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METHADONE

I WANT TO START THIS BLOG BY SAYING THAT I HAVE NO PERSONAL EXPERIENCE WITH METHADONE BUT I KNOW LOTS OF PEOPLE WHO DO AND I ALSO KNOW WHAT I HAVE READ.

THIS BLOG IS GOING TO START OUT WITH FACTS AND STATS AND THEN I AM GOING TO GIVE MY OPINION ON METHADONE. MY OPINION IN NO WAY REFLECTS ANY RECOVERY PROGRAMS OPINION OF THIS AND WHAT I WRITE HAS NO BEARING ON WHAT YOU MAY CALL RECOVERY. MY THOUGHTS WILL BE WRITTEN IN ITALICS AND THOSE I FIND ON WEBSITES WILL BE IN REGULAR SCRIPT.

THAT SAID... HERE ARE SOME FACTS:

(from wikipedia) Methadone is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. It was developed in Nazi Germany in 1937. Although chemically unlike morphine or heroin, methadone also acts on the opioid receptors and thus produces many of the same effects. Methadone is also used in managing chronic pain due to its long duration of action and very low cost.

Methadone's usefulness in treatment of opioid dependence is the result of several factors. It has cross-tolerance with other opioids including heroin and morphine, long duration of effects with the result that oral dosing with methadone will stabilise the condition of the patient by stopping and preventing the opioid withdrawal syndrome, and by at least partially blocking the "rush" resulting from intravenous injection of heroin, morphine, and similar drugs.

Adverse effects of methadone include:

hypoventilation
decreased bowel motility - constipation
miotic pupils
nausea
hypotension
hallucination
headache
vomiting
cardiac arrhythmia
anorexia (symptom)
weight gain
stomach pain
xerostomia
perspiration
flushing
itching
difficulty urinating
swelling of the hands, arms, feet, and legs
mood changes
blurred vision
insomnia
impotence
skin rash
seizures
death

According to the National Center for Health Statistics, as well as a 2006 series in the Charleston (WV) Gazette, medical examiners listed methadone as contributing to 3,849 deaths in 2004, up from 790 in 1999. Approximately 82% of those deaths were listed as accidental- and most deaths involved combinations of methadone with other drugs.

Withdrawal symptoms of methadone include:

Physiological Effects
increased lacrimation
rhinorrhea
sneezing
nausea
vomiting
diarrhea
fever
chills
tremor
tachycardia
aches and pains, often in the joints
elevated pain sensitivity
elevated blood pressure

Cognitive Effects
suicidal ideation
depression
adrenal exhaustion
adrenal fatigue
spontaneous orgasm
prolonged insomnia leading up to delirium
auditory hallucinations
visual hallucinations
enhance olfactory sense
decreased sexual drive
agitation
panic disorder
anxiety
paranoia
delusion

Withdrawal symptoms are generally slightly less severe than those of morphine or heroin at equivalent doses but are significantly more prolonged; methadone withdrawal symptoms can last for several weeks or more. Indeed, there is a trend in the management of opiate addiction towards the reduction of a patient's methadone dosage to a point where they can be switched to buprenorphine or another opiate with an easier withdrawal profile. Ultimately, methadone's long half-life and minimal side-effect profile makes it ideal for maintenance, but is not considered to be a desirable opiate to withdraw from when attempting to become completely opiate-free.

(from drugs.com) Taking methadone improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from methadone. Follow all dosing instructions carefully.
Like other narcotic medicines, methadone can slow your breathing, even long after the pain-relieving effects of the medication wear off. Death may occur if breathing becomes too weak. Never use more methadone than your doctor has prescribed. Call your doctor if you think the medicine is not working.

Do not stop using methadone suddenly, or you could have unpleasant withdrawal symptoms. Call your doctor if you miss doses or forget to take this medication for longer than 3 days in a row. Do not drink alcohol while you are taking methadone. Dangerous side effects or death can occur when alcohol is combined with methadone. Check your food and medicine labels to be sure these products do not contain alcohol. Methadone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Do not drink alcohol while you are taking methadone. Dangerous side effects or death can occur when alcohol is combined with methadone. Check your food and medicine labels to be sure these products do not contain alcohol.

