Methadone is a long-acting synthetic analgesic (painkilling) drug commonly used to treat heroin addiction or dependency on more potent and dangerous opioids. When used as prescribed, methadone can be very effective at treating opiate addiction, but as an opioid itself, nonetheless, it still has some potential for addiction.
When used to wean individuals off other narcotics, methadone doses are closely overseen by medical and addiction professionals. However, due to methadone’s relatively low cost compared to other traditional prescription opioids, doctors have been commonly prescribing methadone to treat chronic pain, as well.
This trend appears to be beneficial for some. Still, it has also allowed more individuals access to methadone than ever before, including those who might be considered “opioid-naive,” or not having used opioids in the past. These additional exposures have contributed to an increasing number of methadone addictions, as well as making methadone more readily available as a recreationally abused substance.
Methadone acts on the brain by binding to the same receptors as other opioids, such as heroin or oxycodone. But because methadone stays in the system for an extended period—from approximately 24-72 hours—it works to block the euphoric and rewarding effects of other opioids and mitigate unpleasant symptoms of withdrawal often associated with the use of these drugs.
Who Becomes Methadone-Dependent?
Persons who become dependent on methadone tend to be either already addicted to opioids or are seeking pain relief. Since the 1970s, methadone clinics and maintenance programs in the United States have been touted as ways for heroin-addicted individuals to avoid the worst withdrawal symptoms while preventing relapse. Today, methadone is still commonly prescribed for this purpose and is subject to close clinical monitoring.
According to the Centers for Disease Control and Prevention (CDC), however, there were as many as 3,400 overdose fatalities in 2014 related to methadone use in the U.S. As noted above, health providers sometimes prescribe this drug to treat chronic pain due to health issues such as multiple sclerosis, cancer, or injuries. Legitimate prescription use can turn into abuse as tolerance develops, and dependence and addiction may rapidly follow once abuse onsets.
Notably, the Food and Drug Administration (FDA) has not approved methadone to treat these forms of pain, yet health providers wrote more than four million prescriptions for methadone as recent as 2009. The uptick in methadone prescriptions for use as an analgesic is likely due to methadone’s reduced cost compared to other opioids, such as oxycodone and hydrocodone.
Fortunately, however, according to a report from The Pew Charitable Trusts (2018), methadone prescriptions for pain management were found to have declined by 26 percent nationwide between 2013-2016 following efforts by U.S. states to reduce the drug’s use.
Non-Medical Methadone Use
As methadone prescriptions to treat pain and not just opiate dependence have become more frequent, this drug has also become more accessible to individuals who engage in drug abuse. Much like the wide availability of hydrocodone, persons who abuse opioid drugs can more easily obtain methadone by garnering it from loved ones or purchasing it illicitly.
The illegal selling of prescription medication is also referred to as drug diversion. It is considered to be among the leading causes of the opioid drug crisis in the U.S. It should be noted that when a person uses methadone for recreational purposes, the individual faces a heightened risk of developing a dependence or overdosing.
Methadone Side Effects
Methadone’s side effects are similar to those associated with other opioid drugs. These include the following:
- Nausea and vomiting
- Impaired cognition
- Impaired motor skills
- Impaired memory
Methadone was initially designed for the treatment of heroin addiction because its symptoms of withdrawal are less severe and do not manifest as rapidly as with many other opioids. This difference is because methadone stays in the body in some form for up to three days.
Methadone withdrawal symptoms may include the following:
- Watery eyes
- Runny nose
- Fever and chills
- Tremors or shakiness
- Muscle aches and pains
- Nausea and vomiting
- Reduced appetite
- Anxiety or irritability
- Sleep difficulties
- Accelerated heart rate
Because methadone is a very long-acting drug intended to relieve symptoms experienced by those addicted to heroin, it can accumulate in the body rapidly and remain in the bloodstream for a significant amount of time. It is critical that individuals with methadone prescriptions use this medication precisely as directed and do not modify their dose without a licensed health provider’s recommendation and supervision. Moreover, it is relatively easy to overdose on methadone due to the potency of a single dose.
Methadone’s half-life ranges anywhere from 8-59 hours, depending on the dose. However, analgesic effects last only up to eight hours. The long half-life helps those in recovery from addiction to other narcotics, as it stays in the body for a prolonged period, working to alleviate withdrawal symptoms and reduce cravings.
However, this also means it is less beneficial for treating chronic pain related to diseases such as cancer because the painkilling effects do not persist for nearly as long as the drug remains in the system. As a result, individuals who use methadone as a painkiller may be at a higher risk of an overdose if their pain returns and take another dose before it is safe to do so.
Methadone overdose symptoms include the following:
- Respiratory depression
- Clammy, cold skin
- Bluish lips and fingertips
- Profound drowsiness
- Nausea and vomiting
- Coma and death
Mixing methadone with other prescription or illegal drugs or alcohol—especially other central nervous system (CNS) depressants—can increase the risk of overdose and result in serious heart issues. These complications include arrhythmia (irregular heart rate) and heart attack.
Many individuals who struggle with methadone addiction also experience co-occurring disorders, such as anxiety, depression, post-traumatic stress disorder, schizophrenia, bipolar disorder, and many others. People who experience mental health issues may attempt to self-medicate to mitigate their symptoms, often with alcohol, painkillers, cocaine, meth, or marijuana. For these persons, methadone addiction may also develop following multiple attempts to overcome other opioid dependencies.
Psychiatric and medical professionals who address drug addiction work to identify underlying mental health disorders that might have compelled the individual to self-medicate away symptoms to feel better. Comprehensive, personalized care that addresses co-occurring conditions is needed to help a person fully recover from methadone addiction.
Treatment for Methadone Addiction
Whether a person begins abusing methadone against a doctor’s orders or as part of an opioid detox program, addiction treatment usually requires both medical detox and long-term, comprehensive therapy. In some cases, individuals may be gradually weaned off methadone. Others may be switched to another prescription opioid medication, such as Suboxone, that has an even lower potential for abuse, dependence, and addiction.
Just Believe Detox and Just Believe Recovery offer medication-assisted therapy to help persons addicted to methadone recover while reducing cravings and relieving the worst withdrawal symptoms. Also, we employ other evidence-based services essential to the recovery process, including behavioral therapy, counseling, peer group support, health and wellness programs, relapse prevention, and aftercare planning.