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Methadone Rehab
Known for its powerful pain-relieving properties, methadone is a man-made opioid that is similar to morphine in its effects. When ingested in either powder, tablet, or liquid forms, methadone will change how someone’s brain and nervous system respond to pain so that they feel at ease almost instantly.
When taken as directed, methadone is also an effective option in the treatment of heroin and morphine withdrawal, as it blocks the high from these drugs while producing a similar feeling.
This treatment regimen is often referred to as Substitution Therapy or Medication Assisted Treatment (MAT) and helps to relieve cravings in those undergoing opioid detox.
Patients must receive methadone under the direct supervision of a physician, usually from a certified Opioid Treatment Programme connected to their rehab clinic.
While the length of time that methadone is taken varies from case to case, most experts suggested a MAT duration of at least 12 months.
What is Methadone Use Disorder?
However, methadone’s nature as an opioid painkiller means it comes with a high risk of misuse, addiction, and overdose.
While many individuals begin using methadone in a clinical setting, when used outside of the guidelines, it can cause the same pleasurable effects as other opioids. Essentially, it works along the same addiction pathways in the brain as other opioids.
This, unfortunately, leads many people to develop a physical and/or psychological dependence known clinically as Methadone Use Disorder (MUD).
Someone is more likely to develop this condition when they have been prescribed methadone for a long time and may begin taking more and more to achieve the same feeling as their tolerance increases.
As with other forms of a substance use disorder, methadone addiction can develop for many reasons which are often genetic, environmental, or social. Someone’s substance use history may also play a part, with many people who were previously addicted to opioids turning to methadone for its similarities.
Unlike its opioid counterparts, those using methadone are usually able to function more effectively and are less likely to fall into a stupor. This means high-functioning addicted individuals are common, and so the symptoms of a MUD might be harder to identify.
Despite this, there are several warning signs to take note of. According to the DSM-5, addicted individuals will continue to use despite damage to their relationships and social lives, need more and more of the substance to get high, and develop serious withdrawal symptoms if they abstain.
Methadone Withdrawal and Detox
The severe physical addictions often incited by methadone, especially when taken in high doses, mean that developing withdrawal is likely.
This uncomfortable process occurs once the body has become reliant on the drug, meaning that when someone stops taking methadone, their system must relearn how to function without it.
The symptoms that manifest are similar to heroin, morphine, and other opiates: arriving in the form of both physical and psychological discomfort. As methadone has a longer half-life than its counterparts, it may take several days for the withdrawal to begin: often fading over a few weeks depending on someone’s severity.
Flu-like symptoms often appear in the first 7-10 days of abstinence: including muscle aches, chills, and fever, and are accompanied by psychological distress or low mood. Some individuals may also suffer from Post -Acute Withdrawal Syndrome (PAWS), a condition that persists for months after detox characterised by depression and inability to concentrate.
To reduce the intensity of such symptoms and increase their chances of full recovery, victims of MUD should undergo a medicated detox. These medically-assisted detoxes involve reducing a patient’s methadone dosage for weeks. While this happens, they’ll receive round-the-clock clinical support: usually delivered in a hospital setting or private rehab clinic.
Depending on how their body reacts to the tapering process, individuals are offered bespoke courses of medication, prescribed by a resident consultant psychiatrist in methadone rehab. Preferable pharmacological interventions include clonidine, naltrexone, buprenorphine, and anti-depressants.
Clonidine for methadone detox is effective in calming the nervous system: preventing both anxiety and agitation, while SSRI anti-depressants can help stabilize someone’s mood following abstinence.
Though an opioid agonist, buprenorphine is less potent than methadone, and so can be used in substitution therapy, while Naltrexone is a popular craving-inhibitor drug.
Inpatient Methadone Treatment
For those with severe MUD, poly-drug addictions, a dual diagnosis, or unstable home environments, inpatient treatment is the most beneficial. An extensive history of methadone use creates such entrenched physical and psychological addictions, that comprehensive rehab is needed to facilitate recovery.
Individuals enrolled as an inpatient must live in the facility for the length of their recovery programme. They’ll have their own private, comfortable accommodation, and will receive 24-hour support from a team of professionals specialising in methadone addiction recovery.
