Methadone is a synthetic narcotic which has effects that are similar to morphine. Originating in Germany, it began being used in clinics after World War II.
Doctors Marie Nyswander and Vincent Dole started to promote methadone in the 1960′s to aid in the rehabilitation of narcotics addicts. This is a Schedule II drug under the Controlled Substances Act and is commonly used in the United States, Thailand, Sweden and Hong Kong in methadone maintenance programs. The legal purpose of methadone is to reduce cravings for opiates. Since these cravings are suppressed for a period of 24 to 36 hours, the drug can be taken once a day for treatment of addiction to opiates.
This narcotic, which is available in several forms, may only be prescribed and dispensed to treat opiate addiction by licensed doctors who are certified by the Substance Abuse and Mental Health Services Administration. However, any licensed physician may prescribe methadone or any other opiate to a patient in the treatment of chronic pain. Under these circumstances, this prescription may be filled by any licensed pharmacy.
Research provided by the Drug Abuse Warning Network (DAWN) informs us that data indicates that methadone abuse ranks among the top ten in drug-related deaths in the following US cities: Chicago, Newark, Phoenix, Detroit, Baltimore. In emergency department episodes where methadone is mixed with other drugs, the top combinations reported are methadone + alcohol, methadone + cocaine and methadone + heroin.
Some addicts manage to sell the methadone which they receive legally through a maintenance program and use the money to purchase heroin. Consequently, various forms of diversion have resulted in methadone joining the ranks of other addictive drugs which are sold on the street.
In the past, methadone was thought to be an effective way to eliminate dependency on opiate drugs. Instead of decreasing dosages, though, many methadone clinics raise them with financial motives. Their patients suffer physically and emotionally from long-term use of methadone, and find themselves tethered to their clinics, unable to travel or live their lives fully. There’s little point to replacing one dependency with another, and many people who use methadone are unhappy that they rely on one drug to keep them from being dependent on another. In fact, methadone has been shown to be more addictive than many drugs it is used to treat.
In terms of chemical structure, methadone is the simplest compound that is an opioid. It has a very long half-life in the body, but still binds to the same sites in the brain as do other opioids. That means that it has had a history as both an effective drug treatment and as a painkiller.
Morphine has been most frequently used to wean people off dependencies to more potent narcotics. This treatment works for both illegal and prescription opioids, and has been the cornerstone of opiate detox for many years. Although the patient then becomes dependent on the methadone, it is considered an improvement in quality of life due to the fact that methadone does not create any “high.” Methadone has recently become popular among physicians as a painkiller. When chronic pain patients don’t respond to weaker painkillers, methadone can be prescribed. It makes a good alternative to opioids like morphine that have shorter half-lives and more dramatic “highs,” but methadone’s use as a painkiller is tempered by the fact that it does create a dependency when regularly dosed.
Millions of Americans are paying for drugs they don’t need every day. Many physicians aren’t familiar with how to properly treat ailments like chronic pain. Not knowing how to cure these often imprecise complaints, doctors will anaesthetized or narcoticize their patients, giving prescription opiates. The problem with this approach to medicine is that it leaves patients dependent on their prescriptions.
Many patients in this situation will try to detoxify to end their dependencies, but unfortunately, too many detox clinics don’t offer proper care. They use methadone to wean the patient off of their prescription drugs, but then leave the patient dependent on methadone. While methadone has a lesser impact on the patient than the original drug did, it is still a dependency–and the patient is still paying for the daily dose.
Any individual who has become addicted to methadone should not consider going through the withdrawal process without consulting a physician who is licensed and experienced in methadone addiction treatment.
Substance abusers who have been using opiates for long periods of time and have then stopped using their original drug of choice and switched over to methadone maintenance may decide at some point that they no longer wish to continue methadone use. Initial use of methadone requires the client to attend the clinic every day for at least thirty days. He or she must drink their dose in front of the dispensing nurse and, in a number of clinics, speak to the nurse afterward to prove that the dose has been swallowed. The reason for this is that some clients have been known to leave the clinic, spit the dose into a cup and sell it for a profit. If their first urine test at the end of the first month is clean, they may then be “promoted” to a higher level of trust, have earned the ability for a take-home dose and are not required to attend the clinic on a daily basis. Depending upon the rules and regulations of the state in which the methadone clinic is located, clean urines are rewarded in decreased attendance at the clinic and more bottles of methadone to drink at home.
Taking methadone on a daily basis is merely switching from an illegal drug to one which is legal as methadone is as addictive as any narcotic on the market. Some of the methadone withdrawal symptoms are as follows:
- aches and pains
- stomach cramps
After a user has been stabilized, the dose can be gradually decreased. The physician in charge of the clinic observes the reactions of the individual and keeps the rate of decrease at a level that is comfortable for the client.
Many individuals become free of addiction to heroin or other opiates and enter a methadone maintenance program. They then exchange their addiction to heroin to an addiction to methadone. It is very easy to fall into a pattern of attending a methadone clinic on a proscribed routine and obtaining a dose on a set schedule based upon federal regulations. Based upon the rules set by the federal government, the following clinical attendance schedule is required by methadone patients:
- First 90 days (1st thru 3rd month): one take-home dose per week
- Second 90 days (4th thru 6th month): two take-home doses per week
- Third 90 days (7th thru 9th month): three take-home doses per week
- Fourth 90 days (10th thru 12th month): 6 days’ supply of take-home doses per week
- After one year of continuous methadone maintenance: two weeks’ supply of take-home doses
- After two years of continuous treatment: one month’s supply of take-home doses.
- Monthly visits to the clinic are still required.
Individual states may impose additional requirements if they so desire.
Take-home doses refer to medication that patient takes unsupervised. Any patient is allowed to receive one single take-home dose for a day when the clinic is closed which includes Sundays and state and federal holidays. The criteria used by the medical director are the following based upon federal regulations:
- Regular clinical attendance.
- Absence of recent drug and alcohol abuse (based upon “clean: urines).
- Absence of recent criminal activity.
- Patient’s ability to safely store take-home medication.
- Absence of behavioral problems at the clinic.
- Stable home environment and social relationships.
- Appropriate length of time in treatment program.
- Assurance that benefits of decreased attendance outweigh possible risks of diversion.
For those individuals who desire to become totally free of chemical dependency and are tired of the need to ingest a dose of methadone each and every day – and wish to end their enforced relationship with the methadone maintenance clinic – there is a solution to your problem! The Lakehouse Recovery Center offers a methadone addiction treatment program designed to help you safely and effectively end your dependence upon methadone without transferring to an addiction or craving for another form of narcotic and without interfering with your career or education.