Do not use methadone with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

(from the FDA) Patients should take methadone exactly as prescribed. Taking more methadone than prescribed can cause breathing to slow or stop and can cause death. A patient who does not experience good pain relief with the prescribed dose of methadone, should talk to his or her doctor.

Patients taking methadone should not start or stop taking other medicines or dietary supplements without talking to their health care provider. Taking other medicines or dietary supplements may cause less pain relief. They may also cause a toxic buildup of methadone in the body leading to dangerous changes in breathing or heart beat that may cause death.

Health care professionals and patients should be aware of the signs of methadone overdose. Signs of methadone overdose include trouble breathing or shallow breathing; extreme tiredness or sleepiness; blurred vision; inability to think, talk or walk normally; and feeling faint, dizzy or confused. If these signs occur, patients should get medical attention right away.

ok, thats the clinical side of methadone. now on to some stuff you really should know but they wont tell you.

(from methadoneaddiction.com) Many people go from being addicted to heroin to acquiring a methadone addiction, and continue with this "treatment" for years, fearing the withdrawal that will occur when they stop. Methadone does not have to be the way of life for former heroin addicts. Gradual cessation followed by a drug-free program of rehabilitation may be the answer for many sufferers.

Critics point out that methadone patients are still addicts and that methadone therapy does not help addicts with their personality problems. In many cases multiple drug use and a strong psychological dependence undermine the gains made. Some addicts manage to resell the methadone they receive in order to buy heroin; this and other illegal diversion have resulted in methadone joining the group of addictive drugs sold on the street.

Fraudulently acquiring methadone is becoming common practice among many individuals with drug addictions. Addiction to methadone can take several forms:

conning a doctor into prescribing a higher dosage than is required
taking more than the recommended dosage
taking methadone in combination with other drugs, including alcohol
using methadone as a 'top up' drug while continuing to take heroin
selling prescribed methadone in order to buy heroin

In blind trials, users who were given both drugs orally were unable to distinguish between the effects heroin and methadone. An added problem for those using methadone to recover from heroin addiction is withdrawal. Withdrawal from heroin should be over after seven to ten days. Withdrawal from methadone though, can take up to a month or even longer.

Ironically, methadone used to control narcotic addiction is frequently encountered on the illicit market and has been associated with a number of overdose deaths. Tolerance and addiction to methadone is a dangerous threat, as withdrawal results from the cessation of use. Many former heroin users have claimed that the horrors of heroin withdrawal were far less painful and difficult than withdrawal from methadone.

A serious problem with much of the methadone prescription in the past was that heroin addicts were often given sufficient methadone to last one week - or even one month. As a result, addicts commonly sold their prescribed methadone in the illicit drug market. Schoolchildren have been found in possession of this drug and several have died. It is more common practice today to require addicts on methadone maintenance programs to collect their prescription from a clinic or pharmacy daily - and to swallow this under observation. This is to prevent methadone from entering the illicit market.

Methadone if taken for long periods and at large doses can lead to a very long withdrawal period. As compared to other opiates in which the withdrawal period is a week to ten days, heavy methadone users can expect to not recover for up to 5 or 6 weeks. Methadone withdrawal is one of the worst feelings that you can ever go through.

Many people trade addictions switching from heroin to methadone. This trade off comes with many downsides though, including one of the most painful withdrawal process known. Many individual end up in methadone "therapy" for years fearing the painful withdrawal that is sure to come when they discontinue use. Methadone does not have to be the way of life for former heroin addicts. Gradual cessation followed by a drug-free program of rehabilitation may be the answer for many sufferers. After several days of stabilizing a patient with methadone, the amount is gradually decreased. The rate at which it is decreased is dependent on the reaction of the individual . . . keeping methadone withdrawal symptoms at a tolerable level is the goal.

