Methadone is an artificially manufactured drug that is used in Opioid Replacement Therapy (ORT), which is a method of detoxifying addicts from opioid drug addiction. There are other drugs as well such as buprenorphine that can be used in ORT. When Methadone is used in ORT such treatment is referred to as Methadone treatment.MethadoneCredit:






How Methadone Works

Methadone mimics the actions of opioid drugs because of structural similarities, and is therefore, an opioid drug. This means Methadone is able to function as a pain reliever, by acting upon the central nervous system just like other opioid drugs. Opioid drugs are medically prescribed as pain relievers when patients are in extreme pain. Usually, such prescriptions are restricted to patients suffering with cancer or rheumatoid arthritis. Like these drugs, Methadone also acts as a ligand and binds to opioid receptors present in the human body. Such receptors are present in central nervous system, brain, and digestive tract of the human body.

Effects of Opioid

There are two varieties of opioid drugs; addictive and not-so-addictive. Addictive drugs create a feeling of euphoria in the drug user's brain. This is what the person starts craving for after frequent abuse of the drug. Examples of such drugs are Heroin and Morphine.

In addition to such cravings, the person also starts feeling severe withdrawal symptoms if denied such drugs in time. These symptoms include physiological and psychological signs in addicts. Of these, physiological symptoms common in addicts are tremors, pains in joints, perspiration, erratic heartbeat, joint pains, cold and chills, diarrhea, cramps, weakness, scratching, etc. Psychological withdrawal symptoms include panic attacks, nausea, insomnia, depression, and aggression.

Not everybody who takes opioid drugs becomes an addict immediately. There are some people who report “one time addictions.” However, the addiction usually takes time, and more than a couple of doses of opioid drugs. Person taking such drugs gradually increases their dosages, because the body develops tolerance to lower levels of the drug. Therefore, the initial euphoric level or "high" that the person could experience with small dose is no longer possible with the same dose forcing the person to change the dosage.

The behavior and cognitive functions of addict take a beating with opioid drugs. The person starts becoming secretive in the transition period, and shows mood swings such as violent behavior or crying. Such addicts also become indifferent to everything and everybody in their surroundings. The cravings increase, and withdrawal symptoms start to manifest. The person may become thinner because he or she loses appetite. Constipation and lack of sleep are other two symptoms associated with full fledged addiction to opioid drugs. 

Why Methadone?

In drug research, there is a process which is referred to as cross-tolerance. This means, if one drug is used, then another drug with similar structure and nature would not have any effect. Therefore, if methadone is used, heroin or morphine would not have similar effect because methadone shares a cross tolerance relationship with such addictive drugs. This happens because Methadone binds to the opioid receptors and denies heroin, morphine, etc., a chance to do so. Thereby such molecules of heroin and morphine cannot create the euphoric feeling in the person.

Methadone does not create euphoric feelings, even though it does subdue pain. Therefore, it is a not as addictive a drug as heroin, or some other opioids. This means, it is effective in controlling the withdrawal symptoms. The pain relieving effect from Methadone lasts much longer, therefore, if the cravings can be brought down gradually, the person can be freed from addiction of this class of drugs. Methadone is needed in small doses to reduce withdrawal symptoms, but a larger dose of Methadone can also reduce cravings for addictive opioids.

Methadone treatment

Methadone Maintenance therapy is divided into two phases. In the initial stages, the patient is given small doses of Methadone and correspondingly the dosage of heroin, morphine, etc., that the addicts used to take are decreased in the same ratio. Slowly, this dosage of Methadone is MethadoneCredit: international.drugabuse.govincreased, and dosage of morphine, heroin, etc., is reduced by corresponding margin till the cravings cease. The process is very gradual. After the withdrawal symptoms diminish or cease, physicians detoxifying the addict start weaning him or her from Methadone as well. This means dosage of methadone is decreased gradually over a period. The entire Methadone treatment process may take several months or years.

Why not deny the addict an access to opioid drugs, and stop addiction? Such drugs have unique ability to get body habituated to them. Therefore, suddenly denying the body such drugs may result in a shock to the body, and all withdrawal symptoms will manifest with greater intensity. Moreover, the addict may injure himself or herself. At times such shocks may kill the addict. Alternately depression may drive the addict to suicide. Considering such grave consequences of sudden denial of addictive opioids, methods such as Methadone treatment have been developed.

Why replace one opioid with another opioid?

The object is to reduce addict's pain due to withdrawal symptom. If the addict can't withstand such pain, then chances are that he or she will discontinue the treatment, and that can have more serious repercussions.

What are serious repercussions of discontinuing Methadone based Opioid Replacement Therapy?

Research so far has indicated that when addicts who have undergone the treatment for only six weeks or so, leave the treatment, then the chances of them getting re-addicted to one substance or the other increase but even more alarming fact is that the withdrawal symptoms including depression they experience makes them 2900 percent times more inclined to commit suicide. Such withdrawal symptoms and cravings are more because the addictive opioid dosages are reduced to an extent by this time.

What are the chances of succeeding with Methadone treatment?

Almost half the addicts undergoing Methadone based ORT stop using the addictive opioids during such treatment. More than 70 percent of such addicts respond better to such detoxifying programs if they receive support to handle legal complications arising due to possession of narcotic substance, and if medical devices such as intravenous drug delivery injections are denied to them.

Why is the Methadone treatment process so slow?

Dosage restrictions imposed by health authorities have been the major cause for the Methadone based ORT being slow, and people leaving this treatment.  Many states are inacting stiffer regulations on Methadone Treatment Facilities.  This is a good thing because some people are abusing the situation. 



Methadone and Opioid Replacement Therapy works.  If you are addicted to the drugs listed in this article, please seek help.  Your family and friends need you back.  You need to be back.  This is a medical procedure and you should seek advice from your medical doctor.  Do not try this yourself.  Do not be embarrassed that you have a problem.  Be embarrassed that you are not doing something to correct it and then do something.

Take care of yourself and others.  Make today and everyday a great day. 

Methadone Clinic
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Methadone Maintenance Treatment: Client Handbook, Revised
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Do not use this on your own. Use it in conjunction with therapy.
Methadone Maintenance: A Physician's Guide to Treatment, Second Edition
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