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methadone chart
Topic Illicit Heroin Addiction Stabilized Methadone Maintenance
Onset of action Immediate 30 minutes
Duration of action 4 - 6 hours 24 - 36 hours or half-life
Route of administration Injection, snorting, smoking ( several times a day ) Orally administered once per day
Effective dose Not applicable For many patients 60 mg/day is lowest effective dose; doses between 80 and 120 mgs/day are most effective for preventing HIV transmission, retention in treatment, reducing the use of other drugs, and increasing social productivity.
Overall safety potentially lethal Medically safe, no toxic effects found in patients maintained on methadone for up to 18 years.
Overdose Can die from overdose of narcotics; potentially lethal, even for tolerant individuals death can occur quite fast without proper medical treatment with narcan. A degree of protection from death by overdose is achieved when receiving 100 mg/day or more; methadone is potentially lethal for non-tolerant individuals, death can occur but more slowly than heroin overdose however, overdose reaction can be reversed and person's life saved if narcotic antagonist such as narcan is prescribed for 24 - 36 hours
Narcotic effects of other opiates ( if tried ) Feels narcotic effects of opiates At 80 mgs/day or more narcotic effects of opiates are blocked
Withdrawal syndrome Can be severe, but can be controlled with methadone Less severe than heroin but more extended, can be controlled by slow reduction in methadone dose
Mood alteration Constant swings None, if patient is not emotionally disturbed or using other drugs
Euphoric effects Approximately 2 hours duration after administration None after administration
Tolerance level Increasing dosage needed Stable level at some dose
Narcotic craving Recurring Relieved and blocked
HIV transmission Effective transmission Transmission of HIV by injection reduced or eliminated for patients who remain in treatment
Immune and endocrine functioning in HIV- persons Impaired Normalizes during treatment
Immune and endocrine functioning in HIV+ persons Rapid progression to AIDS Preliminary studies indicate that the progression to AIDS is slower
Hypothalamus Pituitary Adrenal Axis Suppressed Normalizes during treatment
Sexual functioning / libido Impaired Normalizes during treatment
Female menses Impaired Normalizes during treatment
Pregnancy Serious problems difficult to treat Problems can be brought under control with medical, social and, prenatal care
Emotional affect Impaired Normal, if patient is not emotionally disturbed or using other drugs
Pain and emotion Blunted Feels normal pain and experiences normal range of emotion if not abusing other drugs
Intellectual functioning Impaired Normal if person is not emotionally disturbed or using other drugs
Physical reaction time Impaired Normalizes during treatment
Personal relationships Disrupted Restored with counseling
Social functioning Impaired Normalizes with counseling
Vocational rehabilitation and education High proportion of failure High proportion of success in vocational rehabilitation, education and employability
Employment Difficult, if not impossible, to hold a job Can function in every level and type of profession e.g.: bus driver, lawyer, doctor, teacher, pilot
Mental illness Difficult to treat Treatable if integrated resources exists, however many psychiatric services discriminate against methadone patients and will not accept them
Poly-drug abuse High level (alcohol, crack, cocaine, nicotine, etc.) High level but potentially treatable
Criminal drug abuse Constant high level Reduced level or eliminated
Effect on community Destructive, high crime and death rates, transmission of disease A good methadone program contributes to public safety, reduces mortality, and improves quality of life for all
Criteria for addiction Fits criteria for addiction as listed in the "Diagnostic and Statistical Manual of Mental Disorders" Does not fit criteria for addiction, methadone maintenance is a thoroughly researched and effective medical treatment
Life-style Heroin addiction is about acquired infection and death Methadone maintenance treatment is about good health and life. Methadone chemotherapy normalizes a deranged physiology so patients can stabilize their lives
Onset of action Immediate 30 minutes
Duration of action 4 - 6 hours 24 - 36 hours or half-life
Route of administration Injection, snorting, smoking ( several times a day ) Orally administered once per day
Effective dose Not applicable For many patients 60 mg/day is lowest effective dose; doses between 80 and 120 mgs/day are most effective for preventing HIV transmission, retention in treatment, reducing the use of other drugs, and increasing social productivity.
Overall safety potentially lethal Medically safe, no toxic effects found in patients maintained on methadone for up to 18 years.
Overdose Can die from overdose of narcotics; potentially lethal, even for tolerant individuals death can occur quite fast without proper medical treatment with narcan. A degree of protection from death by overdose is achieved when receiving 100 mg/day or more; methadone is potentially lethal for non-tolerant individuals, death can occur but more slowly than heroin overdose however, overdose reaction can be reversed and person's life saved if narcotic antagonist such as narcan is prescribed for 24 - 36 hours
Narcotic effects of other opiates ( if tried ) Feels narcotic effects of opiates At 80 mgs/day or more narcotic effects of opiates are blocked
Withdrawal syndrome Can be severe, but can be controlled with methadone Less severe than heroin but more extended, can be controlled by slow reduction in methadone dose
Mood alteration Constant swings None, if patient is not emotionally disturbed or using other drugs
Euphoric effects Approximately 2 hours duration after administration None after administration
Tolerance level Increasing dosage needed Stable level at some dose
Narcotic craving Recurring Relieved and blocked
HIV transmission Effective transmission Transmission of HIV by injection reduced or eliminated for patients who remain in treatment
Immune and endocrine functioning in HIV- persons Impaired Normalizes during treatment
Immune and endocrine functioning in HIV+ persons Rapid progression to AIDS Preliminary studies indicate that the progression to AIDS is slower
Hypothalamus Pituitary Adrenal Axis Suppressed Normalizes during treatment
Sexual functioning / libido Impaired Normalizes during treatment
Female menses Impaired Normalizes during treatment
Pregnancy Serious problems difficult to treat Problems can be brought under control with medical, social and, prenatal care
Emotional affect Impaired Normal, if patient is not emotionally disturbed or using other drugs
Pain and emotion Blunted Feels normal pain and experiences normal range of emotion if not abusing other drugs
Intellectual functioning Impaired Normal if person is not emotionally disturbed or using other drugs
Physical reaction time Impaired Normalizes during treatment
Personal relationships Disrupted Restored with counseling
Social functioning Impaired Normalizes with counseling
Vocational rehabilitation and education High proportion of failure High proportion of success in vocational rehabilitation, education and employability
Employment Difficult, if not impossible, to hold a job Can function in every level and type of profession e.g.: bus driver, lawyer, doctor, teacher, pilot
Mental illness Difficult to treat Treatable if integrated resources exists, however many psychiatric services discriminate against methadone patients and will not accept them
Poly-drug abuse High level (alcohol, crack, cocaine, nicotine, etc.) High level but potentially treatable
Criminal drug abuse Constant high level Reduced level or eliminated
Effect on community Destructive, high crime and death rates, transmission of disease A good methadone program contributes to public safety, reduces mortality, and improves quality of life for all
Criteria for addiction Fits criteria for addiction as listed in the "Diagnostic and Statistical Manual of Mental Disorders" Does not fit criteria for addiction, methadone maintenance is a thoroughly researched and effective medical treatment
Life-style Heroin addiction is about acquired infection and death Methadone maintenance treatment is about good health and life. Methadone chemotherapy normalizes a deranged physiology so patients can stabilize their lives
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