Methadone is a (synthetic opiate) narcotic that when administered once a day, orally, in adequate doses, can usually suppress a heroin addict's craving and withdrawal for 24 hours. Patients are as physically dependent on methadone as they were to heroin or other opiates, such as OxyContin or Vicodin. Ironically, methadone used to control narcotic addiction is frequently encountered on the illicit market and has been associated with a number of overdose deaths. Tolerance and addiction to methadone is a dangerous threat, as methadone addiction withdrawal results from the cessation of use. Many former heroin users have claimed that the horrors of heroin addiction withdrawal were far less painful and difficult than Methadone addiction withdrawal.

Methadone withdrawal symptoms include but are not limited to:

sneezing
yawning
tearing of eyes
runny nose
excessive perspiration
fever
dilated pupils
abdominal cramps
nausea
body aches
tremors
irritability

Overdose due to methadone is on the rise in the state of Florida. The Florida Department of Law Enforcement (FDLE) and the Florida Office of Drug Control (ODC) are issuing this safety alert in an attempt to warn the citizens of Florida about the abuse of a dangerous prescription drug. The 2002 Interim Report of Drugs from the state medical examiners indicate that there have been 254 deaths related to the abuse of the prescription drug methadone between January – June of 2002. This number represents a 31% increase in comparison to the last six months of 2001. The deaths related to methadone represent the single largest increase in any category of drugs listed in this report, which includes cocaine, heroin, hydrocodone, oxycodone and methylated amphetamines. Of these 254 deaths, 133 cases involving methadone were overdose deaths. Of these 133 instances where methadone was found in lethal levels, 110 instances involved the use of another drug as well. These numbers are significant, and the danger posed by the abuse of this drug, especially when used in combination with other drugs and without a legitimate prescription from a physician, warrants an immediate notification to the public.

Contrary to popular belief methadone is a highly addictive drug. Abusers will often combine methadone with other drugs, such as Klonepin, in order to intensify the high and make it resemble the feelings they get from heroin. Methadone is a Schedule II prescription drug that is sold in oral, liquid (ampules and vials) and tablet forms as seen in the photos. Reports have emerged that more and more patients are asking for methadone by name, particularly at pain management clinics. Physicians may also be prescribing methadone more often given the media and law enforcement attention that has been focused on the abuse of other opiate drugs, in particular OxyContin.

The purpose of this alert is to make the citizens of Florida and the law enforcement community aware of the misuse and abuse of this prescription drug. In February of 2001, an alert was issued regarding the abuse of hydrocodone and oxycodone. While the 2002 Interim Report of Drugs demonstrated that these two prescription drugs still posed a threat to the public, there were notable decreases in the overdose death rates of these two categories of drugs. We urge all members of law enforcement, hospitals, poison control centers, and emergency medical technicians to contact their area forensic laboratory or Medical Examiners office for information as to the effects and symptoms associated with methadone abuse.

Some methadone deaths result from accidental or deliberate overdoses by patients with legitimate prescriptions, said Bruce Goldberger, a UF forensic toxicologist whose laboratory performs drug analyses for medical examiners in 35 Florida counties. But others occur when the drug is used recreationally for its euphoric, long-lasting high, often by patients who go "doctor shopping" to obtain multiple prescriptions. Deaths also can occur when individuals borrow pills from others for pain medication and accidentally overdose.

"In Florida, we had a 71 percent increase in methadone-related deaths from 2000 to 2001 - now methadone is associated with more deaths than heroin," said Goldberger, a clinical associate professor of pathology, immunology and laboratory medicine at UF's College of Medicine. "Colleagues in other states have told me they've seen an upswing in methadone deaths."

Methadone was detected during 357 autopsies statewide in 2001, compared with 328 autopsies involving heroin, according to an FDLE report on drug-related deaths issued in June. Nationwide, methadone-related emergency room visits nearly doubled between 1999 and 2001, from 5,426 to 10,725, according to the Drug Abuse Warning Network, a federal data collection system.

