The double-edged sword of methadone treatment and abuse can create additional problems for the addict trying to get clean. Methadone is on the one hand used to treat opiate addiction. But on the other, it is by itself, an addictive drug that when used in treatment can create a new addiction.

What is Methadone?
First developed in Germany in 1937, methadone is a synthetic opioid analgesic used in treating opiate addiction (e.g. heroin, Oxycontin, Vicodin, etc.) ;Methadone for treatment was first evaluated in 1964 "as a medical response to the post-World War II heroin epidemic in New York City," says a paper by doctors of the New York State Office of Alcoholism and Substance Abuse Services. It's also used to treat chronic pain for diseases such as cancer.

Methadone is a Schedule II substance under the Controlled Substances Act. Drugs in this category including cocaine and methamphetamine have a high potential for abuse. Methadone is usually taken orally in tablet form

It goes by street names such as Amidone, chocolate chip cookies (methadone or heroin combined with MDMA), fizzies, street methadone, and wafer.

How Does it Work?
Methadone changes the way your brain and nervous system respond to pain by occupying the receptor sites affected by the opiate. It blocks the euphoric and sedating effects of the opiates and prevents withdrawal symptoms.

Methadone for Treatment
As a treatment for opiate addiction, methadone is administered in what's called MMT-methadone maintenance treatment. According to the Centers for Disease Control and Prevention (CDC), MMT:

  • Blocks the euphoric and sedating effects of opiates
  • Relieves the craving for opiates that is a major factor in relapse
  • Relieves symptoms associated with withdrawal from opiates
  • Does not cause euphoria or intoxication itself (with stable dosing), thus allowing a person to work and participate normally in society
  • Is excreted slowly so it can be taken only once a day.

MMT was first used to treat heroin addiction. Under strict doctor-patient control, MMT has been a successful method of treatment. In one National Institute on Drug Abuse study, "among outpatients receiving MMT, weekly heroin use decreased by 69%." Another study showed that "illegal drug use, criminal activity, and hospitalization were lower for MMT patients than for addicts in any other type of drug treatment program."

But when prescription pain relievers like Oxycontin and Vicodin became widely abused, methadone had yet another treatment use…and abuse. Some addicts who underwent MMT simply switched their drug of choice to methadone. It is cheaper than other opiates, easy to obtain, and worst of all, is more unpredictable, especially when combined with other drugs and alcohol.

Methadone Abuse
Methadone is metabolized slowly and remains in the body for 24 to 36 hours. Users won't get the same immediate high as a drug like Oxycontin. "Methadone's delayed narcotic effect and its lack of a potent high are important reasons the drug can be so dangerous," says an article in the New York Times. People who use methadone, especially if they are looking for Oxycontin-like highs, will end up taking dangerously large quantities. Even those in taking the drug for pain or addiction treatment have difficulties. As the National Drug Intelligence Center (NDIC) reports, "The accumulation of methadone to toxic levels during the start of opioid treatment or pain management caused by an overestimation of tolerance and methadone's long, often variable, half-life."

According to the NDIC, methadone-poisoning deaths in the U.S. increased 390% from 1999 to 2004. Most of those occurred in people 15 to 24 years-old. The states with the highest increases in deaths reported were West Virginia, Ohio, Louisiana, Kentucky, New Hampshire, Florida, Oregon, Pennsylvania, Tennessee, and Wisconsin.

Methadone Side Effects
Methadone can cause side effects. Here are some of the most common.

  • Drowsiness
  • Nausea
  • Vomiting
  • Sweating
  • Headache
  • Constipation
  • Dry mouth
  • Weakness
  • Loss of appetite
  • Mood changes
  • Decreased sexual desire

Less Common Side Effects
These are less common and can be serious. If you experience any of these, call you doctor immediately.

  • Seizures
  • Itching
  • Rash
  • Hives

In addition, the National Center for Biotechnology Information, U.S. National Library of Medicine, has this warning:

The risk that you will experience serious or life-threatening side effects of methadone is greatest when you first start taking methadone, when you switch from another narcotic medication to methadone and when your doctor increases your dose of methadone. Your doctor may start you on a low dose of methadone and gradually increase your dose. Your doctor will monitor you closely during this time.

Conclusion
Methadone treatment and abuse presents a thorny problem for all involved with the drug. Methadone can be effective for treatment of opiate addiction. But it is a drug with a high potential for either accidental or intentional misuse.

Sources:
http://www.cdc.gov/idu/facts/MethadoneFin.pdf
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000591/
http://www.ncbi.nlm.nih.gov/pubmed/11064485

http://www.justice.gov/ndic/pubs25/25930/25930p.pdf