This highly structured setting is optimal for those looking to escape triggers at home, such as methadone-using social circles, easy access to the drug, or problematic/abusive relationships. Having removed themselves from their personal lives and daily activities, patients can spend valuable time understanding their methadone addiction.
Moreover, one of the requirements of residential rehab is that patients follow a structured schedule: helping them regain a sense of normality and purpose. Routines as an inpatient are both medical and holistic: serving to close the gaps in time that allows methadone cravings to grow.
A typical day in methadone rehab consists of individual therapy, group sessions, opportunities for recreational activities, and nutritional support. Each patient’s routine will include a combination of different therapeutic and medical activities to suit their individual needs and unique methadone addiction.
This level of personalisation is present in all stages of someone’s inpatient journey: from the medical and psychological evaluation, through detox, behavioural interventions, and the provision of aftercare.
After the initial assessment, professionals specialising in MUD will accurately assess the patient’s medical needs, motivation levels, and mental welfare to design an individualised plan.
It’s important to note that, to access inpatient treatment at a methadone rehab in the UK, patients often have to go private. Such intensive programmes are only available on the NHS in extremely severe circumstances, with patients often having to wait for life-saving methadone detox.
Outpatient Methadone Treatment
In contrast, those partaking in outpatient treatment for their MUD still live at home while attending therapy appointments. This allows for more freedom and little disruption to a patient’s daily life: meaning they can continue working or looking after their families.
The types of outpatient treatment for methadone addictions range from standard weekly or bi-weekly appointments to partial-hospitalisation programmes that are closer to inpatient treatment. After consultation with their GP or specialist, addicted individuals are referred to a programme intensity that aligns with their severity, and how long they’ve been misusing methadone.
During outpatient methadone rehab, patients are exposed to behavioural therapy methods on a pre-determined schedule to suit their needs. This is an ideal situation for those with a less severe methadone addiction, or who have a safe and secure home life.
Moreover, there are many NHS rehab centres and hospitals that can facilitate outpatient care. As such, patients battling methadone addiction can access expert guidance and the same therapy as those in private rehab for a fraction of the cost. This financial protection makes outpatient treatmentan increasingly popular option among UK residents.
Despite the advantages, outpatient methadone treatment can provide setbacks for someone with a moderate to severe addiction.
In addition to dangerously long NHS waiting times, outpatient care lacks the 24-hour medical supervision and personalisation of inpatient rehab. Patients must return home to problematic environments, where they may encounter methadone and risk relapsing.
What is the Cost of Methadone Rehab?
While outpatient care is significantly cheaper than inpatient, it’s important to note that the cost of methadone rehab will vary considerably depending on your circumstances. Moreover, each private centre offers a different range of specialist treatments, accommodation types, and locations for its clients.
Here in the UK, choosing to rehabilitate in a privately funded clinic can cost anywhere upwards of £1,000 per week. As can be expected, the more luxurious the facilities, the higher the price, with some clinics charging £4,000-£5,000 per week.
Overall, a budget methadone rehab will charge around £4,000 for every 28-days spent there, and a luxury clinic can amount to £20,000 for the same number of days. Patients can take certain measures to keep costs down, such as opting for cheaper multi-occupancy accommodation over single-occupancy rooms.
Furthermore, more and more rehab clinics are offering sliding scale fees or financial plans to help their clients cover the cost of recovery. Many centres are can create a payment scheme in which patients pay for their treatment in customisable monthly instalments.
How Long Will Methadone Rehab take?
Many factors will influence the length of someone’s bespoke treatment plan at a methadone rehab. For example, someone might have a co-occuring mental or physical disorder giving them additional treatment needs, or have been addicted to methadone for many years.
While there’s no set timeline for treatment, the severity of opioid addictions often means more extended stays are necessary for the body and mind to recuperate. Patients must ensure they’ve taken an appropriate amount of time to detox (between 7-21 days), and formulate a solid relapse prevention plan for their return to normality.
The majority of clinics offer 30, 60, and 90-day programmes to cater for all addiction severities: with 28-days being the minimum amount of time someone should spend recuperating. As recovery journeys often aren’t linear, there’s always the option for patients to extend their time in rehab, or return home earlier (although this is seldom advised).
It’s also important to note that most programmes in methadone rehab offer aftercare to their clients. After completing their inpatient stays, individuals will continue receiving ongoing support in the form of methadone group counselling, 12-step facilitation therapy, or consolidatory individual therapy.
Types of Therapy Used in Methadone Rehab
While Methadone Use Disorder is a difficult condition to cope with even with the help of rehab, there are several therapy options to help you achieve recovery. Behavioural therapy options help patients to curb cravings through developing coping mechanisms, while motivational counselling help achieve a steady mindset for a range of psychotherapy.
Group Support Therapy
Group Therapy is an effective way of ensuring that those battling Methadone addictions feel supported in their recovery, and less isolated in their illness. Communal sessions in rehab allow participants to share what they’ve learnt in their therapy sessions, give hope to those who are new to recovery, and provide support for those who are struggling with cravings.
Hearing from different people at various stages of their recovery journeys can inspire others to see that their problems may not be as overwhelming as they thought. As Methadone addiction can be a lonely disease, receiving support from other group members can be a huge relief: showing that others are experiencing similar struggles.
Sessions in residential Methadone rehab usually run for 1-2 hours at least once a week and are led by an experienced facilitator or therapist. They’ll help patients feel more comfortable sharing information about their lives and methadone recovery while sharing their advice and relapse prevention strategies.
Family Behavioural Therapy (FBT)
When someone in the family becomes dependent on methadone, every Concerned Significant other (CSO) in their orbit is affected: leading to damaged relationships and a loss of trust. Fortunately, those recovering from methadone addiction can participate in FBT: a cohesive way to educate the family about addictive behaviour while rebuilding closeness.
FBT in methadone rehab has two main goals: to utilise the family’s strengths and resources to aid addiction recovery while reducing the negative consequences of addiction for the patient and their loved ones. Participants can be anyone considered central to the addicted person’s life, even if they’re not biologically related: such as friends or partners.
Sessions are held in a controlled, clinical setting such as the rehab clinic that the addicted individual is currently attending. It’s also essential for an experienced therapist to lead sessions while remaining an objective, calm influence on family discussions.
Initial meetings often see group members come together to learn more about methadone use disorder, and addictive behaviours in general. Armed with this new knowledge, families can progress through healing conversations, opening up about their emotions and how they’d like to move forward as a supportive unit.
Cognitive Behavioural Therapy (CBT)
People battling methadone use disorder often have negative thoughts (cognitive distortions) and belief systems that feed into their addictive behaviours. This means that to facilitate complete recovery, patients must work to interrogate and change these behaviours using CBT methods.
Cognitive Behavioural Therapy positively impacts a person’s recovery by teaching them how their thoughts, feelings, and actions interact.
This allows patients and their CBT therapist to identify the patterns of behaviour exacerbating or informing their methadone use.
After their initial sessions, participants spend the rest of their CBT course learning problem-solving and coping strategies. This helps them to form clearer attitudes around their thoughts and to develop more positive cognitive patterns over time.
Dialectical Behavioural Therapy (DBT)
Developed in the 1980s to treat suicidal thoughts, DBT has since been improved and modified to aid those suffering from emotional problems at the root of their methadone addiction. As a type of behavioural therapy, DBT teaches skills to better manage intense thoughts and emotions, but with a greater focus on mindfulness.
Unlike CBT, DBT doesn’t focus entirely on making changes and instead leaves room for opposing thoughts and feelings to exist together. This philosophy is inherent in the name; the term dialectical is used to describe contradictory ideas being used in harmony.
In this case, these are acceptance and change. DBT participants in methadone rehab will learn to accept themselves and their emotions in the moment while working with their therapist to improve their lives. By finding a balance between acceptance and change, those in recovery can learn to be healthier and happier in their quest for sobriety.
Contingency Management (CM)
This form of behaviour modification intervention reinforces desired behaviours through incentives: in this case, abstaining from methadone. In Contingency Management, patients receive a reward for meeting a treatment goal, passing toxicology testing for methadone, or remaining sober for a certain length of time.
