FAQs About Methadone

DVM wants you to clearly understand the medication you will taking. Methadone is a drug used in the treatment of addiction to illicit opiates. Opiates are derivatives of opium, a naturally occurring narcotic obtained from poppies. Opiates include heroin, morphine, codeine, Dilaudid, OxyContin, and a number of related drugs. Because these drugs are so similar, persons with an opiate addiction are considered to be cross-addicted. In other words, if you are addicted to one of them, you are addicted to all of them.

The initial goal of methadone treatment is to free an opiate-dependent person from the periodic withdrawal that prompts the regular use of illicit opiates. A person may be physiologically addicted to opiates if they have been taking heroin or other opiates daily for extended periods of time and exhibit symptoms of withdrawal when they stop using these drugs. Along with irritability and cravings to use opiates within eight hours of discontinued use, the most common signs of opiate withdrawal are runny nose, large pupils, eyes tearing, sweating, chills, diarrhea, yawning, nausea, cramps, insomnia, joint pain, and gooseflesh. Prior to admitting any new patient for treatment, our physician will conduct a complete physical examination to determine whether methadone treatment is appropriate for that patient.

Here are some frequently asked questions (FAQs) about methadone and Methadone Maintenance Treatment (MMT).

What is methadone?

Methadone is a synthetic medication that was developed during World War II as a substitute painkiller when morphine was in short supply. Subsequent clinical research showed that the drug could be used effectively to treat opiate withdrawal syndrome by replacing morphine or heroin with methadone.

Am I just trading one addiction for another?

Methadone does create physical dependency, but there are number of differences between methadone and opiates:

• Methadone is given orally, which reduces the risk of HIV and Hepatitis C.
• Methadone is very long-acting. You will only have to take methadone once a day. The proper oral dose remains fully effective for 24 to 36 hours to prevent the beginning of withdrawal symptoms.
• Methadone takes effect slowly and gradually, so you will not experience the euphoria caused by street drugs.
• Methadone (and buprenorphine) are physician-prescribed, medically-monitored mediations that are dispensed in conjunction with addiction recovery-oriented counseling services.

How much methadone will I receive?

DVM intends to have every patient on the correct dosage of methadone. We recognize that too low a dose produces unnecessary withdrawal discomfort and invites the risk of heroin and other illicit substance use, as well as prescription medication abuse. We also know that too high a dose produces undesirable side effects and provides no additional benefit to the patient. Achieving and maintaining the correct dosage requires cooperation between the patient and the staff. All patients will be informed of their dosage upon request.

How will I feel on methadone?

After you reach a stable maintenance dose, usually with the first few weeks of treatment, you cannot be distinguished from a drug-free person. Methadone patients feel “normal” and doses generally do not need to increase over time.

Is methadone all I need?

Medication therapies - such as methadone and buprenorphine - are only part of the program for success at DVM. Support for you through a full range of psychological counseling is vital to your recovery.

Does methadone have side effects? 

Methadone’s side effects are infrequent, usually minimal, and short-lived. Side effects most often show up in the early stages of treatment. Most patients experience no severe side effects.

Please notify DVM medical staff if you experience:

• Light-headedness
• Dizziness
• Extreme tiredness
• Nausea and vomiting
• Sweating
• Ankle swelling (edema)
• Skin rash

Much less often, negative effects may include:

• Restlessness
• Malaise (a vague feeling of discomfort)

What are the drug interactions with methadone?

Methadone is a powerful drug and has a number of interactions and side effects that you should understand. Methadone must be used with caution. As with heroin and other narcotics, it is never safe to drink alcohol when using methadone. Excessive use of alcohol combined with methadone can cause breathing to stop, resulting in coma or death.

Note: If you are taking any medication, whether it is prescribed or over-the-counter, you must notify the DVM physician and your counselor at the time you enter the program as well as throughout the course of your treatment with DVM.

Caution: Opiate agonist/antagonist drugs (such as Talwin and buprenorphine) should not be prescribed for methadone-treated patients as they will produce opiate withdrawal illness.

What about pregnancy and methadone?

Federal Treatment Improvement Protocols state the following:
Pregnant women users who are in treatment with methadone deliver healthier babies. It is true that babies born to women on methadone sometimes experience some withdrawal symptoms during the first several days after birth. The symptoms are routinely treated by the baby’s pediatrician and do not result in any long-term damage. In addition, babies born to women on methadone tend to have a slightly lower birth weight than babies of non-addicted control mothers. The most important comparison, however, is not how these babies compare with non-addicted controls, but rather how they compare with babies of mothers addicted to heroin. Studies that have compared babies born to mothers in methadone treatment with babies born to mothers who use heroin have demonstrated tremendous benefits from methadone.

Methadone treatment allows the mother to be followed in prenatal care, to receive nutritional supplements and information and to participate in parenting classes. The vast weight of evidence supports the use of methadone with heroin-addicted women to reduce the risk of miscarriage, increase birth weight, reduce infection and HIV risk to the fetus, and generally produce a much greater chance for a healthy baby.