Methadone

Main type

Methadone is a narcotic and a synthetic opioid – a class of drugs that act on the opioid receptors in the brain and elsewhere in the central nervous system.

Methadone is produced legally and has a number of legitimate medicinal and therapeutic purposes. It is perhaps best known as a legal substitute for Heroin that is used to treat addicts, but it is also used as an analgesic to treat patients suffering from chronic pain.

Though it is not the chemically the same as Heroin, it has many of the same effects and can be used to prevent many of the more severe symptoms of Heroin withdrawal. This is because it acts on the same opioid receptors in the brain, however it does not create the same ‘high’ or rush as Heroin.

Opioids work by ‘binding’ to opioid receptors in the brain and elsewhere in the central nervous system. This blocks pain signals from getting to the brain, as well as inducing a state of euphoria. However opioids can be powerfully addictive, both physically and psychologically. On the physical level, the body craves the substance it has become used to. Psychologically, the individual can be become habituated to the act of taking the substance, as well as craving the feelings that it induces.

When used as a substitute for heroin, Methadone can help an addict to successfully come off the drug over time. Methadone effectively prevents the user from experiencing the most intense negative effects of heroin withdrawal, and is usually strictly controlled by a doctor or treatment clinic who will help the patient to gradually and safely reduce their dosage.

Methadone is manufactured legally but is tightly controlled. It is usually a green coloured liquid which is taken orally, though it may also used in tablet form, or injected. In addition to heroin addiction treatment it is prescribed to patients in some countries for the treatment of chronic pain.

However, Methadone has also found its way onto the black market, and may be abused by those to whom it has not been prescribed. Possession or supply of Methadone outside of official and licensed channels is highly illegal in many countries. In the UK, Methadone is a Class A drug, and possession of it can result in a maximum of seven years in prison, while supplying others can result in a life sentence. In the US it is classed as Schedule II, and is illegal to possess without a prescription.

Other Types

Methadone is produced legally for pharmaceutical use by many different companies, and so may go by a variety of brand names. Common brand names include: Dolophine, Amidone, Methadose and Heptadon.

‘Street Methadone’ which is distributed and used illegally also goes by a variety of slang names. These include: Dollies, Juice, Fizzies, Done and Meth (not to be confused with ‘crystal meth’)

Street Methadone is particularly dangerous because in many cases it is impossible to tell how pure it is. Sometimes heroin addicts who are in a Methadone-supported recovery programme will sell some of their supply, or drug dealers will obtain supplies illegally. In order to make more money by selling it they will often dilute it with anything from water to fruit juice.

Methadone may also be combined with other illegal drugs, such as MDMA (Ecstasy). The street name for this particular combination is Chocolate Chip Cookies.

Major Effects

When taken as part of a legitimate addiction recovery programme, Methadone use is carefully monitored and regulated to produce specific effects. The main effects of the drug in these circumstances is that it negates the withdrawal symptoms that would otherwise be felt following cessation of Heroin use, accompanied by feelings of detachment and relaxation.

One of the major reasons why Methadone use must be closely monitored and controlled by medical professionals is that it is in itself highly addictive. Though the drug lacks the intense euphoric high of Heroin, it nonetheless creates a state of mind and physical sensations that are alluring on a psychological level. On top of this, chemical dependency on the drug develops as with many other opioids. Tolerance also increases, so that stronger doses are required to achieve the same effects.

Without the safeguards of proper medical supervision, Methadone has a high potential risk of abuse, and dangerous consequences.

Because of the tolerance that develops during Methadone use, a person who takes another’s dose of the drug may potentially take an overdose of the drug. This problem is compounded by the impossibility of knowing the strength of street-bought Methadone, and lack of knowledge concerning the effects and quantities of the drug.

A Methadone overdose is very dangerous, and potentially fatal. Symptoms include difficulty breathing, extremities turning blue, seizures and nausea. High overdoses left untreated can result in coma and respiratory failure.

In the short-term Methadone use can lead to restlessness, nausea, constipation and other side effects, while long-term use can lead to respiratory difficulties.

Production countries

Methadone is manufactured legally in developed countries throughout the world, by pharmaceutical companies. After first being developed by scientists in Nazi Germany prior to World War II, the drug entered commercial production as an analgesic shortly after the war. It is now produced under license in laboratories around the world, in places as geographically far flung as the US, France, Belgium, India and China.

Unlike opiates such as codeine and morphine, which are made using products of the Opium poppy, Methadone is an opioid which is entirely synthetic and manmade. Because of this, its manufacture does not depend on supply from Opium crops.

Illegal street methadone is predominantly sourced by dealers from patients who have been legally prescribed the drug, either as a Heroin substitute or as a painkiller. It may also be stolen or diverted from pharmaceutical sources, rehab clinics and other places that are legally allowed to hold supplies of the drug and distribute it.

The ease with which Methadone flows into the black market depends largely on the controls and restrictions placed on the therapeutic use of the drug. For example in a country where recovering addicts are allowed to take home substantial supplies of the drug without monitoring, there will be a greater risk that this will then reach the street. Methadone may also be smuggled from one country to another.

Illegal distribution and use of Methadone can carry heavy criminal penalties, including lengthy jail sentences, but it continues to be bought and sold on the street.

Facts and stats

Facts

  • Methadone is a narcotic opioid
  • It was first developed synthetically as a painkilling analgesic by German scientists in 1937.
  • It was not produced commercially until after World War II, and its potential for treatment of opiate addictions was later discovered in the 1960s.
  • It is legally used on prescription in many countries as a Heroin substitute, and as an analgesic painkiller.
  • Methadone works by interacting with Opioid receptors in the brain.
  • The effects of Methadone are similar to Heroin, but without the intense high. It triggers feelings of warmth, relaxation and detachment.
  • Methadone can also be bought illegally on the street and is used by some recreational drug users. Unlicensed use and supply in this way is illegal in the UK, US and many other countries.
  • Though used to treat Heroin addiction, Methadone itself can be highly addictive, particularly when used without proper supervision and monitoring.
  • Over the years it has been a controversial topic in drug rehabilitation, and some critics contend that using Methadone in this way is simply replacing one drug addiction with another.
  • Supervised treatment with Methadone has been shown to be considerably less dangerous than an untreated Heroin addiction, with fewer risks of overdose, diseases associated with needle sharing, or fatalities. It has also been shown to reduce Heroin-related crime in communities, such as theft.
  • Combining Methadone with other illegal or legal drugs, such as alcohol, can be highly dangerous and increase the risk of overdose.

Stats

  • In the US, deaths due to Methadone overdose rose from 790 in 1999 to 5,420 in 2006. The largest proportion of these was Caucasian males aged between 35 and 54.
  • Opioids, the drug group to which Methadone belongs, were implicated in 40% of US deaths due to poisoning during that period.
  • An estimated 73- 80% of deaths due to Methadone overdose in the US are classified as unintentional.
  • Methadone is slow to take effect, with its full effects often not felt until between two to four hours of taking it. This presents a particular risk of overdose to those who take it ‘recreationally’, as they may take an additional dose because they feel they are not getting the high they desire.
  • The effects of a single Methadone dose can last up to 24 hours. This is good for recovering addicts who need to feel this lasting relief from the withdrawal symptoms of heroin, but can mean that side effects such as nausea and dizziness can be persistent.
  • In Scotland, the death rate due to Methadone decreased by 7.0 per 1,000 ‘client years’ to 1.0 after higher quality controls of treatment and supervision of prescriptions were introduced.
  • There were 1,406 deaths in which Methadone was the only factor in England between 2001 and 2008.
  • In 2008, more than 147,000 Heroin users in England were prescribed Methadone or a similar substitute drug.
  • The cost of Scotland’s Methadone prescription programme in 2010 was approximately $24million (£15million).

Addiction Signs

Though Methadone is used to treat heroin addiction, it is itself an addictive substance. When taken as part of a therapeutic programme its use is usually monitored closely for this reason.

It’s not only recovering Heroin addicts who may become addicted to Methadone. Those taking it as prescribed for its painkilling properties may also become dependent on the drug.

In addition to these two groups of legitimate users, it is also possible that recreational drug users who have no previous history of Opiate or Opioid use may also become addicted to the drug after acquiring it on the street. Likewise, untreated Heroin users who have acquired street Methadone as an alternative due to Heroin supply scarcity may also become addicted.

As with other narcotics, there are two components to the addiction - the chemical dependency and the psychological dependency, both of which fuel the habit.

Those addicted to the drugs that have been prescribed it may lie to doctors and healthcare professionals about the severity of the symptoms in order to obtain higher quantities of the drug. They may also become very hostile towards the idea of reducing their dosage.

Those who are using street methadone may also exhibit certain side effects that suggest their use of the drug and possible addiction. Such side effects include unusually euphoric or content moods and rapid mood swings, nausea, urinary difficulties, reduced libido, appetite loss, increased sweating and spells of dizziness. However, it is important to remember that any of these symptoms may also be symptomatic of other substances or health conditions.

Treatments

Although Methadone is used as a prescription drug in certain circumstances, addiction to the drug is not only possible, but it can also be dangerous and needs to be treated as with any other narcotic addiction.

Treatment for Methadone addiction needs to tackle both the physical side of the addiction (the chemical dependency that has developed within the individual’s body), and the psychological aspect of it.

As with other Opiate/ Opioid addictions, there are a number of different methods that may be used to help the individual break free of their dependency on Methadone. Whichever method is used, the process must be closely monitored and tailored to the individual, due to the potential severity of the withdrawal effects, and the relatively high chance of relapse.

In severe cases of addiction the best route involves admission to a specialised rehabilitation centre or hospital where the individual can receive the care and treatment they need to get off the drug.

Detoxification is the first step in treatment. One approach is to gradually taper off the dosage of the drug, so as to reduce the number and intensity of unpleasant side effects that the patient experiences while coming off Methadone. Many former addicts have reported that the process of detoxing from the drug is as bad as or even worse than stopping taking Heroin.

Another approach is the rapid detox, or ‘cold turkey’ method, which involves immediate cessation of Methadone. This is almost always done in hospital under supervision, and medication may be used to ease the patient through the worst of the withdrawal symptoms.

Possible withdrawal symptoms of Methadone include: Vomiting, nausea, suicidal thoughts, intense anxiety and depression, diarrhoea, auditory/visual hallucinations, sleep problems and suicidal thoughts. These are usually accompanied by intense cravings to take the drug.

These symptoms can unfortunately be quite long in duration, lasting as much a month to six weeks. Even once the worst of these effects are over, close treatment for the addiction may be required for many months. In some cases an extended stay in a rehabilitation clinic for several months may be necessary to help the addict through the recovery process and prevent relapse into old substance seeking behaviours.

As well as medical supervision, rehabilitation programmes may also include counselling, therapies and support programs in the company of others struggling to beat their own addictions. This element of treatment is just as essential as actually physically stopping taking the drug, as it will not only help the patient to deal with the challenges and obstacles of recovery, but it will also help them find new substance-free ways of living.

In some treatment programmes a Methadone substitute may be given to the patient. In doing so care must be taken not to once again replace one addiction with another, and that is why drugs with a low addictive potential and relatively few withdrawal effects are chosen. One common replacement for Methadone is Buprenorphine, also known as Suboxone. This may be used throughout the treatment process to reduce cravings and help the patient to deal with the Methadone withdrawals more comfortably.