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a man comforts a woman in a methadone addiction treatment programMethadone is a prescription medication used to treat moderate to severe pain. It is also prescribed to the patients during the treatment of heroin addiction to ease down the withdrawal symptoms. Heroin causes an overload of dopamine to be released into user’s brain. Methadone affects the same opioid receptors, but without producing the feelings of ecstasy that come with using heroin. As soon as the desire to use heroin is completely gone, the patients are weaned off from of the methadone, but this can take up to several years to complete. With the help of proper substance abuse treatment, you can ensure the process is effective and efficient.

What is Methadone?

Methadone, sold under the brand name Dolophine, among others, is an opioid medication used to treat pain and as maintenance therapy or to help with detoxification in people with opioid dependence. An opioid is sometimes called a narcotic. Methadone reduces withdrawal symptoms in people addicted to heroin or other narcotic drugs without causing the “high” associated with the drug addiction. Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs and is only available from certified pharmacies.

Methadone is a synthetic opiate manufactured for use as a painkiller and as substitute for heroin in the treatment of heroin addiction. It has similar effects to heroin but doesn’t deliver the same degree of buzz or high as heroin.

Opiates are sedative drugs that depress the nervous system. They slow down body functioning and reduce physical and psychological pain. A patient who is addicted to heroin will often be prescribed methadone to take instead of heroin and the dose of methadone is gradually reduced over time. This means that the patient can give up heroin avoiding acute withdrawal symptoms. The key effects of methadone include:

  • Reduced physical and psychological pain.
  • Feelings of warmth, relaxation and detachment.
  • Overdoses that can lead to coma (and even death from respiratory failure i.e. when breathing stops).

How Does Methadone Work?

Methadone is a prescription drug used both to relieve moderate to severe pain and to help treat opioid dependence. Specifically, Methadone works by “occupying” the brain receptor sites affected by heroin and other opiates. The result is that methadone blocks the euphoric and sedating effects of opiates while relieving cravings and symptoms associated with withdrawal from opiates. While highly debated, methadone potentially can cause a euphoric “high” when it binds to the opiate receptors of the brain. However, methadone high effects are less intense than other similar medications. The decreased addiction liability for Methadone have made Methadone Maintenance Programs a popular form of addiction treatment since the 1960’s. Methadone is excreted slowly so it can be taken only once a day.

How Fast Does Methadone Work?

Methadone is detectable in the blood within 30 minutes of ingesting the drug, although it doesn’t reach peak concentrations until after about 4 hours. How long it takes for methadone to work can vary between individuals, but it can take several hours before onset of action.

How Long Does Methadone Work?

Methadone’s effects can last anywhere from 24-36 hours, depending on the opioid tolerance of the individual. For pain management, it should be taken throughout the day as directed by a doctor. When used to help treat opiate and opioid withdrawal, it’s only given once a day.

What Makes Methadone Work Better?

Methadone works best when it’s taken in the doses prescribed by a doctor. Because it can take so long to notice the effects of the medication, it’s important not to assume it “isn’t working” and take more for pain management purposed – this can easily cause an overdose and even death.

Does Methadone Work For Everyone?

No, methadone is not a right choice for everyone. When taken as prescribed, methadone is safe and effective. But all medicines have risks. The physical effects of methadone must be managed in order to get the maximum benefits of the medication. And because methadone is habit-forming, it’s not always the best choice for someone who wants to quit drugs altogether. Methadone can also have serious side effects in some individuals, including allergic reactions. You may be taking other medications which interact with methadone. Speak to your doctor or pharmacist if you have any questions about methadone being right for you.

Why Is Methadone Addictive?

Taking methadone illegally does involve risks. Methadone that’s prescribed by a doctor is subject to stringent controls, as with any other medicine, so you can be sure of its strength and that it has not been tampered with. You can’t be as sure with methadone that’s bought on the street how pure it is. Here’s what it could do to you:

  • Street methadone may be an unusually concentrated variant and more powerful than expected.
  • Some people become sick the first time they take it and they can become very constipated.
  • With high doses, users feel sleepy. Even higher, and the user can fall into a coma or stop breathing completely.

