For many people seeking an escape from heroin or OxyContin addiction, methadone may seem like a no-brainer. But is it really recovery, or is using methadone just a substitute addiction?
What is methadone?
Methadone is a synthetic narcotic pain reliever with effects similar to morphine. Methadone is also used to help reduce the withdrawal symptoms in people addicted to heroin and other narcotic drugs without producing the “high” associated with those narcotics.
Most opioids are derived from the opium poppy, and include heroin, morphine, codeine, and hydrocodone. Methadone, on the other hand, is totally a synthetic opioid. Even though it is structured dissimilar to naturally derived opioid products, methadone nevertheless acts on the same sites in the body as the other opioids. It’s for this reason that methadone has been used in the treatment of heroin addiction.
What is different about methadone versus heroin and other opioids? For one thing, the onset is slower and it lasts longer in the body. Methadone is usually taken orally as a syrup, rather than by injection.
But methadone is still a narcotic, and it is addicting. Granted, it is less addicting than heroin or other opioids, but addiction is addiction. Why substitute one addictive substance for another?
There isn’t the rush that’s associated with heroin, and the withdrawal phase is not as severe. This is the primary reason many heroin addicts choose methadone as a kind of middle ground between heroin use and total abstinence. Indeed, going “cold turkey” from heroin addiction is almost never successful. Addicts are simply unable to tolerate the severe withdrawal pain and the cravings are insurmountable. It’s far easier to just revert to heroin use.
How methadone is used
Tapering off and gradually reducing the dosage of methadone is one way of kicking the heroin habit. Another use for methadone is as daily maintenance. Why would someone choose methadone maintenance? Using methadone in this manner allows the heroin addict to try to rebuild parts of their lives that have been damaged by heroin addiction. It’s not a perfect solution, but it can be useful as a temporary one.
Still, methadone is not a safe drug, as many accounts and numerous studies have found. It is a Schedule II narcotic under the Federal drug classifications, requires a special license to dispense, and carries a high risk of dependence.
Brand names of methadone include Amidone, Methadose and Dolophine.
Side effects of methadone, depending on dose, include dizziness, drowsiness, constipation, lethargy, lowered respiration rate and elevated mood.
Methadone can also serve as a gateway drug for other narcotics. Another reason methadone isn’t safe is that it is dangerous in combination with alcohol and other types of drugs an individual may be taking, particularly barbiturates. Both alcohol and barbiturates act on the central nervous system
Why methadone is not addiction recovery
Many addicts do not like methadone and will use the synthetic opioid only until they can return to using heroin, or when they procure a regular supply of heroin once again.
Methadone can also be considered a way to extend addiction, rather than going through the withdrawal that is necessary to get addictive substances out of the body. Extending addiction puts off the likelihood that a person will go into treatment to overcome addiction to heroin or other opioid drugs.
When a patient is dependent on methadone, it should always be dispensed with an approved treatment program. Such a treatment program should also include testing to ensure that the patient doesn’t continue to use heroin on the side.
Methadone use has other side effects as well, which may cause problems for the individual. He or she may be refused a job because they are on methadone and the job includes operating heavy machinery or equipment for which mental alertness is necessary. It is also possible that the individual’s employer will find out about the methadone use, especially if an insurance company is paying for the methadone treatment.
Newer drugs for treatment of heroin addiction
While methadone is the oldest treatment for heroin addiction, there are newer drugs that have been approved by the U.S. Food and Drug Administration (FDA) for treating opioid addiction.
One of these drugs is naloxone, marketed as Suboxone, which the FDA approved for opiate treatment in 2002. With methadone, a patient has to travel to a clinic to receive a daily dose. With Suboxone, doctors can prescribe a month’s supply of the drug, which is much more convenient for many individuals.
But methadone is less expensive than Suboxone and is more widely available.
Buprenorphine is another drug that has been FDA-approved and is useful in helping to block cravings. The combination of buprenorphine and Suboxone has proven effective in some patients.
Another medication-assisted therapy for opioid dependence is naltrexone, although studies have found that naltrexone treatment is poor except for highly-motivated patients under strong external pressure to comply with treatment regimen. With the introduction of once-monthly injectable formulations, such as Vivitrol, however, this situation may be changing. Vivitrol has been approved by the FDA for preventing relapse to opioid addiction.
Treatment for opioid addiction
If methadone or Suboxone and buprenorphine are helpful in allowing an individual to better manage opioid withdrawal symptoms while they are getting treatment to overcome addiction, what kind of treatment works best?
Traditional treatment for opioid addiction includes a period of detoxification (also called detox), followed by counseling and therapy that are designed to help the patient stay off the drug. There are also specific therapies that include Chinese medicine, hydrotherapy, mindfulness meditation and spiritual counseling, restorative yoga, nutritional wellness and detoxification juicing, hypnotherapy, massage therapy, dry sauna, and EEG biofeedback (neurofeedback).
How should you go about finding treatment for opioid addiction? You can start by asking your doctor for a recommendation to a treatment facility that specializes in treating patients addicted to heroin.
Office-based opioid treatment providers often refer their patients to substance abuse counselors, social workers, psychologists or nurses for counseling, but physicians can also provide counseling to their patients as part of medication management. Weekly urine testing early in treatment has been recommended by most clinicians. That is because it is expected that patients will have at least some ongoing use. Prescription intervals can be used as a contingency to help motivate patients to abstain from opioid use, or at least spur them on to a recovery trajectory.
Another avenue to finding therapy is to use the Treatment Facility Locator maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is an online searchable directory of drug and alcohol programs showing the location of facilities around the country that treat alcoholism, alcohol abuse and drug abuse problems.
Included are listings for residential treatment centers, outpatient treatment programs and hospital inpatient programs for drug addiction and alcoholism. Select “Detailed Search” and click the box for specific services desired to search for treatment facilities offering such services in addition to detoxification and treatment (including counseling).
Heroin relapse rates are quite high which often necessitates repeated stints in rehab. For this reason, recovery from opioid addiction is usually considered an ongoing process.
In combination with treatment, participation in various 12 step self-help groups such as Narcotics Anonymous is strongly recommended. Indeed, most treatment programs include mandatory participation in 12 step meetings as part of the overall treatment plan.
Hope for opiate-dependent individuals
While the path toward recovery from opioid addiction may seem uncertain, with relapse rates high and multiple stays in rehab often required, the outcome is not negative. Indeed, with each treatment stay completed, patients do seem to make progress, according to numerous research studies.
The fact that many opioid-dependent individuals also have other substance abuse problems, specifically alcohol abuse or addiction, and/or use of cocaine or other illicit substances, along with possible co-occurring mental health disorders (including depression, anxiety, bipolar disorder and others), means that it may take longer for the comprehensive treatment to begin to work effectively.
Bottom line: If you are addicted to heroin or OxyContin or other opiates, going into treatment, sticking with it, and developing a strong support network will put you on the road to recovery. It may take you a while to get there, but you can and will see progress as long as you remain committed to sobriety and do the hard work necessary to maintain it.
Is recovery worth it, no matter whether you go the methadone route or another of the FDA-approved treatments for opiate addiction, coupled with counseling, 12 step meetings and so on, of course? Only you can decide. But your future very much depends on your decision. Why wait? Seek help today so that you can begin to learn how to overcome what very likely is impacting your life in a negative way.