What Is Methadone?

Methadone is asynthetic opioid currently classified as aSchedule II drug by the FDA. Schedule II drugs are recognized as having a legitimate medical use but have a high risk fordependence. Methadone has the potential for physical dependence and abuse. It is illegal to use methadone for any purpose other than that prescribed by a physician.

What Is Methadone Used For?

Methadone has two primary purposes: it is approved to treat moderate-to-severe pain andopioid use disorder (OUD), particularlyheroin addiction.

Methadone is not typically the first-choice medication for treatingchronic pain. It is more commonly used for pain that does not respond to non-narcotic treatment options or other opioids. It is often used incancer patients or those who are terminally ill. If used for non-cancer pain, an assessment for risk factors that could contribute to misuse is recommended.

Some of these risk factors include:

• Mental health conditions
• Lack of social support
• History of substance use disorder
• Unemployment or underemployment

Methadone is one of two medications approved by the FDA for treating OUD. The other isbuprenorphine. When treating OUD, these medications must be used within a federally regulated treatment program. Methadone may be used fordetoxification or maintenance therapy, depending on the individual’s circumstances.

Methadone Maintenance Treatment

Methadone is considered an essential medicine by the World Health Organization (WHO) due to its importance in treating OUD. The WHO reports that methadone maintenance therapy has several potential benefits for treating OUD, including:

• Reduced drug injecting
• ReducedHIV transmission
• Decreasedoverdose deaths due to OUD
• Decreased criminal activity by people with OUD

A medical provider who is experienced in treating opioid use disorder must carefully supervise methadone maintenance treatment. These programs are generally administered through federally licensed treatment programs. A physician must oversee these programs, but other healthcare providers may dispense oral medication. Methadone doses may interact with other medications, so it is essential to ensure the treatment program knows all the medicines the person is taking.

Like any medication, methadone has potential side effects. While side effects are rare, methadone maintenance treatment is associated with:

People who have severe problems with their liver should not use methadone maintenance therapy.

Is Methadone Addictive?

Methadone is potentially addictive. When used to treat moderate to severe chronic pain, it is possible to become physically or psychologically dependent and addicted to the drug.

When used for methadone maintenance therapy, methadone can treat addiction and decrease cravings. Methadone is heavily regulated, and people who are using methadone for OUD are usually either in an inpatient setting or go to amethadone clinic daily.

Using methadone for this purpose may be safer because the drug is coming from a known source and is less likely to be contaminated with other substances than drugs purchased through illegal channels. The duration of treatment varies based on the individual, but it is generally recommended for at least 12 months.

People using methadone for OUD are already at an increased risk of abuse because they have a history of opioid dependency.

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Can Methadone Be Abused?

Like all opioids, methadone carries the potential for addiction and abuse. Any person who uses more methadone than prescribed or anyone who uses it without a prescription is abusing the medication. The high potential for methadone abuse is one of the reasons that methadone is so heavily regulated, especially for treating OUD.

Methadone does not have the same euphoric effects asmorphine, heroin, or some other opioids because it is designed to block the pleasure sensations associated with other opioids. Methadone is longer acting, which allows the medication to reduce withdrawal symptoms and cravings while not producing the same pleasurable feelings.

Deaths related to methadone overdose, as well as those related to other opioids, increased during the COVID-19 pandemic. These numbers have since stabilized.

What Are The Pros And Cons Of Methadone?

Methadone has well-documented benefits, but it also carries the potential for abuse and addiction.

Pros Of Methadone Use

Some of the pros of methadone include:

• It has a long duration of action.
• It can treat chronic pain and OUD without causing the euphoric high that other opioids can.
• It is well-documented to be safer than commonly abused opioids such as heroin.
• Because it is taken orally, rather than injected, it can decrease the rate of HIV transmission as well as reduce drug injection.
• The careful regulation of methadone for OUD means that there is a reduced risk of overdose because people are only given one dose at a time. This regulation also provides structure and routine to the day of people with OUD, which may help the recovery process.
• Methadone can help people avoid painful opioid withdrawal symptoms and reduce cravings.

Cons Of Methadone Use

Some of the cons associated with methadone use include:

• It has the potential for abuse and addiction.
• Like with other opioid medications, methadonetolerance may develop, though this tolerance seems to be less than that of other opioids such as morphine.
• Long-term use of methadone for treatment of OUD may be a con for people hoping to get off opioids altogether. Methadone treatment programs can work with individuals to gradually wean the dose over time to ultimately be free from opiates.
• Medication treatment alone does not address some of the other concerns associated with OUD, such as mental health conditions. Medication-assisted treatment for OUD is just one part of a comprehensive treatment program.Support for dual diagnoses, as well astherapy, is also crucial for long-term recovery.

How To Safely Use Methadone

When used correctly, methadone can be a life-changing medication. However, using methadone safely requires strictly following the healthcare provider’s instructions.

Methadone has the potential to interact with multipledrugs and other substances, so it is imperative to inform your healthcare team of all medications you take, including herbal medicines and supplements.

Using methadone for addiction treatment is individualized, and a dose that is safe for one person may not be safe for another. Methadone has the potential for fatal overdose, so you should only take it under the direct care of a healthcare professional or supervised treatment program.

Some tips for safely using methadone include:

• Follow dosing instructions exactly. Take the medication exactly as prescribed, at the exact dose and at the precise time.
• If you miss a dose or don’t feel it’s effective, do not take an extra dose. Taking doses too close together can potentially lead to overdose.
• Do not combine methadone with other drugs or medications that affect the central nervous system.Alcohol, other opioids, sedatives, orbenzodiazepines can suppress the drive to breathe and, if taken with another drug such as methadone, can lead to respiratory depression and death.
• Keep your healthcare provider informed about all medications and supplements you take, includingover-the-counter products, to ensure accurate and effective treatment and avoid dangerous drug interactions. Methadone is metabolized in the liver, so medicines that affect the liver can cause the levels of methadone in the body to be higher or lower than expected. If you start a new medication, inform the provider responsible for your methadone treatment immediately.

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If you or someone you love is struggling with opioid addiction or abuse, there are many treatment options available, including programs that include methadone maintenance treatment.

If you’re ready to start your recovery journey, visit ourrehab directory orcontact a treatment provider today to learn more about your treatment options.