What is Methadone Used to Treat?

Methadone is a synthetic opioid used in the United States as a treatment for opioid addictions in opioid detoxification and maintenance programs. In more recent years, it has become a principle analgesic drug intended for use in the treatment of chronic and severe pain.

Methadone has restrictions in prescribing practices for the treatment of opioid addictions that are more infringing than they are for prescriptions to treat pain. Federal and state regulations limit the disbursement of methadone for opioid addiction treatments under strictly monitored programs whereas when prescribed as an opioid pain reliever (OPR), it can be prescribed like any other painkilling drug.

This had led to an epidemic and disproportionate rise in opioid overdose occurrences sweeping across the country. According to the CDC, “Vital statistics data suggest that the opioid pain reliever (OPR) methadone is involved in one third of OPR-related overdose deaths, but it accounts for only a few percent of OPR prescriptions”, (less than 18.5 % distributed).

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Methadone Used in Opioid Detoxification Treatments

Methadone is an opioid agonist that activates the same opioid receptors in the brain and central nervous system as heroin, morphine, and other prescription opioids. It is used to treat opioid withdrawals including cravings and to reduce the dangerous behaviors associated with illicit opioid abuse such as needle sharing, prostitution, and crime.

Methadone works much more slowly than illicit opioids which require frequent dose administrations increasing opioid tolerance, abuse, dependency, and many physical, psychiatric, and social consequences. According to the Scripps Research Institute, “From initial, positively reinforcing, pleasurable drug effects, the addictive process progresses over time to being maintained by negatively reinforcing relief from a negative emotional state.”

uses for methadone

Methadone is used to treat opiate addiction, and it is also used as a pain medication.

In a medically assisted withdrawal or a longer term detoxification plan that can last up to 6 months, methadone can be administered on a daily basis to provide relief from withdrawals with stable functioning abilities for 24-36 hours at a time.

Based on treatment preferences, needs, and treatment goals, methadone can be used until the person decreases their tolerance to the short acting opioids, reaches their detoxification recovery goals, and is able to maintain abstinence, at which point it can be gradually tapered off at the discretion of the patient and treating clinician.

Methadone Used to Treat Opioid Addictions

Opioid addiction is a chronic and relapsing brain disease that, although it cannot be cured, it can be successfully treated with methadone and comprehensive care that includes counseling, behavioral therapies, and psychosocial interventions to help the person improve their quality of life.

According to the SAMHSA,” Methadone’s pharmacological profile supports sustained activity at the mu opiate receptors, which allows substantial normalization of many physiological disturbances resulting from the repeated cycles of intoxication and withdrawal associated with addiction to short-acting opioids. Therapeutically appropriate doses of methadone also attenuate or block the euphoric effects of heroin and other opioids.”

As the person loses their ability to control their use of opioid drugs, the negative consequences such as loss of a job, freedom, finances, or family support and trust, can be factors that contribute to increased abuse and the cycle goes on and on. Intense cravings and high relapse potentials can last for months and strip away the person’s ability to remain abstinent for the necessary time they need to truly recover. Many opioid dependents will attempt to cease use several times before they either give up and accept their plight or seek the life saving treatment of methadone maintenance which will help keep them in recovery for as long as they wish, are progressing in recovery goals, and face the risk of relapse.

The benefits of methadone used to treat opiate addictions in methadone maintenance include:

  • Reductions in IV use and the spread of diseases and infections
  • Improved physical, mental, and emotional health
  • Improved social functioning with access to resources and social agencies for educational, vocational, legal, family, child welfare, transportation, housing, and financial services.
  • Reduction in overdose and mortality (according to the NIH,”Addiction-related deaths, including accidental overdose, drug-related accidents, and many illnesses directly attributable to chronic drug dependence explain one-fourth to one-third of the mortality in an opiate-addicted population.”
  • Reduction in crime, immoral, and dangerous activities surrounding drug abuse
  • Reduction in poly-substance abuse

Methadone Used to Treat Pain

Rises in methadone prescriptions for the treatment of pain are concerning, but, the fact is that methadone is a powerful pain reliever that according to the SAMHSA,” causes no harm to tissues or organs and is medically safe when taken responsibly.”

According to the CDC “The primary advantages of using methadone over other opioids for pain treatment are its long duration of action, relatively low cost, and availability in liquid formulation for oral use.” Physicians and patients need to be aware of the risks, contraindications, and safeguards of use. Methadone is not intended to be taken with other central nervous system depressants or substances, taken by opioid naïve individuals, or taken in high amounts or frequencies other than prescribed because of its powerful ability to slow heart rate and respiration to possibly fatal extents.

People metabolize methadone at different rates and because it long-half life and long lasting storage in the body, overdose can occur hours after taking the last dose. Effects should be closely monitored, especially in the elderly and for the first 5 days until the person gets use to the drug.

Methadone prescribing practices to date still leave a lot to be desired. According to the CDC “Methadone and other, extended-release opioids should not be used for mild pain, acute pain, “breakthrough” pain, or on an as-needed basis. For chronic noncancer pain, methadone should not be considered a drug of first choice.”

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