out the best dosage for your specific situation. It’s important to remember that methadone is itself a narcotic and, as such, improper usage and dosage can lead to unintended consequences like developing a new addiction rather than treating an old one.

Given the potential for methadone abuse, it’s absolutely critical that you take only the methadone dosage that your doctor prescribes.

While each individual’s dosage will likely be different, adults taking methadone for opioid addiction will likely begin by taking 20 to 30 milligrams a day in the form of a single dose. This, of course, can be adjusted by your doctor throughout the recovery process but probably won’t exceed 40 mg in a single day.

Children using methadone to treat an opioid addiction will have even more selective dosages determined by their doctors.

Anyone taking methadone for opioid addiction should also be careful not to take another dose if they miss one. Instead, they should take their dose the next day as previously scheduled. Double dosing should be avoided.

It should also be noted that you should never stop taking methadone without first consulting your doctor, even if you feel like you no longer need it. One of the purposes of methadone treatment is to stave of opioid withdrawal symptoms. By stopping your methadone usage suddenly, you may start experiencing these symptoms and be tempted to use again.

Methadone: A Powerful Yet Potentially Dangerous Tool

Methadone has been shown to be incredibly beneficial when it comes to treating opioid addiction recovery. In fact, many clinics recognize this particular drug as a crucial component of any successful recovery program.

That being said, there can be a dark side to this drug when it isn’t used properly and when abused, methadone can be just as dangerous as other opioids.

That’s why it’s critical that methadone is taken strictly according to the doctor’s orders. Otherwise, you may be simply trading one addiction for another.

Sources:

Mayo Clinic (2017, March). Methadone (Oral Route). Retrieved from http://www.mayoclinic.org/drugs-supplements/methadone-oral-route/description/drg-20075806

MedlinePlus (2017, Jan.). Methadone. Retrieved from https://medlineplus.gov/druginfo/meds/a682134.html

National Institute on Drug Abuse (n.d.). Effective Treatments for Opioid Addiction. Retrieved from https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction/effective-treatments-opioid-addiction

National Institute on Drug Abuse (2012, Dec.). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) – Opioid Addiction. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies

Substance Abuse and Mental Health Services Administration (2015, Sep.). Methadone. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone