Methadone Symptoms

Melanie:

i work as a mental health nurse and have nursed people who are prescribed methadone, they tell me that they are just as addicted to it as they were to heroin. they just tell me that it easier because its legal and they do not have to commit crime to get it. i believe its a government way of reducing crime.

Sparrow:

Okay, first:
Myths:

1) methadone treatment has been largely supplanted by more effective meds like suboxone.
Methadone was, and in fact, continues to be the most successful form of maintenance based treatment for opiate addiction. It has been studied far longer, and deemed far safer than other maintenance therapy drugs, and statistically, methadone-treated addicts have the highest rate of recovery once they have completed treatment, compared to both maintenance & abstinence based treatments.

2) Methadone is easily abused.
Methadone does not impair cognitive ability, motor skills, or produce a feeling of euphoria- and once a person starts a methadone program, the methadone binds to the same receptors opiates normally do, making them fairly ineffective when taken in conjunction with, in terms of a “buzz”. It still retains the danger of overdose, b/c the toxicity is present.

3) Suboxone is more difficult to abuse.
Suboxone has become the darling of the recovery world this past year or so,mainly because it can be given in prescriptions,and has little required in terms of follow up. A doctor need only take a few hours of in services to become certified, and once so, is permitted up to 30 patients he can subscribe to. Suboxone has a much lower success rate than methadone, even in the very short time it has been used. Like methadone, Suboxone does not get you high, and blocks opiates from receptors if taken together, but does not take away the cravings that methadone does.

Now- some basic info for you:

I’m assuming we’re all familiar with the science of addiction, but if not: the long and short of it is that our bodies produce endorphins- natural pain killers- in small amounts, as needed. Opiates- drugs derived from the poppy plant- (heroin, vicodin, Darvon, oxycontin, morphine, dilaudid, etc.)- when taken, cause an influx of these endorphins. When a person takes opiates on a regular basis, the human body, which is extremely adept at conserving it’s natural resources- recognizes that the person is providing them with more than enough synthetic endorphins through opiates- and the body stops producing it’s small amounts. So when an opiate addict suddenly stops using opiates, the body goes into an endorphin-deficiency, causing the person to become very ill.
Until the last decade, addiction was not recognized as a disease. Since then, the medical community has found evidence of “addictive” genes, in the form of THIQ- a chemical produced from opiates & alcohol by certain people thought to contain the addictive gene. Those without the Addictive gene don’t process the opiates or alcohol the same way, and therefore, do not turn any portion of them into THIQ, the way a person with the addictive gene does. THIQ is believed to be part of the reason that an addictive-prone person develops such strong cravings & is unable to stop using, compared to the non-addictive prone. There has also been some suggestion that the genetically addictive prone were born with an endorphin deficieny, and have likely never had the proper amount, which is what drives them to seek that elsewhere.

The first thing you have to understand is that MMT- Methadone Maintenance Therapy- when used for opiate addiction is not a “quick fix”, or a short term solution. There are other routes~ cold turkey, or detox- detoxes are usually in hospital like settings and last 4-5 days; during which they wean you down with mild narcotics in decreasing doses, like Ultram and Bupranex. The actual meds vary by institution, but bear in mind detox is not considered recovered. After detox, the best chance at recovery requires residential rehab- upwards of 6 months’ worth- followed by a halfway house, then IOP (Intensive Outpatient Therapy) and Aftercare~ and this may all take more than 1 year. A year in which you can’t work, live with your family, or do anything else but focus on recovery.
I would never reccomend MMT to an addict newly seeking recovery- total abstinence should be the goal, but if someone has tried all the avenues, more than a few times, and been unable to get clean, then MMT can be a life saver.
MMT has the highest success rate among opiate treatments- but the best chance of sobriety comes to those who spend a MINIMUM of 2 years on the program. The program involves taking your daily dose, and doing some counseling, but otherwise, you are able to immediately start over-
I’m assuming you’re familiar, but in case not- opiate addiction, unlike other drugs, causes a physical dependence. If an addict suddenly stops using opiates, they become severely ill. Methadone is an opioid agonist- not an opiate, but a synthetic drug that works on the same receptors in the brain that opiates do, and therefor “tricks” the brain into thinking it’s getting opiates.

