Frequently Asked Questions
Methadone is one of the most widely researched medications in the US, and also one of the more misunderstood medications for use in recovering from substance dependency. This information is not intended to be all inclusive, but is intended to assist your decision to enter treatment.
What are opiates?
One of the most widely prescribed medications, opiates and its related medications (Lorcet, Lortab, Percodan, and OxyContin) are opioid-based pain medications. Opiates are a derivative of opium which is also used to manufacture heroin and morphine. Opiates are successful in diminishing pain but are highly addictive, and the withdrawal symptoms of opiate addiction are very similar to the pain it was relieving. Opiates are some of the most commonly abused prescription pain medications today.
What is methadone?
Methadone is a rigorously well-tested medication that is safe and efficacious for the treatment of narcotic withdrawal and dependence. It works as an opiate agonist and occupies the brain receptor affected by opiates and is the stabilizing factor that permits addicts on methadone to change their behavior and to discontinue opiate use.
Methadone is trading one addiction for another. True or False
The term "addiction" refers to the loss of control over drug use or other behaviors such as eating or gambling, with resulting social, health and family difficulties. Methadone-maintained patients are in control of their daily medication and noted improvement is seen in their daily social and family lives. Drug Czar, General McCafferey used the comparison of methadone-maintained patients being similar to diabetics or others who require daily medication to remain healthy.
Methadone Harms Your Bones, Rots Teeth, and Causes Internal Organ Damage. True of False
Over forty years of research demonstrates the positive effects of methadone on patients health. Patients have significantly reduced risks of infections associated with IV drug abuse, sexual behaviors, and other risky health behaviors. Many methadone-maintained patients begin experiencing increased physical and mental health within days of starting a treatment program. Most medical conditions observed in methadone-maintained patients are either related to their preexisting health conditions, new conditions secondary to their past drug abuse, or normal aging processes and health. A patient’s health actually improves in methadone maintenance treatment.
What is the proper dose of methadone?
Doses must be individually determined, due to differences in metabolism, body weight, and opiate tolerance. Doses of 60 to 100 mg, and sometimes more, are required for most patients.
There is no specific dose that is best for everyone. Your methadone dose level is dependent upon many factors, which the Medical Director considers when adjusting your daily dose. Patients going through opioid withdrawal due to insufficient methadone doses, or experiencing methadone over medication effects, such as sleepiness or fatigue, might not perform as well. This includes methadone patients who are abusing other substances, such as alcohol or benzodiazepine medications. Any central nervous system depressant medications or substances will impair your skills and ability to safely operate a motor vehicle or operate equipment.
Is Methadone Safe?
YES. Research and clinical study, particularly the ongoing work at Rockefeller University, has demonstrated the unequivocal medical safety of long-term methadone; there are no serious adverse effects, no harmful medication interactions, and it is safe for pregnant women.
You Cannot Safely Withdraw from Methadone. True or False
Because methadone is very long acting, withdrawal from methadone does last much longer than withdrawal from short-acting opioids. Research found that withdrawal symptoms actually were less severe in patients maintained on methadone than in those taking equivalent doses of short-acting opioids like heroin. Gradual withdrawal from methadone, when properly done under medical supervision, can be virtually free of discomfort. On the other hand, patients who try to withdraw from methadone by themselves, on their own time and dose schedule, usually experience undue discomfort and fail.
Methadone Patients Are At Higher Risk for Traffic Accidents and Should Not Operate Heavy Equipment. True or False
The public has justified concerns about persons using alcohol or any drugs that might impair mental functioning while driving motor vehicles. Federal motor vehicle regulations prohibit operation of motor vehicles under the influence of psycho-active substances. The key to this question is "under the influence". A person adequately stabilized on methadone is not impaired or "under the influence".
Is Methadone Effective?
Methadone is the most widely known pharmacologic treatment for opiate dependence and is effective in reducing illicit narcotic use, retaining patients in treatment and decreasing illegal drug use. Ongoing methadone maintenance decreases the risk of contracting and transmitting HIV, hepatitis B (HBV) and hepatitis C (HCV) and is considered a cost-effective intervention. Long-term methadone maintenance is more successful in averting relapse than shorter-term treatment.
If I Am A Methadone Maintained Patient, I May Require Pain Medications Following An Injury Or Surgery. True or False
Methadone maintained patients have a higher tolerance for the effects of opioids, which are used to control pain. Since methadone is an analgesic, many believe a methadone-maintained patient does not experience pain. On the contrary, patients stabilized on methadone feel pain just like anybody else. When it comes to treating pain, you will have the same needs as other people for adequate pain medication. For headaches or muscle strain, over-the-counter painkillers (analgesic) should do the job. If pain is more severe and/or long lasting, opioid painkillers with actions similar to morphine may be prescribed.
Methadone is an opiate agonist. Some pain medications are opioid antagonists that block the effects of methadone and precipitate withdrawal symptoms. Propoxyphene medications are not recommended because large doses may be needed to provide adequate pain relief in a methadone-maintained patient.
Is methadone maintenance treatment for life?
Some patients remain in methadone treatment for more than ten years, and even for the rest of their lives, but they constitute a minority (5 to 20%) of patients.
How long should treatment last?
Generally, the length of time spent in treatment is positively related to treatment success. The duration of treatment should be individually and clinically determined, and treatment should last for as long as the physician and the individual patient agree is appropriate.
To Assist in Withdrawal, I Should Keep My Methadone Dose Low. True or False
The therapeutic benefits of methadone are to eliminate cravings and withdrawal symptoms, and provide a blockade effect if opioids are used. Patients who do not reach their therapeutic methadone levels do not enjoy the benefits of methadone and the feeling of being "normal" again. Treatment experience demonstrated that patients who keep methadone levels low are not successful in a drug-free recovery, and have very high relapse rates within 30 days of detoxification.
Methadone and Pregnancy:
A pregnant woman who abuses opioid drugs risks serious damage to herself and her unborn child. While methadone itself does not eliminate all potential problems of pregnancy, a comprehensive methadone maintenance treatment (MMT) program can greatly reduce the possibility of sickness or even death in the mother or child.
What advantages does Methadone Maintenance Treatment offer?
Opioid drug use can cause serious complications during pregnancy, including miscarriage or premature delivery. Medical experts have recommended methadone maintenance for opioid-dependent pregnant women. Research has clearly shown that methadone maintenance is safe for pregnant women and offers a much greater chance for a healthy baby.
Helps the mother escape from a drug-seeking lifestyle.
Reduces the risks of contracting HIV, hepatitis and other infections.
Prevents erratic blood levels of drugs that put the unborn baby through dangerous withdrawal.
Improves nutrition, leading to a healthier weight and condition of the newborn.
Reduces medical complications both before and during childbirth, allowing for a healthier newborn.
How does Methadone affect the baby?
At birth, the infant may have a slightly lower than average birth weight than a drug-free newborn. This is only temporary and can usually be avoided if the pregnant woman receives proper care before childbirth, and does not smoke or drink alcohol. Methadone crosses from the mother to the baby in the womb, and the baby can experience some withdrawal symptoms during the first few days after birth. Withdrawal usually develops slowly and is routinely treated by the baby’s doctor. There is no long-lasting harm to the child from methadone.
What about after childbirth?
The methadone should be continued as the mother is in the hospital. A mother can breast-feed her new baby while taking methadone. Although methadone does show up in breast milk, research has shown that it is too small an amount to affect or harm the child. However, a mother should not breast-feed if she has an infection such as HIV or hepatitis.
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