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Methadone Abuse and Addiction: A Gift & A Curse

Opiates have some of the worst withdrawals of almost any drug available today.

In fact, sometimes the symptoms can be so unbearable that many users resort to abusing these drugs again simply for relief from the painful detox symptoms.

Methadone is one of the most effective methods for combating these withdrawals without addiction sufferers needing to relapse entirely. It can help eliminate the painful symptoms of detoxing while also blocking the euphoric effects of these drugs as well.

But methadone abuse and addiction has become a problem in its own right. In fact, the CDC reports that methadone was actually involved in 6% of all drug overdoses in 2015.

And the more you know about this dangerous addiction, the better prepared you’ll be to spot the signs early and get the help you need to kick your addiction to methadone.

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What Is Methadone & What Is It Used For?

Methadone is a synthetic opioid that is mainly used for pain relief and in the treatment of opioid addiction. It is one of the oldest medication-assisted therapies (MATs) and has been instrumental in helping thousands, if not hundreds of thousands, since its first use in treating addiction in the 1950s.

Methadone is uniquely structured to have a dual-pronged beneficial effect when it comes to treating opioid dependence.

The main methadone mechanism of action is to stimulate the opioid receptors of the brain – the same receptors that other opioids like heroin act upon.

The only difference is that it stimulates these receptors to a much smaller degree, thereby eliminating cravings for other drugs while still reducing the symptoms of withdrawal.

Additionally, methadone molecules also block other opioids from attaching to these receptors as well. If a recovery drug user tries to abuse an opiate while methadone is still in their system then, the effects of that drug will be blocked, thus cutting down on the incentive to use again. 

This combination of unique abilities makes it a perfect drug for treating opioid addiction.

It’s currently categorized as a Schedule II by the U.S. Drug Enforcement Administration and as such is illegal to use outside of a clinical setting.

One of the most common uses for methadone is in the treatment of opioid addiction, usually referred to as a methadone maintenance treatment plan or MMT.

Methadone is a prime candidate for treating opioid dependence because it helps lessen the unbearable symptoms of opiate withdrawal without providing the euphoric effects that many substance abusers crave.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), methadone is particularly effective at helping heroin users reduce their opioid abuse while also keeping them in addiction treatment programs for longer.

Like many other types of MATs such as buprenorphine, methadone has come under scrutiny time and time again. Some people claim that it’s unreasonable that an illicit drug addiction is allowed to be treated by another illicit substance. After all, methadone itself is an opioid and can become addictive.

But the hard truth of the matter is that methadone (and MATs in general) work better than almost any other alternative and have been instrumental in helping numerous addicts kick some of the toughest substance use disorders.

In fact, NIDA reports that after MATs were implemented in Baltimore, heroin overdose deaths decreased by an astounding 37%. Numbers like that are tough to argue with.

Given the fact that methadone is associated with the potential of developing a physical addiction, facilities that administer it as a treatment option are highly regulated by governmental organizations.

By law, the only way a treatment facility can dispense methadone is if it is part of an opioid treatment program (OTP) that’s actually certified by SAMHSA.

These programs are exceedingly comprehensive as well. For example, SAMHSA states that an OTP must offer “medical, counseling, vocational, educational, and other assessment and treatment services, in addition to the prescribed medication.”

What’s more, these OTPs must also go through the lengthy process of receiving accreditation according to the standards of the Division of Pharmacologic Therapies (DPT), part of the SAMHSA Center for Substance Abuse Treatment (CSAT).

Methadone comes in a number of different forms:

  • Injectable solution at 10mg/mL
  • Tablet at 5mg and 10mg
  • Dispersible tablet at 40mg
  • Oral solution at 5mg/5mL and 10mg/5mL
  • Oral concentrate solution at 10mg/mL

Liquid forms of methadone are typically measured by a special dose-measuring spoon or a provided medicine cup. Dispersible tablets can be dissolved directly in at least 4 ounces of either water or other citrus flavored beverages like orange juice.

Methadone comes in a number of different brands, including:

  • Dolophine
  • Methadose
  • Methadose Sugar-Free
  • Diskets 

During the beginning of your methadone treatment program, you’ll likely be getting your doses directly from a physician or a medical professional at a certified clinic. Over time, you may be given the opportunity to administer your own dosages at home.

As the risk of abuse increases significantly when doses aren’t only administered at a licensed facility, a patient typically has to first demonstrate full compliance to the guidelines of the program and have been in recovery for around a year at least.


Benefits of Using Methadone Maintenance Treatment for Addiction

As one of the earliest mediations used in medication-assisted treatment for opioid dependency, there are a significant number of studies that have shown the long-term benefits of this treatment program.

