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Holliee put together some helpful info on methadone :)
Methadone, the mainstay of treatment for heroin addiction, was originally synthesized by chemists in Germany after the United Nations cut of their supplies of Turkish opium that were interrupted during World War II. It was developed as a morphine substitute for analgesic purposes.
This compound has about the same analgesic strength as morphine but is longer acting (24 hours vs. 5-6 hrs.). Methadone was first offered commercially in the U.S. as Dolophino in 1947 by Eli Lilly Pharmaceuticals. It was first used as a long-acting painkiller for surgical and cancer patients. It was not until about 1950 that it was first used on a short-term basis to treat the withdrawal symptoms in addicts being taken off of heroin or morphine. Synthetic narcotics were first investigated at the Addiction Research Center of the United States Public Health Hospital at Lexington, Kentucky.
The main pharmacological properties of methadone are similar to morphine and the other narcotics (codeine, Demerol, dilaudid, etc.). Cross-tolerance occurs with all other opiates. That is, the administration of any opiate will eliminate or stem the withdrawal symptoms of any other opiates. One is not addicted to both heroin and methadone - one is addicted to the drug class Opiates.
The major differences among the opiates are strength, length of action, and the most effective method of use. Methadone is most effective when used orally, the effects last from 24-36 hours, and it is as strong as morphine. Methadone (orange tablets), dolophine (white tablets) and Methadose (liquid suspension) are equally effective at equal doses. Only the 'binderâ, the ãstuffä to which the active medication is added and held together differs. Preference for one form over the other is merely a matter of preference and experience and has no basis in pharmacology.
Methadone, as an opiate, is an addictive central nervous system depressant. It product analgesia or insensitivity to pain, sedation, slowing of respiration, lowering of blood pressure, constipation, slowing of pulse and, in some patients, nausea. The subjective effects following single doses in non-addicted individuals are similar to those noted after morphine or heroin use: feelings of well-being, drowsiness and euphoria.
Tolerance (the body's ability to develop counteracting and restabilizing effects) develops to the analgesic, nauseant, sedative, euphoric, respiratory and cardiovascular effects. However, no tolerance develops to the drug's ability to stave off withdrawal symptoms. Therefore, once the addict is stabilized on methadone (s)he can function normally - physically and psychologically - without requiring larger and larger doses in order to eliminate withdrawal symptoms and remain physiologically "comfortable". This occurs regardless of the stabilizing dose (that which is required to suppress withdrawal symptoms and to which the patient is equally tolerant to in illicit opiates. In some patients, at higher doses, methadone may help decrease anxiety although it is not effective as a potent mood elevator.
The most common side effects are: weight gain, constipation, increased intake of fluids, increased frequency of urination, tingling in the hands and feet, increased sweating, skin rash, nausea and delayed ejaculation. Symptoms may be temporary.
Methadone can also chemically block the craving for heroin although it does not produce or mimic heroin's warm, euphoric 'rush'. At greater doses than those that are available in illicit opiates, it produces a blocking effect to the high of illicit opiates. This means that if the addict uses heroin while in methadone treatment, (s)he will experience little or no effect from the heroin. However, methadone does not block the intoxicating effects of non-opiate drugs (sedatives, tranquilizers, stimulants, alcohol, etc.). That is why some patients die from an overdose. Most overdoses occur when addicts in treatment supplement their prescribed methadone with other central nervous system depressants. Particularly dangerous when used in combination with methadone are: placidyl, valium, methaqualone, illicit methadone and large amounts of alcohol.
The character and severity of withdrawal symptoms that appear when narcotics are discontinued depend on many factors, particularly: what the drug is, dose, duration of use, interval between doses, health, personality, and expectations and motivations of the patient. The symptoms of abrupt withdrawal from methadone (complete discontinuation of administration of the drug) are: insomnia, anxiety, hypertension, irritability, chills, excessive perspiration, 'runny' nose and eyes, enlarged pupils, sore joints, sore muscles, aching joints, muscle spasms, abdominal cramps, nausea, diarrhea, and overall malaise. Symptoms appear 24-48 hours after the last dose and increase in intensity for six days. They then begin to subside and most major symptoms are minimal by the 14th day. However, general discomfort, loss of appetite and insomnia may persist for as long as six months. These symptoms can be drastically reduced and often eliminated by withdrawing according to a slow, deliberate dose decrease managed by a physician. The longer the process, the less the symptomology.
Methadone maintenance is a long-term treatment for opiate addictions of all types. The patient must regularly visit a clinic and receive his/her medication. Many patients lead normal, productive lives, working and caring for their families and enjoying an active social life. According to a Federal 15-year follow-up study, methadone does not cause any physical deterioration even after 15 years of use. Since methadone programs are voluntary, the length of time spent in treatment depends greatly upon the patient. Studies show that patients are more likely to stay in treatment for relatively long periods if they are over 30 years old, are married, have dependent children, and have spent time in jail due to their addiction. All these factors tend to strengthen the patient's determination to overcome his / her addiction and become a more productive social being.
Methadone is not a cure for opiate addiction. It is a pharmacological tool which suppresses withdrawal symptoms, lessens the craving for narcotics, and, coupled with therapy, facilitates those interpersonal interactions involved in strengthening motivations, changing lifestyle, and breaking the cycle of life patterns and stress reactions underlying relapse.
Methadone is the most widely researched yet heavily regulated pharmaceutical known. Some regulation is necessary but after a certain length of time in treatment, usually after 1-2 years, the successful patient should be allowed to be medically maintained. This means fewer clinic visits