Methadone for Addiction Treatment
In recovery, a doctor may recommend certain medications to help curb drug or alcohol cravings. These medications aren’t for using on their own; rather, they are often a part of a well-rounded recovery program. For those with opioid use disorder, methadone is a common medication-assisted treatment, or MAT.
What Is Methadone?
Methadone is a medication that aims to treat opioid use disorder. The first formal report on methadone and its properties that was published in the United States appeared in 1947, and shortly after, it began to be used as a therapy for those suffering with opioid dependence. In that sense, methadone is the original MAT.
Methadone continues to be an effective treatment when used short-term and long-term. One study indicated that treatment with methadone or buprenorphine, another MAT, leads to a 76% reduction in overdoses in the first three months of treatment and a 59% reduction in the first year.
Methadone is a medication that is usually taken orally, but individuals can inject it in certain situations. Most prescribers offer it in the form of a liquid, a powder or a wafer.
It’s important to understand that methadone, like heroin, is classified as an opioid. However, it is used as a step-down treatment because methadone dependence is significantly safer than dependence on heroin and similar substances. It’s safer for a few reasons:
- Methadone is taken orally, so there’s no risk of contracting HIV or other blood-borne illnesses if someone shares their needles.
- Since methadone is a pharmaceutical, those who use it know exactly what’s in it. When using heroin, it’s nearly impossible to know how pure it is.
- Often, people who use illegal heroin need to dedicate significant time and money to obtaining it. When people are have a prescription for methadone, they can spend their time on healthier and more productive activities.
How Does It Work?
Methadone is a drug that binds to opiate receptors in the brain. In doing this, it accomplishes two key things: it reduces symptoms of opiate withdrawal, and it also blocks the high-producing effects of both opiates and semi-synthetic opiates. If someone taking methadone as prescribed uses heroin, codeine, morphine, hydrocodone or oxycodone, they won’t feel a high.
In some cases, methadone can be used as part of a detox program. Your doctor can help you gradually transition from the opioids you are currently using to methadone.
How Doctors Prescribe Methadone
Methadone is different from most other MATs in that program clients, at least at first, need to go to a clinic in order to receive doses. In some cases, clinic practitioners may decide that a client can take some methadone doses at home and come to the clinic less often.
There is no standard dosage for methadone treatment, and medical professionals determine proper dosage on an individual basis. Initial daily doses are typically around 20 milligrams, but that amount may be increased if you have an unusually high opioid tolerance. Once you’ve had some time to adjust to the medication, your doctor will adjust dosages until you reach one that works well for you.
The length of time that you will need to take methadone also depends on your individual needs. In most cases, medical professionals recommend treatment for at least a year. Depending on the degree of your prior opioid dependence, your risk for relapse and other factors, your doctor may recommend longer-term maintenance treatment. If you are working toward stopping methadone entirely, your doctor will gradually taper your dose down until you no longer need the medication.
Like most medications, methadone is completely safe when you take it as prescribed. But there are certain risk factors that can increase the likelihood of complications. Be sure to take the following precautions before or during treatment to ensure maximum safety and effectiveness:
- Tell your doctor your full health history – Some health conditions may make methadone treatment less safe. Even if you think a given condition may be unrelated to treatment, be sure to tell your doctor. The more information they have, the easier it will be for them to help you find the optimal dose.
- Tell your doctor about any other medications you take – Certain medications may react with methadone and cause serious issues. This includes any illegal drugs or supplements you take.
- Don’t take more than your prescription calls for – Taking too much increases your risk of overdose, as does taking it at times other than when your doctor advises. Spacing out doses ensures maximum effectiveness, whereas taking multiple doses too close together can cause too much methadone to build up in your body.
- Don’t drink alcohol while taking methadone – Methadone can increase the effects of alcohol, making it more likely that you experience respiratory suppression, slowed heart rate and even coma. It also can impair your motor skills more than alcohol alone, which may make even everyday activities riskier.
- Be careful driving or operating heavy machinery – This is especially important in the first part of your treatment when you still aren’t sure how methadone affects you. In some people, methadone treatment may slow reflexes or cause drowsiness.
In Case of Emergency
- Call 911 immediately if you take too much – Overdosing on methadone, whether accidentally or deliberately, can cause serious health complications. Even if you initially feel fine, call emergency services in case of serious issues.
- Store your prescription away from light and at room temperature – Light and extreme temperatures can cause the medication to degrade, making it less effective.
- Don’t share your prescription – Methadone treatment is highly specific for each individual. The dosage that works for you may cause severe health issues for other people even if they have a similar opioid tolerance.
- Keep methadone away from pets and children – For children and animals, ingesting methadone can be harmful or even fatal. Make sure to keep it on a high shelf and out of the way.