According to the National Institute on Drug Abuse (NIDA), some of these proven benefits are:

  • Reduced use of illicit drugs
  • Reduced criminal activity
  • Reduced needle sharing
  • Reduced HIV infection rates and transmission
  • Reduced commercial sex work
  • Reduced number of reports of multiple sex partners
  • Improved social health and productivity
  • Improved health conditions
  • Better retention rates for addiction treatment
  • Reduced suicide rates
  • Reduced lethal overdoses

And while this medication might seem like the obvious solution to any opioid addiction, the exact dosages of drugs like Dolophine need to be highly catered to the needs and specificities of the individual. Not everyone reacts the same to this medication and, as such, there are more factors at play than just gender and weight.

What’s more, a successful methadone treatment program (just like any other treatment program) depends on the dedication and commitment of the substance abuser, especially when treatment is outpatient rather than inpatient.

Getting the proper daily dosage down is the key to using methadone effectively for treating opiate withdrawals. As such, the absolute best way of ensuring your future recovery and successful journey to sobriety is by following the exact instructions of your physician.

They have the experience, expertise, and medical knowhow necessary to create the kind of highly-individualized treatment program that you need to use drugs like Methadose properly.

As such, the guidelines provided here are meant only for educational purposes and in no way should substitute for the instructions of a qualified physician.

According to Drugs.com, the proper dosage for opiate withdrawals is as follows:

  • Day one doses should be administered under supervision while withdrawal symptoms are present. The initial dose should be 20 to 30mg with 5 to 10mg additional doses if withdrawal symptoms are still present after 2 to 4 hours.
  • The maximum initial dose should not exceed 30 mg and the maximum dosage on the first day should not go above 40 mg.
  • Over the first week, adjust the doses using the guideline of controlling withdrawal symptoms 2 to 4 hours after the dose. The trick is to block the effects of opiates as well as cravings without causing the sedative side effects.

This course of treatment can be continued as long as necessary along with concurrent counseling and therapy (integral to long-term recovery). The preferred outcome, however, is to gradually taper off of drugs like Diskets or Methadose and attempt to function without it.

Like many other opioid-based prescription medications, methadone can have a number of uncomfortable short-term side effects, both physical and psychological in nature.

Some of the most notable ones, provided by MedlinePlus, include:

  • Headache
  • Stomach pain
  • Sore tongue
  • Difficulty urinating
  • Vision problems
  • Difficulty falling asleep or staying asleep
  • Mood changes
  • Flushing
  • Dry mouth
  • Weight gain
  • Seizures
  • Hives
  • Swelling of the eyes, face, mouth, tongue, or throat
  • Difficulty breathing or swallowing
  • Nausea
  • Vomiting
  • Loss of appetite
  • Weakness
  • Dizziness
  • Inability to get or keep an erection
  • Irregular menstruation
  • Decreased sexual desire
  • Extreme drowsiness
  • Hoarseness
  • Rash
  • Itching
  • Agitation
  • Hallucinations
  • Fever
  • Sweating
  • Confusion
  • Fast heartbeat
  • Shivering
  • Severe muscle stiffness or twitching
  • Loss of coordination
  • Diarrhea

When methadone is used as a substance of abuse, however, it’s possible that these symptoms will increase in intensity. Beyond that, mixing methadone with other substances like alcohol, benzodiazepines, or sedatives can also exacerbate these symptoms as well.

In many cases, methadone use is part of a long-term maintenance plan with some programs lasting as long as several years. As such, it’s important to recognize the potential dangers of using methadone long-term in treating addiction, as well as the particular hazards of abusing methadone.

Methadone is at its core an opioid. And opioids carry with them a number of long-term side effects. The most notable is, of course, the risk of developing a physical dependency and an eventual addiction.

Given the highly addictive nature of methadone then, it’s incredibly important that you follow the exact orders of your prescribing physician as straying even a little can end up with the development of a dependency.

Beyond actual addiction though, NIDA also reports that research is currently being done on the long-term effects of the decreased respiration that usually goes hand-in-hand with opioid abuse. This condition (called hypoxia) is characterized by reduced oxygen flow to the brain and could result in a significant decrease in white matter.

The result could be a number of psychological and neurological side effects such as an impaired ability to make decisions, an inability to regulate behavior, impacted stress responses, permanent brain damage, and even coma.

Methadone Interactions with Other Substances

As a partial central nervous system (CNS) depressant, methadone does not interact well with other drugs that slow down respiration or any other essential bodily systems. Using and abusing alcohol, for instance, can lead to breathing problems that could end up being deadly.

Benzodiazepines like Ativan and Xanax as well as other sedatives in general should not be taken with methadone as the effects of each will likely be intensified to a deadly level.

There are an enormous number of other drugs that shouldn’t be taken with methadone that you can find out about through the Mayo Clinic. As a rule of thumb though, always tell your doctor about every single medication you’re taking, even if you don’t consider it to be relevant.

