Methadone Health Article

Definition

Methadone is classified as an opioid (an analgesic that is used for severe pain). In the United States, methadone is also known as dolophine, methenex and methadose.

Purpose

Methadone is used in the long-term maintenance treatment of narcotic addiction. Both heroin and methadone are opioids; as such, methadone and heroin bind to the same places in the brain. Methadone, however, is the opioid of choice for the treatment of narcotic addiction since it is longer lasting and patients don't experience the "high" associated with the drug of abuse. In opioid maintenance therapy, a person addicted to heroin receives methadone instead of heroin. Essentially, the person is switched from an opioid that gives a "high" to an opioid that does not. The dose of methadone may then be decreased over time so that the person can overcome his or her opioid addiction without experiencing withdrawal symptoms, or, after a person has received methadone for a period of time, he or she may choose to go through detoxification with clonidine. In the United States, methadone treatment is associated with a significant reduction in predatory crime, improvement in socially acceptable behavior, and psychological well-being.

Methadone may also be prescribed for pain relief, but in these cases, the physician must note this use on the prescription.

Description

Methadone has been used successfully to treat narcotic addiction for over twenty years in the United States. Methadone is the only FDA-approved agent in its class for the maintenance treatment of narcotic addiction.

Methadone for maintenance treatment is dispensed in methadone clinics. The program needs to be registered with the Drug Enforcement Agency. For admission to methadone treatment in clinical programs, federal standards mandate a minimum of one year of opiate addiction as well as current evidence of addiction. Pregnant, opiate-addicted females can be admitted with less than a one-year history and AIDS patients are routinely accepted. New patients must report daily, take medication under observation, and participate in recommended psychosocial treatments.

Some studies have shown that over 50% of patients in methadone clinics do not abuse drugs in the first month of treatment. After ten months, however, the success rate drops to approximately 20%. Moreover, major depression is a powerful predictor of relapse in methadone treatment. If the patient has dual addictions (alcoholism along with the heroin addiction, for example), management of the other addiction increases the success rate of the methadone therapy. Proper psychiatric and psychological treatment can considerably improve methadone treatment outcome.

In the cases of pregnant women who are addicted to heroin, detoxification (discontinuing the opioid altogether) is associated with a high rate of spontaneous abortions in the first trimester and premature delivery in the third trimester. Therefore, pregnant women can be in methadone maintenance programs if they are at risk of returning to drug dependence. These women should receive the lowest effective dose, receive appropriate prenatal care, and be warned about risks of returning to drug abuse, as well as the dangers associated with withdrawal effects of methadone. Methadone is associated with lower birth weights and smaller head circumference, but it has never been shown that this has any impact on the infants' further development.

Methadone is available in 5-, 10-, and 40-mg tablets and a solution.