"If you've never used opiates before, it's very difficult to predict how you'll respond to the typical methadone pill - that's why doctors use such care in determining the correct initial dosage," he said. "More than half the methadone-related deaths in Florida in 2001 were people ages 35 to 50. I suspect many of them were not trying to get high; they simply needed pain relief, got a pill from someone else and didn't realize the danger they were getting into."

Goldberger said he's seen deaths in nearly every age group, from an 18-year-old man who ingested small doses of methadone and alcohol recreationally, to middle-aged and elderly patients who were prescribed methadone legitimately but died as a result of combined drug intoxication.

The seriousness of methadone intoxication/overdose and its possible consequences cannot be overemphasized. For non-tolerant adults, a single day's maintenance dose of methadone (50-100 mg) can be lethal. For those beginning MMT, starting doses of 40 mg have lead to deaths after three days of treatment. The lethal dose is less if it is taken together with other opioids, alcohol, benzodiazepines or barbiturates. Children may overdose if they mistake the medication for a drink. A 10 to 20 mg dose of methadone can be fatal to a child.

In 1992 there were 131 deaths attributed directly to methadone overdose. Methadone is relatively available on the illicit market as there are large numbers of tolerant individuals whose daily dose is well over the lethal dose for non-tolerant individuals. This may explain why, of the fatalities above, only 25% had been previously notified to the Home Office, and why methadone overdose deaths among people in treatment are relatively rare. Methadone is one of the strongest opiates. It has a slow onset of action and a long half-life and causes severe respiratory depression which is usually the cause of death.

Methadone overdose is a serious medical emergency. In the event of suspected overdose call an ambulance. If the person is losing consciousness lie them on their side in the recovery position so that they will not choke if they vomit. Inducing people to vomit is not recommended because of the risk of rapid onset of CNS depression/unconsciousness which could lead to choking.

Symptoms of an Overdose from Methadone include but are not limited to the following:

muscle spasticity
difficulty breathing
slow, shallow and labored breathing
stopped breathing (sometimes fatal within 2-4 hours)
pinpoint pupils
bluish skin
bluish fingernails and lips
spasms of the stomach and/or intestinal tract
constipation
weak pulse
low blood pressure
drowsiness
disorientation
coma
death
respiratory depression
circulatory collapse
cardiac arrest
euphoria
dysphoria
motor retardation
sedation

(from heroinaddiction.com) Is methadone more likely to kill you than heroin?
By Drs Marcel Buster & Giel van Brussel, MD
Municipal Health Service Amsterdam

Based on literature and analysis of mortality figures Dr Russell Newcombe concluded that methadone programmes as a form of harm-reduction possibly cause more victims than they prevent. We have doubts whether the conclusion about methadone is fully justified. Looking at the mentioned literature gives a one-sided view at the problem. Moreover, the conclusions drawn are beyond those justified by the results of the analyses. Several points of debate come to mind:

Methadone is not an innocent substance; 'one's methadone maintenance dose is another's poison'. A regular user of opiates develops a certain tolerance. Therefore, it is possible that a tolerant person can function normally with dosages which can be fatal to a non-tolerant person. Also, methadone dosage in the case of first entry to the programme has to be evaluated carefully. It is wise to begin with a low dosage that has to be increased slowly in the course of weeks or even months. At entry to the programme it has to be carefully evaluated whether a patient has a clear and unambiguous heroin dependence. In methadone maintenance programmes, methadone is dispensed to tolerant persons, moreover, this tolerance remains high because of daily use of methadone. Therefore, it is not surprising that deaths at the King's College Hospital caused by methadone were not those of participants of a methadone maintenance programme but were those of 'recreational' users of illicit methadone.

In cases where more than one drug is used, the drug responsible for death due to overdose is difficult to establish. Moreover, the same drug prescribed by physicians can also be bought on the street. In seventy percent of the deaths due to overdose studied in Glasgow and Edinburgh a combination of different drugs was found.