Doing so may end up saving you from a number of uncomfortable side effects, a potentially lethal drug interaction, or a recovery process that’s much more painful than it needs to be. 

As an opioid itself, continued methadone abuse can lead to eventual physical dependency as well as the development of an actual addiction.

And given the dangerous short- and long-term effects of continual abuse, the sooner you are able to identify a methadone addiction in yourself, the more likely you are to make a full recovery without the harmful side effects.

If you think you may have a methadone use disorder you can take a number of self-assessments to give you a better idea of whether or not you should seek additional help. A short online quiz may be all the guidance you need.

Or you may want to take a more comprehensive look at your behaviors by comparing them with the guidelines used in the Diagnostic and Statistical Manual of Mental Disorders. This is a trusted resource for physicians and mental health professionals across the country and is generally the best way to tell if you have an underlying substance use disorder.

Side Effects of Methadone Withdrawal

One of the most notable long-term side effects is, of course, becoming physically dependent and eventually addicted to this powerful synthetic opioid.

While true addiction is a complex disorder characterized by emotional, social, and behavioral changes, the physical dependency aspect of addiction is what causes the body to go through withdrawals.

You see, as the body builds up a tolerance to the continual presence of methadone in the system, it begins to physically and chemically adapt and make the intoxicating effects more muted in the process.

When methadone is rapidly removed from someone’s patterns of abuse, however, the body struggles to return to a state of homeostasis. As a result, detoxing from methadone can bring about a host of uncomfortable and sometimes unbearable withdrawal symptoms.

Some of these symptoms include:

  • Anxiety
  • Chills
  • Confusion
  • Cravings
  • Depression
  • Dilated pupils
  • Fatigue
  • Insomnia
  • Lightheadedness
  • Muscle pains
  • Restless legs
  • Shakes
  • Suicidal thoughts
  • Vomiting
  • Sweating
  • Sleepiness
  • Runny nose
  • Nausea
  • Mood swings
  • Irritability
  • Headaches
  • Dizziness
  • Diarrhea
  • Depersonalization
  • Cramps
  • Concentration problems
  • Body aches

In the addiction treatment community, there are generally three types of drugs that are considered to have fatal withdrawals: alcohol, benzodiazepines, and opioids like methadone.

When it comes to alcohol and benzodiazepines, the lethality is generally attributed to the way the two drugs interact with the neurotransmitter GABA and how the brain tends to overcompensate after the drugs are removed. The result can be a deadly onslaught of grand mal seizures as well as other symptoms like hallucinations and psychosis in the case of alcohol’s delirium tremens.

With opioids like methadone however, the potentially fatal withdrawals are a bit different. For example, the methadone withdrawal symptoms themselves are not actually lethal. Excruciating, yes. But fatal, no.

The real danger, however, comes from the risk of overdosing in the case of relapse. To explain, the opioid withdrawal process is painful and protracted, sometimes lasting for months at a time even. As such, many people simply cannot avoid relapsing, try as they might.

One study even found the relapse rate for their subjects was as high as 91% with 59% relapsing within the first week.

But tolerance to opioids like methadone tends to drop much faster than other drugs. If an addict relapses and then uses at the same level as they did before trying to go sober, their body may not be able to handle the potency. Thus, a potentially fatal overdose occurs.

So, while the immediate withdrawal symptoms may not be fatal by themselves, they can be the impetus for relapsing during detox and increasing the risk of a lethal overdose.

Dealing with Methadone Overdose

There are a few things to remember before calling emergency services. First, do not force the person overdosing to throw up unless you’re told to do so by qualified medical personnel. Doing so may cause damage to the esophagus or cause the vomit to leak into the lungs which can be very problematic.

It is also helpful to have a bit of information ready beforehand including the person’s age, weight, and condition, the type of medicine and how much was swallowed, and when the medication was swallowed in the first place.

If you suspect an overdose, call 911 or the national poison help hotline at 1-800-222-1222.

So many people have tried to do just that, but for most of them, it doesn't work. This is because their addictions are much stronger than they think they are. These individuals don't realize the power this drug can have over their lives.

Amytal treatment centers off you unconditional support, guidance and accountability. These are so important for the recovery process to be successful. You'll be working with professionals who know the best way to help patient recover. This knowledge is incredibly valuable as you think about the long-term outcome.

Methadone: A Gift & A Curse

For many substance abusers, methadone gives them the ability to function in day-to-day life without feeling crippled by opioid cravings or debilitated by opiate withdrawals. In essence, it gives them a whole new lease on life.

But methadone can actually become a substance of significant abuse itself. And the consequences can be disastrous.

Methadone, then, is both a gift and a curse. And spotting the signs of addiction early on will help you prevent it from turning into the latter.

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