- Dispose of methadone you don’t use safely – Your prescribing doctor will be able to offer guidance on how to do this.
Can Methadone Alone Treat Addiction?
Methadone and other recovery-assisting medications are designed to be used alongside other therapies. You and your doctor may decide that it’s a good option to use after you complete residential treatment, or you may prefer to use it while attending an outpatient or partial hospitalization program. When used as intended, methadone works alongside a few other elements of recovery.
Methadone and other MATs must be prescribed by a knowledgeable physician with experience treating opioid use disorder. Finding the right dosage is critical, and one must take great care when tapering off of methadone.
Social support is one of the most important parts of recovery. Usually, when you’re undergoing treatment with methadone or another MAT, your physician will suggest finding support groups for people with similar struggles. Sober living environments, 12-step programs and other support groups can be helpful.
Seeking therapy from a professional is often a critical part of recovery. Counselors can help people in recovery manage cravings and handle other pitfalls of the recovery process. They also can help explore underlying issues that may have contributed to opioid dependence.
Are There Any Side Effects?
Like any medication, methadone does have side effects. Serious side effects are rare, but if you experience any of them, stop taking methadone immediately and call 911 or speak to your doctor. Here are some of the main serious side effects that can occur:
- Chest pain
- Elevated or pounding heartbeat
- Confusion or hallucinations
- Lightheadedness or feeling weak and faint
- Trouble breathing or taking very shallow breaths
- Swelling of the throat, lips, tongue or face
- A rash or hives
If you take methadone, be sure to always take it exactly as prescribed. This can reduce your risk of serious side effects, but it is still possible to experience these side effects while taking the medication as prescribed.
Less Severe Side Effects
Less severe side effects are more common with methadone treatment. Here’s what to look for:
- Sexual issues
- Sweating heavily
- Slower breathing
If these side effects are especially bothersome or don’t lessen as your body adjusts to the medication, be sure to talk to your doctor. They may be able to help you better manage your symptoms.
Methadone and Women Who Are Pregnant or Breastfeeding
If you are pregnant or breastfeeding and have an opioid use disorder, treatment is essential for both your health and the health of your child. But is methadone safe to use if you’re pregnant or breastfeeding?
The answer is yes. Methadone reduces symptoms of opioid withdrawal, and undergoing withdrawal while pregnant can lead to miscarriage and premature labor. MAT treatment during pregnancy is not shown to cause birth defects.
If you are breastfeeding and taking methadone, know that it does enter breast milk. However, it’s a very small amount, and it should not cause any harm to the baby.
How Is Methadone Different From Suboxone?
If you’ve looked into different MATs, you may have already learned that Suboxone is also sometimes used to treat opioid use disorder. These two medications work similarly, but Suboxone is actually a compound of two different medications. The first, buprenorphine, is a partial opioid agonist. Since methadone is a full opioid agonist, the opiate-like effects of Suboxone are less powerful than those of methadone.
The second component of Suboxone is naloxone. Somewhat confusingly, naloxone is an opioid antagonist. It blocks many of the effects of opioids, and it largely prevents users from feeling high. It also blocks the pain-relieving effects of opioids. This feature helps to deter users from injecting it, but it also means that Suboxone is a weaker medication than methadone. However, people prescribed Suboxone do not need to go to a clinic to receive it.
Switching Between Methadone and Another MAT
Sometimes, you may need to switch from methadone to another MAT or vice versa. Make sure you talk to your prescriber if you want to switch. Switching is a process that must be done very carefully.
Do You Need Methadone?
If you think you may have an opioid use disorder, it’s often up to you to make the first steps toward recovery. However, if you don’t know the symptoms of opioid dependence or an opioid use disorder, it can be difficult to know if you need to make a change. Here are some of the key signs of opioid dependence:
- Isolating from friends and family
- Giving up activities you once enjoyed in order to use opioids
- Being unable to control how much you use once you start
- Having intense and uncontrollable cravings for opioids when you aren’t using
- Frequently feeling ill or experiencing flu-like symptoms
- Stealing or engaging in other criminal activity to obtain opioids
- Experiencing new financial issues
- Having unexplained weight loss
- Decreasing hygiene habits
- Experiencing drowsiness and changes in sleep habits
- Experiencing a decrease in libido
Of course, methadone may not be right for everyone with an opioid use disorder or opioid dependence. Once you make the decision to seek help, your doctor will be able to tell you whether methadone or another MAT is a good option for you.
Ready to Make a Change?
When you’re struggling with a substance use disorder, it can be easy to feel as though maintaining sobriety long-term is impossible, but there’s hope. At Granite Recovery Centers, we meet you wherever you are and help you work toward a better life. Give us a call today!