Many CM programmes in methadone rehab offer built-in bonuses where patients can earn greater rewards for the accumulation of clean drug tests. Such tangible incentives include vouchers that can be exchanged for useful products, specific foods, or activities.
Voucher-Based Reinforcement (VBR) is a model preferred by many clinics for its ability to motivate individuals and increase treatment retention in methadone programmes. Clinics might also use the Prize Incentives CM model, where patients who passed their drugs test draw from a bowl containing chips ranging in value.
Holistic Therapy (HT)
Holistic Therapy is utilised in rehab centres to address the entire person rather than merely their methadone addiction. HT workshops focus on nurturing the mind, body, and soul to achieve an optimal state of physical and psychological health.
In the field of Methadone addiction treatment, many experts are advocates of HT for its ability to increase a patient’s overall happiness outside of therapy. As many scientific reports have shown, ongoing stress, poor nutritional health, and lack of exercise can cause anxiety, depression, and a greater risk of relapse for those addicted to Methadone and other substances.
HT participants can overcome imbalances in their well-being by choosing activities that enhance relaxation, improve nutrition, and provide an outlet for negative emotions. Popular examples include meditation, yoga, breathing exercises, art workshops, tai chi, and nutritional enhancement therapy.
Finding a Methadone Rehab in Your Area
If you’re ready to face your methadone use disorder, or know someone who needs the help of inpatient rehab, now is the time to reach out. Here at Rehab Recovery, we have the tools and expertise needed to facilitate your search for the perfect clinic in your area.
By scheduling a free evaluation with one of our consultant specialists, you’ll be taking the first crucial steps towards living a normal life free from methadone. They’ll assess your physical health, mental wellbeing, the severity of your dependency and risk of severe withdrawal to build a list of recommended clinics.
Many of our partner rehab clinics in the UK offer programmes directly specialising in methadone use disorders, and each provides a different experience. Our referrals team will take you through all the options specific to your area, before securing your place in a centre to suit your individual needs and preferences.
As with any substance use disorder, delaying treatment for methadone addiction can be dangerous, and there’s never a “best” time to reach out for professional advice. Simply call our team on 0800 088 66 86.
References
[1] Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction – Google Books
[2] Methadone-Associated Overdose Deaths: Factors Contributing to Increased Deaths and Efforts to Prevent Them Methadone-Associated Overdose Deaths: Factors Contributing to Increased … – Kathleen M. King – Google Books
[3] Unbroken Brain: A Revolutionary New Way of Understanding Addiction Unbroken Brain: A Revolutionary New Way of Understanding Addiction – Maia Szalavitz – Google Books
[4] Cognitive Behavioural Therapy – Rehab Recovery https://www.rehab-recovery.co.uk/addiction-treatments/cognitive-behavioural-therapy/
[5] Motivational Interviewing https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques
[6] Cognitive Behavioural & Relapse Prevention Strategies Cognitive Behavioural & Relapse Prevention Strategies (unodc.org)
[7] DSM-5 Criteria Psychiatry.org – DSM-5 Fact Sheets
[8] 12 Step Facilitation Therapy https://pubs.niaaa.nih.gov/publications/projectmatch/match01.pdf
[9] Frontiers – Resocialising the Vulnerable Brain: Building an Ethically Sustainable Brain Disease Model of Addiction https://www.frontiersin.org/articles/10.3389/fsoc.2018.00039/full#:~:text=The%20brain%20disease%20model%20of%20addiction%20(BDMA)%20states%20that%20addiction,is%20portrayed%20in%20the%20model.
[10] Drug Misuse in England and Wales: Year Ending March 2020 https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/drugmisuseinenglandandwales/yearendingmarch2020
[11] Methadone: medicine used to treat heroin dependence Methadone – medicine used to treat heroin dependence – NHS (www.nhs.uk)
[12] Cognitive Behavioural Therapy in Addiction Treatment Cognitive Behavioural Therapy in Addiction Treatment – Rehab Recovery (rehab-recovery.co.uk)