Methadone is very beneficial when it comes to the treatment of chronic pain and addiction to opioids like heroin and morphine. However, being an opioid itself, the drug has great potential for being abused to elicit the same euphoric feelings. This can then lead to Methadone addiction.
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The opioid is safe and effective when used as directed. Methadone addiction develops when patients take it either without a doctorโs consultation or in larger, more frequent doses.
So, what is Methadone used for? What are the abuse signs? And how to get treatment?
What Is Methadone?
Methadone is a synthetic opioid drug that is indicated in the treatment of moderate to severe chronic pain that usually arises after surgery or due to certain illnesses. According to a study published in the Cochrane Database of Systematic Reviews, this long-acting opioid is also used in maintenance therapy and detoxification of people who are addicted to heroin and other opioids.
The Medication Is Sold Under Several Brand Names:
- Dolophine
- Methadose
- Westadone
- Diskets
More About Opioids:
The drug comes in different forms and strengths. The drug may be administered orally and rarely through intravenous means. Methadone for pain comes in liquid and tablet forms. Routes of exposure include the mouth, insufflation, intravenous, rectal, and sublingual.
The Substance Abuse and Mental Health Services Administration maintains that this medication is a Schedule II controlled substance. This is because it has a high potential for abuse, leading to addiction despite its legal indications.
The medicationโs mechanism of action involves the active metabolites of the substance binding to mu-opioid and delta-opioid receptors in the body. As an agonist of these receptors, the drug blocks pain signals from being transmitted from the body via the spinal cord to the brain.
Furthermore, the medication is quickly absorbed into the bloodstream; it is present in the blood after only half an hour. Of note is the fact that it can stay in oneโs body for around 5 to 59 hours. This is because the metabolism of Dolophine in the liver into its inactive metabolites takes long.
Putting all this together, it shows that the drug is so addictive because a single dosage of Dolophine takes long to be cleared from the body, increasing the time the patient experiences the painkilling, sedative, and euphoric effects.
What Is Methadone Used For?
The primary among Methadone uses is the treatment of opioid addiction. In 1972 it was approved by the FDA for this use. However, if someone needs ongoing pain management for a long time, doctors can also prescribe this medication.
This mainly because of its long half-life and its relatively low addiction potential compared to other analgesic opioids.
Maintenance Therapy
Maintenance therapy addresses patients with opiate addiction and consists of the administration of Dolophine for an extended period. The purpose of Dolophine use is to replace the illicit, parenterally administered heroin with a legal, oral opiate that has a long half-life. Maintenance therapy helps patients avoid the dangers and struggle of the procurement and use of heroin, including the high risk of mortality, and helping the individual reintegrate into society as a functional member.
What maintenance therapy does is prevent opiate withdrawal symptoms by blocking the high effect of heroin and reducing cravings. The dosage in this situation usually starts at 10-20 mg. It is gradually increased to 40 but, in some cases, even 80 mg a day.
Detoxification
Methadone uses include the treatment of opiate addiction. The detox implies the short-term use of the drug to diminish abstinence symptoms in individuals dealing with dependence on opioids. The dose of the medicine is gradually tapered until the patient achieves a drug-free state.
Unfortunately, this method is not very useful. It has a high recidivism rate, mainly caused by a physiologic state and the abstinence syndrome, which is still present long after completing the detox.
For detox, the Dolophine dose also starts at 10-20 mg, being increased to 40 mg a day to control withdrawal symptoms. Once the patient is stabilized, the dosage is maintained for 2-3 days and then decreased daily by 10% or 20%. But this depends on each patient, and the tapering schedule can last for weeks or even months.
For more effectiveness, gabapentin and Dolophine can be used to reduce drug use and relieve withdrawal symptoms.
Methadone For Pain
Another one of the Methadone uses is in chronic pain. The medication is used for its practical analgesic effects and other unique properties. Patients who have severe health effects from other prescribed opioids or the drugs that do not prove effective usually have their treatment replaced with Dolophine.
Unfortunately, the drugโs long half-life increases the chance of adverse health effects and drug accumulation in frequent dosing.
