A Guide to Methadone

By The Fix staff 08/02/14
Image: 
methadonepage.jpg
Shutterstock

Methadone is a synthetic opioid analgesic used to treat moderate to severe pain. It  is best known, however, for preventing withdrawal symptoms in patients with opiate addictions, particularly heroin. Chemically, it is a 50:50 mixture of two enantiomers which are (R-) or levo- or l-methadone and (S-) or dextro or d-methadone. Known brand names of methadone include: Dolphine, Methadose, Westadone and Methadose Oral Concentrate, Symoron, and Metadol. It is taken orally, rectally, by insufflation, sublingually or intravenously.

How it affects the brain

In much in the same way that other opioid analgesics do, methadone changes how the brain and nervous system perceive pain. As with heroin, methadone binds to opioid receptors in the brain. The difference is the heroin rush and high, which is mostly absent with methadone in higher doses. As a result, methadone maintenance has been used widely for 50 years to block the craving for and the effects of heroin and similar drugs. Globally, several million people are believed to have experienced methadone maintenance as a way to live normal lives. 

Medical Uses

Apart from its use to treat moderate to severe pain and as an opioid-craving blocker, methadone is advised to be used in a short term detoxification for the purposes of stabilization. It also prevents withdrawal symptoms in patients with previous opiate addictions. It is further prescribed to treat violent cough. Half life is 15-60 hours.

Addictive Properties (Signs of Abuse)

Although there is debate about the extent of methadone's physically addictive properties, the withdrawal symptoms can be as severe and sometimes more so than withdrawal from heroin. Consequently, many addicts tend to remain on methadone maintenance for years. The fact that there is a strong street market for it is another indication of its ability to bond a person to it. And as it builds up in the body, it causes tolerance and a risk for addiction.

Long Term Effects of Use

Methadone alters the sensitivity and capacities of some prefrontal parts of the brain. It  can impair judgment and decision-making skills, cause irregular heart activity, risk of stroke damage, and in some people liver problems. Reports of dry mouth and occasional nausea and vomiting, diarrhea or constipation, and some loss of appetite are common though hardly universal. Some users also report decreased sex drive or impotence. Others, anxiety and restlessness. It tends to react poorly with other drugs and so users must be certain their prescribing doctors are familiar with methadone.  

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682134.html

http://ajp.psychiatryonline.org/data/Journals/AJP/3853/08aj0390.PDF 

http://www.cdc.gov/vitalsigns/MethadoneOverdoses/ 

http://www.rockefeller.edu/pubinfo/news_notes/121500e.html 

http://www.dailyrecord.co.uk/news/health/methadone-users-risk-brain-damage-1278295 

http://www.opiateaddictionresource.com/opiates/types_of_opioids/methadone 

Please read our comment policy. - The Fix
Disqus comments
the-fix-logo.png

The Fix staff consists of the editor-in-chief and publisher, a senior editor, an associate editor, an editorial coordinator, and several contributing editors and writers. Articles in Professional Voices, Ask an Expert, and similar sections are written by doctors, psychologists, clinicians, professors and other experts from universities, hospitals, government agencies and elsewhere. For contact and other info, please visit our About Us page.

Disqus comments