Prescribed drugs such as temazepam were often encountered in deaths in Glasgow. However, among only 14 of the 34 persons who died in 1992 and where temazepam was found, this was prescribed by their physician. Because of the presence of other drugs it is not clear whether temazepam really caused the death of these people. Probably the combination of these different drugs was fatal to them. This was also the case with the methadone deaths in Edinburgh. However, in Edinburgh, the authors could not determine whether methadone was prescribed or not. Both Hammersley and Obafunwa report that heroin/morphine deaths seldom occur in Edinburgh (4). 'The fall of the deaths due to overdose in the Lothian and Borders Region of Scotland (LBRS) after 1984 reflects in part the strict policing that took place, in particular in the Edinburgh area'.

'The increase of methadone deaths is probably due to the introduction of a street trend to use this agent as a substitute to heroin'. The author suggests that methadone deaths are mainly caused by the use of illicit methadone.

Therefore, these figures suggest that participants of methadone programmes are at lower risk of death due to overdose. However, this does not mean that methadone is an innocent substance. The high and increasing number of methadone deaths in Britain is alarming and certainly needs more attention. The first priority should be to establish whether the methadone causing death has been prescribed within a methadone programme or bought on the street. It also should be evaluated at what point during the course of the methadone programme death takes place. Further instruction doctors prescribing methadone could be necessary. The use of non-prescribed methadone without medical supervision can lead to high risks, especially when it is used as a substitute for heroin in order to get a 'high' instead of to prevent withdrawal symptoms. Physicians have to be aware of this danger and they should make sure that the prescribed methadone (as well as other psycho-active drugs) does not end up in the 'grey market'.

ok... enough facts and stuff, you can pretty much draw your own conclusion. its my turn.

my opinion is that methadone is as bad as the opiates it is meant to replace or even worse. the reason? it has a much longer half-life and is far harder to detox from than any heroin or prescription medication addicts can be on. it is simply a horrible drug and i have no idea why anyone would use it as a clinical therapy to detox someone. i understand that some doctors try to use it to get junkies off heroin but it doesnt work a lot of the time and i will tell you why. it doeant work because doctors are giving a drug to an addict that is in an unsupervised situation. most addicts walk into a clinic and get their drugs and walk right back out. there is no accountability. what is an addict with no accountability? it is most likely an addict that is still using. i personally know many addicts that used methadone to suppliment their heroin addiction.

IT WILL WORK FOR SOME. I HAVE NO DOUBT ABOUT THIS. the thing is, it will only work if you have some things in place, like a recovery program. methdone alone will NOT keep an addict clean in almost all cases. i also think that if it is used it should only be used in a closely supervised situation, either an inpatient rehab or a closely monitored outpatient deal. i think that if someone is going to give you drugs to detox then they have the right to pee, blood and hair follicle test you as well.

methadone is worse in a lot of ways than heroin. it lasts longer, its a horrible detox (worse and longer than heroin) and some addicts will shoot heroin on top of their daily dose of methadone. this is a major overdose situation because methadone is in the same family as heroin. some addicts think they are safe if they dont shoot heroin and just drink, smoke pot, do coke or other drugs and theyre not. they are in a much higher risk of overdose, synergestic effects, re-addiction and becoming addicted to new drugs.

the jury is out as to whether methadone is a good thing or not. for some it works and to those i say congrats. for some it doesnt and they suffer greatly. the major thing is this: look into why you are thinking of getting on methadone. also look into alternatives. there are detoxes and rehabs. there are other medications available and there are other options. there is also a program of recovery and without it this addict thinks that no other method will work.

only you can define your recovery. if your recovery includes methadone that so be it. dont allow anyone to say youre not in recovery if this is the case. thats between you and your doctor. the thing is this; if you really want to quit then you will. if youre on methadone longer than you used other opiaters then it might be a good idea to look into why.