Is Methadone Maintenance Worth the Risks?

Methadone is a synthetic agonist opioid used in maintenance therapies to assist individuals in their recovery efforts from other opioid drugs. The benefits of methadone maintenance exceed the risks for most and according to the University of Texas Medical School at Houston “It is currently the most successful treatment for chronic opioid dependence, although not without fairly substantial financial and personal costs to individuals participating in this therapy.”

Understanding the nature of addiction has come a long way through research and scientific evidence, but, the answer to the question, “Is methadone maintenance worth the risks?” remains unique to each individual.

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About Methadone Maintenance

methadone pros and cons

Methadone treatment doesn’t only benefit you, it also benefits your loved ones.

Like heroin and prescription painkillers such as oxycodone, morphine, and codeine, methadone interacts with specific receptors and brain systems to reduce the cravings and distress that chronic opioid dependents suffer and helps them to get on with their lives in a more healthy and positive way. Methadone maintenance is not intended to be viewed as “replacing one addiction for another”, but, rather, as a way of correcting brain and other physiological conditions while retaining the patient in treatment to prevent relapse and abuse to the more harmful short-acting opioids.

Detox, alone is generally, insufficient in helping these individuals recover and many will go through multiple relapses or several other forms of treatment before the decision to enter a methadone maintenance program is made. As the methadone normalizes physical and psychological functions, the methadone maintenance promotes recovery retention by reducing the consequences of the short-acting opioid abuse and addresses the patient’s needs to help them improve their quality of life.

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What are the Benefits of Methadone Maintenance?

Since being implemented, methadone maintenance programs have incorporated multifaceted services into their programs to care for the existential medical, psychiatric, and social needs of their patients.

The benefits of methadone maintenance include:

  • Reduction in withdrawals, suppression of cravings, and the ability to block other adverse opioid effects, such as euphoria and sedation, to reduce the compulsions to use short-acting opioid drugs for 24 hours or more.
  • Reduction in abuse of other substances through daily dosing and drug monitoring efforts.
  • Physical and mental health improvements that increase the opioid dependent’s ability to become self-sufficient, lead to a more productive and satisfying life.
  • Education, counseling, and psychosocial services improve social functioning abilities. According to Institute of Medicine (US), “Heroin-dependent persons have a number of social problems, including difficulty in holding jobs, obeying laws, maintaining stable marriages, making and keeping friends, and functioning as caring and responsible parents.”
  • Restructured lives decrease behavioral risks associated with opioid dependencies as a result of frequent needs to stave off withdrawals and cravings. These individuals, typically, become involved in more crimes and immoral acts as they progress through their addiction. They must first, find the drugs and/or money to get the drugs, use the drugs, and the cycle continues to repeat.
  • Decreased mortality and overdoses related to opioid drugs. According to the CDC “Of the 22,767 deaths relating to prescription drug overdose in 2013, 16,235 (71.3%) involved opioid painkillers.”
  • Prevention of diseases and infections is one of the major goals of methadone maintenance. IV use, needle sharing, prostitution, and other risky behaviors contribute to the majority of hepatitis, AIDs, and HIV, cases while the infections that can be caused via IV use are increasingly, being attributed to amputations, circulatory, cardiovascular, and pulmonary diseases.
  • Cost of methadone maintenance is generally much less than the cost of maintaining an opioid habit. Although many people obtain their opioid drugs through insurance programs such as Medicaid, increasing tolerance means increasing dependency and amounts needed which may require additional purchases on the street or fraudulent means to obtain the drugs such as “doctor shopping”, or theft.
  • There is no time limit on methadone maintenance treatment. According to the National Institute on Drug Abuse,” no matter how ideologically attractive the notion of a time-limited methadone treatment for heroin abusers, longer-term methadone maintenance treatment is far more effective.”

What are the Risks of Methadone Maintenance?

Methadone is a synthetic opioid drug that possesses abuse and addiction liability potentials the way other opioids do and while it works differently from those opioids to provide benefits to opioid addicts in recovery, it also carries a certain amount of risks for individuals including:

  • Overdose when abused in higher amounts than prescribed by the methadone maintenance provider, abused with other substances, or when co-existing health conditions are present. According to the Institute of Medicine (US) “A daily dose of methadone stabilizes a maintenance patient pharmacologically by the creation of a drug reservoir in the tissues of the body that holds the plasma level within narrow limits.” Liver impairments and other compromised health issues can impact the levels of metabolism and storage of methadone increasing overdose risks.
  • Methadone maintenance follows structural procedures that may be unsuitable to some people such as required daily visits, controlled doses determined by the methadone maintenance provider and random drug testing. It usually takes about a year before take-home doses are allowed and recipients must comply with program rules and regulations in order to remain in the program.
  • Methadone maintenance continues to have a stigma attached to it that is slowly decreasing, but, for some, the psychological burdens have been known to damage relationships with families, employers, or in other important elements of their life.
  • Methadone maintenance is intended to be a long-term treatment, but, as with any other opioid drugs, the withdrawals can present a myriad of complications that may become life-threatening. A gradual dose tapering under careful monitoring of the methadone maintenance provider is necessary and caution should be taken to avoid relapse to any other opioids due to reduced tolerance to those drugs and the increased risk of overdose.

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