Methadone, when used to treat opiate addiction, and taken in the prescribed, stabilization dose, does NOT impair cognitive ability, motor function, or logic. The very basis of why methadone has been successful in treating opiate addicts is because it works in a time released capacity- rendering it incapable of producing feelings of euphoria or, in laymen’s terms, unable to get you high.
Now- someone who has never taken methadone before, who takes a large enough dose, may experience marked drowsiness- but that’s why Methadone Maintenance Clinics (MMT) follow strict regulations that entail starting every new patient/opiate addict off at the very low dose of 20-30mg, regardless of their height, weight, or tolerance level to opiates. From there, each patient is seen by the clinic physician on a weekly basis, and given the small increase of 2 -5 mg once a week, until they are “stabilized”- meaning they’re feeling normal- not in acute physical withdrawal from the sudden lack of opiates in their system. From that point on, there is a blood test called a peak and trough, that measures the serum levels of the methadone in the patient, to ensure their dose is of a therapeutic level, and not so high as to cause drowsiness.
There has been a lot of propaganda in the press lately about the dangers of Methadone- the bulk of which is directly related to a few celebrity deaths that were caused by the mixing of methadone and alcohol, or methadone & other medications. What is not so well known is that NONE- ZERO- of those cases involved opiate addicts taking methadone in a methadone maintenance program. All of them were the result of a personal physician prescribing methadone for pain, to patients who abused the medication by taking it with other drugs, creating a lethal reaction. The Harrison Drug Act made it illegal for physicians- general practitioners- to prescribe methadone to patients for opiate addiction. Only MMT clinics, which are strictly regulated, may prescribe it for addiction. MMT clinics require frequent, SUPERVISED, random drug screens (so anyone on methadone for opiate addiction cannot be abusing other meds, or they would be kicked off the program); as well as one on one counseling, group treatments, state required classes, state required physicals and blood tests, as well as anything else the individual’s counselor feels they need. They must complete treatment plans and goals on a monthly basis, demonstrating they are moving forward with employment, housing, etc., and they are not permitted to take many medications, even when prescribed by a physician, if there is any chance of an interaction. For example, benzodiazepines are well known for their ability to interact with methadone in a way that induced euphoria- (i.e., a buzz)- and are a major no-no. The MMT clinic will prescribe another medication that will not interact, if necessary, but using the benzo’s will result in being kicked off the program. A general practitioner, on the other hand, can prescribe methadone to whomever he sees fit for pain management, and there are no other regulations.

The removal of cravings is MMT’s biggest benefit, and where other treatments- suboxone, detox, etc- fall short. Suboxone does some good here, but in studies, trials, and other reviews of MMT clients who converted to Suboxone, it is not nearly as effective as Methadone is in taking them away.. While acute physical withdrawal is hell, the chronic, mental withdrawal, and the lingering physical withdrawal symptoms like insomnia, leg cramping and that awful crawling out of your skin feeling. Those can take upwards of a year to dissipate without methadone.
In the near decade I have now had sober, I have turned my life around. I a m a mother, a wife, a business owner, and a tireless advocate for the rights of addicts and MMT.
Not everyone agrees that MMT is a good thing; but I find that the majority of them have not had first hand experience, or have simply been misinformed. There are tremendously ridiculous myths about MMT, and as someone who found her life again through it, I feel it’s an obligation to educate others. I strongly support reform and regulation of policy- the strict adherences iomposed on MMT clinic clients may seem like a pain, but they are what protects us as well- and should be in effect for ANYONE prescribing MMT- not just for opiate addiction.
I don’t expect everyone to agree with me- I simply ask that you take the time to educate yourself on BOTH sides of the story- only then can you make a truly informed position.
If you have any other questions, feel free to email me-

Some other resources:
* http://www.facebook.com/erinmsantana#!/group.php?gid=106559159942&ref=ts
(This is a group on Facebook about MMT education. If you have any questions, feel free to email me; i am the admin for the group).

* http://www.methadone.org/ (NAMA_ National Alliance for Medication Assisted Recovery , is one of the leading sources of information and education on methadone for MMT)

*http://www.drugtext.org/library/books/methadone/section4.html (The Methadone