In the use of Methadone for pain, the transition to this drug is usually done either rapidly by discontinuing the previous opioid at once. Another option is gradually tapering the previous opioid while including Dolophine into the treatment.
Methadone Addiction
As an opioid, Dolophine is a very useful but also addictive drug. According to SAMHSA, the medication is often prescribed to help guide addicts off the use of other drugs such as heroin. However, many users get hooked on it by taking it as medication initially before becoming tolerant. This tolerance leads them to take more of the drug so that they receive the same painkilling effects. This then triggers them to become addicted.
As a less potent opioid, addiction to the medication can lead to an overdose on Methadone because addicts take a lot of it to get the same feelings as those of heroin or morphine.
If Methadone addiction does set in, then it is essential to overcome it in a treatment center. Recovery can be challenging, but it is necessary to be done as soon as possible.
The first step to solving an addiction problem is recognizing it as an issue. A person can then get the Methadone addiction help they need. An individual should contact a medical professional. They will guide one through the steps required to start a recovery from Dolophine.
Abuse Statistics
A study in the American Journal on Addictions examined the abuse of and addiction to this drug. Of the visits to the emergency rooms involving Methadone abuse symptoms, 78 percent were due to misuse of this drug.
This number included those with Methadone addiction symptoms and taking the drug when it was prescribed for someone else (7 percent). Although 10 percent of these patients were seeking detoxification from addiction, 5 percent of emergency room visitors had tried to use the medication to commit suicide.
The study also examined the number of patients who mix Dolophine with other drugs or alcohol. Between 2004 and 2007, the mixing of this medication with other pharmaceutical drugs increased by 83 percent.
In the same time frame, mixing the medication with illegal drugs and alcohol increased by 233 percent. Due to this mixture of drugs, the medicine may stop working or result in dire adverse health effects.
When it comes to the treatment of Methadone abuse problems, the number of patients admitted increased from 0.1 percent in 1992 to 0.3 percent in 2007.
Signs And Symptoms Of Methadone Abuse
When a patient abuses Dolophine, various uncomfortable side effects occur. These effects can alert a doctor or family members and friends that the patient is abusing the medication. Additionally, there are changes in a patientโs behavior that are signs of Methadone addiction.
Methadone Abuse Signs Include:
- Changes in behavior, for example, becoming more reclusive
- Irritability
- Disruptive behavior
- Less interest in hobbies
- Neglecting responsibilities at work and home
- Restlessness
- An increase in impulsivity and risky behavior
- Bad financial management to fund the habit
Addiction Treatment Help
Although Methadone for pain or opioid addiction has shown to be effective, there is still a risk of abuse. When a patient presents with symptoms of Methadone addiction, they need to seek professional medical attention in a treatment center. This is because the doctors know how to deal with the addiction. If a patient goes cold turkey, they might experience withdrawal symptoms.
Although not as strong as other narcotics, this medication can also cause a considerable addiction that is difficult to break. Patients need to check into an addiction treatment center. The personnel therein needs to be well-versed with the Dolophine facts and how to manage the addiction.
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Page Sources
- Substance Abuse and Mental Health Services Administration. Methadone. 2019. https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone
- Kreek, M. J., Borg, L., Ducat, E., & Ray, B. (2010). Pharmacotherapy in the treatment of addiction: methadone. Journal of addictive diseases, 29(2), 200-216. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885886/.
- Maxwell, J. C., & McCanceโKatz, E. F. (2010). Indicators of buprenorphine and methadone use and abuse: what do we know?. The American journal on addictions, 19(1), 73-88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723402/.
- McNicol, E. D., Ferguson, M. C., & Schumann, R. (2017). Methadone for neuropathic pain in adults. Cochrane Database of Systematic Reviews, (5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353163/
- Anderson, I. B., & Kearney, T. E. (2000). Use of methadone. The Western journal of medicine, 172(1), 43โ46.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070723/
- Luty, J., O'Gara, C., & Sessay, M. (2005). Is methadone too dangerous for opiate addiction?. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1309631/
- Psychiatric Research Institute, What is Methadone? https://psychiatry.uams.edu/clinical-care/cast/what-is-methadone/