Methadone is a synthetic (man-made) opioid that has effects similar to those of heroin and other opioid painkillers. Historically used as a replacement drug for addiction to heroin and other opioids, methadone has a ceiling effect at higher doses which blocks the euphoric effects associated with opioids. Often, methadone doses are reduced slowly, over time to completely eliminate drug use, but treatment may be continued for several months or years to maintain addicts. When it is used as directed in a methadone maintenance treatment (MMT) program, the drug has proven to be effective in reducing cravings and relapse rates for those addicted to heroin and other opioids. More recently, methadone has been prescribed as a pain reliever for severe pain in patients with opioid tolerance, and most often, those with terminal illnesses like cancer. Because methadone has a long length of action (up to 8 hours), and a half-life of up to 60 hours, it has been an effective source of pain relief as well as opiate maintenance. This added benefit of methadone has led to a 1000% increase in methadone prescriptions from 1997-2006, according to the Drug Abuse Warning Network (DAWN). The benefits of methadone do not come without dangers, and as the prescription rates for this drug have increased, so have the occurrences of overdose.
Dangers of Methadone Abuse
Methadone is a very strong opioid, and as such, it is not intended for use among those who are not opioid-tolerant (or accustomed to taking large amounts of opioids and/or opiates). The abuse of methadone places non opioid-tolerant people at severe risk of overdose. Since methadone is widely available through prescriptions and extremely cheap (relative to other opioid painkillers), many who are experimenting with drugs, or seeking a stronger high may try methadone without awareness of its powerful effects on the central nervous system. Although methadone does have a ceiling effect in higher doses, which can block the euphoric effects of other opioids, this has created a devastating side effect. According to the Drug Abuse Warning Network (DAWN), emergency room admissions that are methadone related have skyrocketed. Whereas only 5% of all opioid prescriptions dispensed were for methadone, a staggering 33% of opioid-related deaths from 1999-2004 involved methadone. Because methadone has a long half-life, it remains in the system of a user long after the effects have worn off. Many naive individuals may believe that the drug has been completely expelled from their system, and seek a euphoria in either more methadone, or other painkillers. This has become a problem because the depressant central nervous system (CNS) effects of methadone are still active in the body for up to 60 hours, and when another CNS depressant like heroin, alcohol, benzodiazepines, or painkillers is added, respiratory depression or failure is a significantly increased risk. One of the most alarming dangers of methadone use is that which is inflicted by under-informed doctors and physicians who may not prescribe the drug correctly. Because the analgesic effects of methadone wear off after 8 hours, but the drug remains active in the body for up to 60 hours, proper prescription directions can be difficult to determine, and often lead to overdose when methadone is taken multiple times in one day.
Methadone Abuse and Addiction
Although methadone has a ceiling effect which prevents the euphoric effects of the drug and other opiates, this is limited to higher doses. At lower doses, methadone still binds to the opiate receptors in the brain, however the ceiling effect is not as evident, especially with the use of other CNS depressants. Methadone abuse is most common among those who are experimenting with drugs; however, it is not uncommon for opioid tolerant individuals to abuse the drug for greater sedative effects. Contrary to some beliefs, it is not only the euphoria of drugs like opioids that can be appealing. For many, especially those who are addicted to benzodiazepines, the sedative effects of methadone and other opioids are particularly attractive. Because methadone is an opiate, chronic and long-term use of the drug can easily produce dependence, which results in painful withdrawal symptoms. Additionally, the withdrawal symptoms produced by methadone are longer lasting than those associated with short-acting opioids and heroin. Because methadone stays active in the system of users for up to 60 hours, it takes longer for withdrawal symptoms to peak and lessen. In some cases of prolonged methadone use and abuse, protracted withdrawal symptoms can persist for several weeks or months after use has stopped. Some of the withdrawal symptoms associated with the cessation of methadone use include:
- Nausea and vomiting
- Abdominal pains
- Muscle pain and spasms
- High fever
- Intense cravings
- Increased anxiety
Dependence is a result of increased tolerance to the drug, and not necessarily methadone abuse. However, when individuals do abuse methadone, it is usually in conjunction with other CNS depressant drugs. The long length of action of methadone provides additional, and long lasting sedation in those who abuse the drug. Since the drastic increase in methadone prescriptions, its availability has greatly increased. The majority of individuals who abuse methadone do not have prescriptions for it, but rather acquire it through more illicit and dishonest means.
