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Article Summary

A Guide To Methadone Addiction

Methadone abuse, according to NDIC (the National Drug Intelligence Center) has gone up over the past 20 years. This increase has been caused by the rising frequency with which doctors prescribe the drug for pain heroin withdrawal and pain relief, as well as the frequency at which the medication is availed illegally or stolen.

For decades, the drug was used for addiction treatment. However, the past 10 years have seen a 700% increase in the prescriptions written for pain relief and management. NDIC further states that this increase has been due to other pain killers, like Oxycontin, which are now getting lots of attention in the media.

Understanding Methadone

An opioid, methadone is used in the treatment of opiate abuse and heroin addiction. Although this is the case, the drug is also potentially addictive. While being used for opioid dependence, it might be prescribed and administered at licensed medical centers.

However, methadone might also be used in treating pain. In this case, it would be prescribed by physicians based in an office. What most patients don't know is that the drug is long acting, sometimes staying in the system for 22 hours or thereabouts. This means that it should be administered once daily.

If you take more than the recommended dose or use it recreationally, the drug will likely cause addiction and usher in various severe effects. As with any other opioid drug, methadone abuse often leads to addiction and overdose, sometimes even causing the death of the addict.

Most people who get methadone prescription are usually addicted to and dependent on opioids, such as prescription painkillers, morphine, and heroin. In this case, the drug would be administered to deal with the addiction because:

  • It reduces and illuminates opiate withdrawal symptoms
  • Its duration of action is quite long
  • It can reduce harm associated with illicit opiate addiction, such as crime, overdose, iv related diseases, etc.

However, problems can arise when you abuse it without a valid prescription or if you combine it with alcohol, opioids, and benzodiazepines.

That said, methadone is also branded as Diskets', Dolophine', Methadose', Methadose' Oral Concentrate, and Westadone', to name a few.

Methadone Uses

Chemically referred to as Methadone Hydrochloride, methadone is a synthetic opiate or opioid. It was created by German pharmaceutical companies during WWII. During this time, the drug was marketed as Dolophine for use as a painkiller (analgesic) to deal with severe pain. Today, it might still be used to provide relief from pain.

The medication is now used in treating narcotic addiction. Since its effects last longer than those from most morphine-based drugs, methadone should be administered once daily especially when it is used in heroin detox and maintenance.

That said, methadone is available as a mixture or as a liquid (linctuses), designed for swallowing. However, your doctor might also prescribe intravenous ampoules and tablets.

Irrespective of the system of administration, methadone acts fast to eliminate or reduce cravings for other opioids, as well as the harsh withdrawal symptoms arising from opioid addiction.

Methadone Effects

Methadone causes a wide variety of health effects, most of which will depend on your body. If you do not get off the drug early enough, you increase your risk of suffering such long term effects as:

  • Sleepiness, dopiness, nodding off
  • Impaired judgment
  • Mood swings/agitation
  • Respiratory problems
  • Sexual dysfunction
  • Addiction

Methadone Side Effects

All medications come with side effects. However, many people may not feel these effects or might be able to bear with them. Irrespective of the case, it is important to ask your doctor or pharmacist about the potential side effects of the medication you are required to take.

That said, the benefits of taking methadone might outweigh the relatively minor side effects. Similarly, these effects are likely to go away after your body adjusts to the medication. However, if you are still bothered by the effects and are worried about continued use, talk to your doctor. They might lower the dose or ween you off the drug for an alternative.

The following are some of the side effects arising from using methadone, which are similar to other opioids. You should get help if you experience these effects:

  • Constipation
  • Forgetfulness
  • Impaired coordination or balance
  • Confusion or impaired cognition
  • Dizziness or lightheadedness
  • Nausea
  • Vomiting
  • Drowsiness or sleepiness
  • Swelling of the throat, tongue, lips, or face
  • Trouble breathing

You should also talk to your doctor immediately after experiencing the following:

  • Hives
  • A slow, fast, or pounding heartbeat
  • Increased sweating
  • Flushing or redness of the face

Methadone Addictive Qualities

Methadone is an addictive opioid. It works by binding itself to the same brain receptors that are affected by other opioids like OxyContin and heroin. Since the drug's effects remain in your body for a relatively extended period of time - between 1 and 3 days - it will likely block the euphoria arising from other opiate medications you have been abusing. As such, you will experience less painful symptoms from withdrawing from these drugs, primarily because methadone is also an opiate medication in itself.

However, since methadone is long acting, it can build up in your body quickly and stay in your system for a long while. This is why it is vital that you only use the drug as your doctor prescribed, and not adjust your dose without medical advice and oversight. Keep in mind that some users have overdosed on the drug even with a single dose.

Methadone is a powerful opiate medication, however it might not elicit an effect profile as intense as that from shorter acting but more powerful opioid substances (such as heroin).

But when taken in high doses, you are highly likely to subject yourself to the heightened and potentially fatal effects of methadone. Additionally, methadone is a highly addictive opiate and because it has a longer half-life that most other opiates, the withdrawal symptoms that arise when discontinuing methadone use are very long and extremely discomforting. This makes methadone an extremely difficult drug to get off of, once addicted.

Methadone Overdose

It is common for methadone users to also use benzodiazepines such as Ativan or Xanax or antidepressants (Zoloft, Lexapro, or Paxil). These sedative medications metabolize through the liver, the same path that methadone follows and interferes with how the body metabolizes methadone. At times, this is likely to result in the toxicity of the methadone, which can lead to an overdose even when you take the proper dose.