Methadone use during pregnancy may possibly increase the risk of miscarriage, still births and low birth weight. However, it’s not a good idea to stop using opiates suddenly if you’re pregnant as this can cause premature labour and miscarriage. Methadone can be continued throughout pregnancy to minimise such risks.

How Should Methadone Be Used?

Methadone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Misuse of narcotic medication can cause addiction, overdose, or death, especially in a child or other person using the medicine without a prescription. Selling or giving away methadone is against the law.

Follow all directions on your prescription label. Methadone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Dissolve the dispersible tablet in at least 4 ounces of water, orange juice, or other citrus-flavored non-alcoholic beverage. Allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Drink this mixture right away. To get the entire dose, add a little more water to the same glass, swirl gently and drink right away. Never use methadone tablets or liquid to make a mixture for injecting the drug into your vein. This practice has resulted in death with the misuse of methadone and similar prescription drugs.

When used as part of a treatment program for drug addictions or detoxification, your doctor may recommend that each dose be given to you by a family member or other caregiver. Additional forms of counseling and/or monitoring may be recommended during treatment with methadone. You should not stop using this medicine suddenly. Follow your doctor’s instructions about tapering your dose. Store at room temperature away from moisture and heat. Keep the medication in a place where others cannot get to it.

Keep track of how much of this medicine has been used. Methadone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

Do not keep leftover methadone pills or liquid. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills or liquid medicine down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.

Common Methadone Drug Combinations

Interactions between methadone and other drugs can lead to overdose or death. Drugs that depress the respiratory system (e.g. benzodiazepines) increase the effects of methadone. Drugs that affect metabolism can induce methadone withdrawal symptoms. In particular it is important to note interactions between methadone and medications used to treatment HIV and tuberculosis. The HIV medications nevirapine and efavirenz increase metabolism of methadone, causing opioid withdrawal. Some protease inhibitors (PIs) may have the same effect, especially when associated to a small boosting dose of ritonavir. The tuberculosis medication rifampicin increases metabolism of methadone and reduces the half-life of methadone.

Patients in methadone maintenance treatment can become tolerant to the pain-relieving effects of opioids. In the event that an MMT patient requires pain relief, non-opioid analgesics such as paracetamol can be given. If methadone patients are provided with opioid analgesics, they may require higher than normal doses to experience pain relief.
Mixing methadone with alcohol, or with other sedatives such as benzodiazepines, can have serious consequences: an overdose is more likely, and this can lead to a coma or respiratory failure and death.

American Statistics on Methadone Abuse

Methadone was introduced into the United States in 1947 by Eli Lilly and Company as an analgesic under the trade name Dolophine, which is now registered to Roxane Laboratories. Since then, it has been best known for its use in treating opioid dependence. A great deal of anecdotal evidence was available “on the street” that methadone might prove effective in treating heroin withdrawal and is not uncommonly used in hospitals and other de-addiction centers to enhance rates of completed opioid withdrawal. It was not until studies performed at the Rockefeller University in New York City by Professor Vincent Dole, along with Marie Nyswander and Mary Jeanne Kreek, that methadone was systematically studied as a potential substitution therapy. Their studies introduced a sweeping change in the notion that drug addiction was not necessarily a simple character flaw, but rather a disorder to be treated in the same way as other diseases. To date, methadone maintenance therapy has been the most systematically studied and most successful, and most politically polarizing, of any pharmacotherapy for the treatment of drug addiction patients.

In the US, generic methadone tablets are not very expensive. The retail price ranges between $0.25 and $2.50 per defined daily dose. Brand-name methadone tablets may cost much more. Methadone is a Schedule II controlled substance in the United States, with an ACSCN of 9250 and a 2014 annual aggregate manufacturing quota of 31 875 kilos for sale. Methadone intermediate is also controlled, under ACSCN 9226 also under Schedule II, with a quota of 38 875 kilos. Methadone maintenance clinics in the US charge anywhere from $5 to $400 per week, which may be covered by private insurance or Medicaid.

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