Methadone Abuse Through Friends and Family
As is the case with many prescription drugs of abuse, methadone abuse is common among those who have friends or relatives who have been prescribed the drug. Whether an individual gets methadone from these people with or without their knowledge and approval, using or possessing any prescription drug without a prescription is highly illegal and dangerous. Since individuals who abuse methadone are most likely abusing other drugs, taking it from others for whom it has been prescribed can be particularly dangerous. Especially without knowledge of the particular strength or formulation of the methadone taken, this activity carries significant dangers and risks of overdose and potential death from respiratory depression and failure.
Methadone Abuse From Doctor Shopping
Although some doctors may be unaware of proper prescribing equivalencies for methadone, most know how dangerous methadone is with other drugs, especially sedatives like benzodiazepines. According to the Center for Disease Control (CDC), about 17% of all methadone related deaths in 2006 involved the use of benzodiazepines such as Xanax and Klonopin. Many medical professionals who view this statistic understand the dangers, and are baffled as to how individuals obtained both methadone and benzodiazepines. The way most who are engaged in methadone abuse obtain both of these dangerous drugs at the same time is through doctor shopping, as it is extremely uncommon for doctors to take the risk of prescribing both to the same patient. Since most doctors do not have any way to know what other physicians a new patient has seen, or what medications he or she has been prescribed, obtaining either methadone or benzodiazepines is often much easier than one may think.
Methadone Can Be Obtained Through Pill Mills
Pill mills are most commonly associated with health or pain clinics located in strip malls, but private practitioners can also run their own pill mill, taking cash for prescriptions of whatever an individual requests. Unfortunately, doctors and physicians who run pill mills do not take into account the dangers of the various drugs they prescribe, and users who wish to obtain methadone for abuse (most frequently with other drugs), can do so immediately and without any questions.
Detox and Recovery From Methadone Abuse and Addiction
Once dependent on methadone, it may be necessary to begin a detox program to slowly reduce the dosage over time. The speed with which this tapering occurs depends greatly on the individual and his or her response to reduced dosages. Since methadone is an opioid, withdrawal symptoms will occur if it is suddenly discontinued. For this reason, it is recommended that methadone be tapered by appropriate amounts for the individual. During methadone detox, symptoms of withdrawal may persist for longer periods than are common to other opioids, and this is the result of the long action of methadone in the system. Whereas most opioids have a maximum half-life of 24 hours, methadone’s half-life is 60 hours, so a typical methadone detox period is up to 30 days, and even longer in some cases. Once methadone detox has been completed, it may also be necessary to participate in some form of addiction treatment to help ensure sustained recovery from use of methadone and other addictive drugs. While some individuals in need of methadone detox may not have had a problem with addiction to heroin or other opioids, it is important to note that cravings and protracted withdrawal symptoms may persist for several weeks or months after detox is complete. In these cases, it is advantageous to have a system of support and a firm foundation for sobriety to prevent relapse. Especially with a drug as powerful as methadone, a relapse after sobriety can be deadly. Once drugs are no longer in the system of an individual, if he or she relapses, the effects can be devastating, as tolerance is often depleted in accordance with the amount of time that individual has been sober. If you, or someone you know are engaging in methadone abuse, please call us now and speak with a certified counselor about detox and treatment options, based on individual needs, preferences, and belief systems. It is always important to understand the best options for any individual in need of addiction help, as the choices vary greatly. Choosing the first option without knowing the needs of the person in need can end up having little to no value for recovery purposes. We will talk with you about the person in need of help, his or her circumstances, and work with you to determine the kind of treatment that will best suited for that individual. Please don’t wait for life to spiral out of control, and don’t suffer methadone abuse and addiction alone. There is help that works, and we can help you find what will work for you. Please call now for assistance in reclaiming a vibrant, addiction-free life.