Since methadone is slow acting and lasts within the body for a long period if time, compared to most other opiate drugs, this greatly increases the potential for overdose. The drug's peak effects may not occur until 3 - 10 hours after first ingestion and users can initially think the drug is not working as they would desire it to and therefore take an additional dose in that time. This is the recipe for disaster because once the peak effects of both doses finally start to take effect, it is too late and overdose occurs. According to the Center for Disease Control and prevention, from 1999 to 2006 the rate of methadone overdose deaths increased 600%, from 0.3 persons per 100,000 in 1999 to 1.8 persons per 100,000 in 2006.

To this end, you should watch out for the following common symptoms of a methadone overdose:

  • Blue fingernails and lips
  • Cold and clammy skin
  • Coma
  • Constipation
  • Difficulty breathing
  • Disorientation
  • Dizziness
  • Drowsiness
  • Fatigue
  • Limp muscles
  • Muscle twitches
  • Nausea
  • Shallow or slow breathing
  • Small pinpoint pupils
  • Intestinal or stomach spasm
  • Stopped breathing
  • Vomiting
  • Weakness

If you notice someone displaying these classic signs of an overdose from methadone, you should:

  • Not put them in a cold shower or bath because it might cause them to go into a shock, or they could fall or drown
  • Not walk, drag, or slap the person to make them work. If you are unable to make them wake up by pinching the ear, rubbing their knuckles on sternum, or shouting, further stimulation might lead to a serious injury
  • Not try to force them to vomit because they might inhale or choke on the vomit

The best way to deal with a suspected or actual methadone overdose is to call emergency medical help or go to an emergency room where a dose of Narcan can be delivered which is an opiate antagonist that reverses the effects of opioid drugs. Failure to do this will very likely endanger the life of the individual overdosing.

Methadone Withdrawal

If you stop using methadone abruptly, your body will need some time to recover. During this time, you will likely undergo withdrawal, which is likely to produce a wide range of serious symptoms. These symptoms include but are not limited to:

  • Agitation
  • Anxiety
  • Diarrhea
  • Muscle pains
  • Nausea
  • Stomach cramping
  • Sweating
  • Trouble sleeping
  • Vomiting

Additionally, since methadone is a long-acting opiate, the withdrawal symptoms when discontinuing methadone use can last a very long time, sometimes up to 30 days or more. This can make going through methadone withdrawal extremely difficult and therefore make quitting methadone use equally difficult.

To help minimize these acute withdrawal symptoms, your doctor might gradually reduce your current methadone dose slowly. This process is commonly called tapering, where your body slowly adapts to the decreased volumes of the drug in your system. Eventually, with discipline and sticking to the doctor's tapering plan the person may be able to free themselves from the drug.

Although methadone withdrawal tends to be extremely uncomfortable, it is not necessarily life-threatening. As you seek treatment for methadone addiction, the doctors might prescribe medications to manage these withdrawal symptoms and any cravings for the drug you are bound to experience.

Methadone Dangers

Using methadone illegally or without following the prescription from your doctor will prove to be risky. Today, prescribed methadone is widely controlled.

If you buy the drug off the street, you might not know about its purity or chemical composition. These types of medications might:

  • Be unusually concentrated and more potent than you anticipated
  • Be mixed with other dangerous drugs
  • Lead to sleepiness if you take them in high doses; higher doses might cause you to stop breathing or go into a coma

As an opiate, methadone might also increase your risk of premature labor, still birth, miscarriage, or the birth of a small baby.

If you mix the drug with sedatives like benzodiazepines or alcohol, it might cause serious consequences. The most likely risk is an overdose and such mixing might lead to respiratory failure, coma, or sudden death.

Signs And Symptoms Of Methadone Abuse

Those who abuse methadone are likely to experience the following symptoms:

1. Physical Symptoms
  • Drowsiness
  • Flushing
  • Dopiness/sedation
  • Lack of normal interest in sex
  • Nausea
  • Itching skin
  • Sleeplessness
  • Sweating
  • Swelling of the body's extremities
  • Vomiting
2. Behavioral Symptoms
  • Attempting to get more than one prescription
  • Doctor shopping
  • Getting the drug from another source
  • Lying or exaggerating about the symptoms of methadone abuse to receive higher doses
  • Neglecting aspects of your life, including your relationships and job
  • Refusing to undergo appropriate referral, testing, or examination
  • Reporting loss of the prescription repeatedly
  • Skipping your scheduled doses to stockpile them so that you can administer them later
  • Taking a larger dose than was prescribed
  • Using methadone more or in a higher dose than your doctor prescribed
3. Psychological Symptoms
  • Borrowing or stealing money
  • Distancing yourself from family members and friends
  • Irrational anger
  • Losing interest in appearance and personal hygiene
  • Loss of interest in or enthusiasm for those activities you once cared about
  • Mood swings
  • Neglecting responsibilities at school, work, or home
  • Secretive behavior, including unexplained absences

Treatment For Methadone Addiction

Luckily, you can get treated for methadone addiction. Some treatment centers will manage the specific effects of withdrawing from the drug as the initial part of your rehabilitation.

The best way to deal with your addiction is to get evaluated from a substance abuse facility or counselor. They will assess your particular condition to understand the intensity, frequency, and level of your dependence, as well as all the associated addictive indications. Depending on the responses you give, you might have to undergo detox followed by inpatient or outpatient rehabilitation to treat the dependence and addiction.

As with other addictions, the best solution is to report that you have been abusing methadone. The doctors will recommend an appropriate treatment program or facility, and you will soon be weaned off the drug.

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