Pros and Cons of Methadone

There are an estimated 337,574 people in the UK thought to be high-risk opiate users.(1) It’s common that for those in treatment for severe heroin or benzodiazepine addiction, methadone is prescribed.

Methadone is used to treat chronic pain as well as substance abuse. Due to its effects, it’s a controversial drug. However, if prescribed under clinical supervision and when combined with other approaches, it can offer people a way out of the grips of addiction.

What is methadone?

Methadone is an opioid which is used in the addiction field to treat people who are addicted to opiates or opioids. It’s synthetic, meaning that it’s man-made. It was first discovered by the Germans during World War II.(2)

Why is methadone necessary?

In the case of severe addiction to opioids, users have lost control of drug use. They use drugs despite the negative effects on their physical, mental, and emotional health.

People will return to the drug and use it in dangerous ways. They’ll put themselves and others at risk and for the vast majority of people, they’ll lose their sense of usual responsibilities as prioritising the drug takes over.

This is partly due to the extremely uncomfortable withdrawal symptoms a person experiences as opioids leave the body.

Withdrawal is the cause of perpetual relapse for many people. This is because of how uncomfortable it feels as the substance leaves the body. Where people are addicted to benzodiazepines, seizures are possible and these can be fatal.

For those who really want to quit a substance, methadone offers a way to manage withdrawal symptoms.

When a person has control of the physical aspects through the use of a methadone prescription, they’re then able to focus on the mental and emotional aspects of recovery. This increases the chances of a successful recovery.

Why is methadone used in addiction treatment?

Methadone is an agonist for opioids. It binds to the same opioid receptors in the brain that heroin and prescription painkillers do.

This binding activity is what prevents withdrawal symptoms and cravings from kicking in. It can also prevent people from experiencing a high from other opiates.

Using methadone as a treatment enables a person to have time away from the constant need of getting their next “hit”. Doctors usually start by prescribing around 10-20mg of methadone.

This dose will be increased until the patient’s withdrawal symptoms are controlled.

This medication remains active in the system for hours at a time. It could last anywhere from 24 to 56 hours. The length of time really depends on the dose and individual factors such as a person’s height and weight. The fact that methadone is a long-lasting medication means that the person doesn’t have to keep taking more.

Once the withdrawal symptoms are controlled, the doctor will then begin to reduce the methadone dose each day to wean the person from this too.

What is opioid substitution therapy?

Opioid substitution therapy is where prescribed medication is offered in place of the illegal substance that the patient is addicted to. This approach is used to support people addicted to opiates to manage their addiction or quit a substance. (2)

It’s often used as a harm reduction method. Many risk factors associated with using illegally consumed drugs are reduced. People aren’t at risk of HIV or hepatitis or at risk of overdose if they follow medical guidance.

This type of treatment is supervised by a doctor and often goes hand-in-hand with psychological treatments.

For the person who aims to quit heroin, for instance, methadone , as well as talking therapies and alternative therapies, would be combined as a therapeutic approach.

Methadone is usually prescribed as a pill or liquid to be swallowed. Sometimes it comes as a powder to be dissolved in water and drunk.

The method of administration is what reduces the associated risks to those who would usually inject.

How is methadone similar to heroin?

Methadone and heroin are both opioids. As such, the two have properties in common. They’re both painkillers that depress respiratory functioning and cause sedation, low blood pressureand affect bowel movements.

Where heroin can cause diarrhoea during withdrawal, methadone can encourage bowel movement. Methadone is also useful in reducing anxiety and mood swings that are common during heroin withdrawal.

Unfortunately, like heroin, methadone can also cause physical and psychological addiction. This is why it’s essential that patients are under the care of a doctor while trying to reduce or quit.

It’s best prescribed as a short term detox to wean a person off heroin or prescription drugs. As soon as possible, the person will be supported through a tapered off prescription.

This is to stop using methadone whose side effects are less severe than heroin.

Pros and cons of methadone use

As with all medications, there are pros and cons to using methadone. It’s helpful to be aware of these and to discuss the topic with your GP and local drug workers.

You can also call Rehab Recovery for advice around this.

The benefits of methadone include:

It can be used where there is any level of physical dependency.
Eases opioid withdrawal symptoms.
Reduces cravings. This is one of the most useful advantages for heroin users.
Effective addiction management for those who have the most severe addictions.
Reduces the risk of bloodborne viruses as people don’t use needles.
Managing physical symptoms allows the person to focus on psychological and emotional healing.
People are more likely to enter recovery and abstinence when they switch from heroin to methadone.
Reduces the likelihood of illicit drug-related crime.
Improved familial and social life.
Improved prospects related to education and employment.

The negatives of methadone use

It doesn’t stop you from being triggered. Therapies are required to support managing triggers.
It takes time to be weaned off methadone effectively.
There can be negative physical and mental side effects (mentioned below).
Long term use can cause damage to the lungs and respiratory system.
It’s physically and psychologically addictive.
It can cause similar withdrawal effects as heroin, such as sweating, shivering, chills, sickness and diarrhoea, and pain in muscles.

A daily prescription

Interestingly, when a person has a methadone prescription they usually have a particular time of the day to pick it up and take it. This is to ensure that they don’t overdose. For many people, this offers some daily structure from which a routine can be built.

When a routine is developed, people are more likely to be able to introduce other helpful daily activities. This might include going to 12 Step groups or various other outpatient services.

The short term side effects of methadone use

As with any substance, there are side effects that need to be considered. It’s useful to have professional support you to objectively assess the effects and how you might respond.

Short term effects of methadone use can include the following:

Decelerated breathing (due to respiratory depression).
Headaches.
Dry mouth.
Sweating.
Constipation.
Weight gain.
Mood swings.
Sleep disruption.
Sexual dysfunction.
Fluctuations in appetite.
Sickness and diarrhoea.
Feeling as though your skin is itching.

It’s important to be aware of particular effects, for instance, dizziness, as in some cases, you might require medical attention. Talking with a doctor will help clarify when would be appropriate to call a doctor or ambulance for additional support.

What happens if a person uses methadone over a long period of time?

Unfortunately, some people become addicted to methadone. On the other hand, some will use it long-term in order to manage an addiction to a substance that might create more risks. In these two cases, it can alter cognitive functioning and memory.

If a person becomes addicted they’re more likely to participate in polysubstance abuse.

Where this occurs the chances of a fatal overdose are highly increased. It’s really important to seek professional help if you’re considering using more than one substance at a time.

This indicates a severe addiction and the need for specialist support.

What else is needed to support a person to quit an opioid addiction?

For those who are keen to quit an opioid addiction, other treatments are necessary as well as a methadone prescription.

Psychosocial support such as counselling, psychotherapies, 12 Step groups, and alternative therapies are essential.(4)

Through these approaches, people are able to begin deep healing and create positive change.

Final thoughts

In the case of methadone, like all medications, it comes with positive and negative effects. It’s incredibly important for the person to have thorough discussions with their doctor and drug workers about it.

What’s really useful to bear in mind is that it really eases the severe heroin cravings a person experiences during withdrawal. With this medication, people also have fewer health risks.

Methadone is probably best summed up by these words, “If used appropriately, it can help people tremendously. If used improperly, it can harm them.”(5)

If you’d like to speak with someone about your opioid use and to seek guidance about treatment, contact Rehab Recovery today.