What is Methadone?

It must be prescribed by a physician who has been specially trained to use it.   It works by blocking the receptors in the brain so that the patient doesn’t feel the euphoric sensations caused by their drug of choice. It also reduces the withdrawal symptoms that occur within the body when a person has stopped abusing drugs. This makes coming off drugs much more bearable and comfortable for the person and greatly improves their chance of success.

Not only does it help in suppressing withdrawal symptoms it also has the ability to dramatically decrease cravings. These cravings are what commonly drive “clean” people back to drugs because they are difficult for anyone, who was once addicted, to resist.

Although methadone is safe medication when taken as prescribed there still remains the risk of death as it still a powerful narcotic.   Do not combine methadone with alcohol  or certain prescription drugs such as painkillers, antidepressants,  anxiety medication or sleep aids.  Your doctor will talk to you more about this at your first visit.

Methadone belongs to the opioid family of drugs. Examples of other opioids are oxycodone (OxyContin or Percocet), fentanyl, hydromorphone (Dilaudid), heroin, morphine, codeine, etc. This is the reason why methadone works similarly as a pain reliever.

While methadone is an opioid as mentioned, there are some differences between methadone and the other opioids. The main difference is methadone’s longer onset of action.   This allows a more even and stable action of the medication as opposed to the rapid onset and offset of a short acting opioid such as morphine or oxycodone. So while methadone exerts its opiate-like effect, it does it in a slower and more controlled way. This effect is one that is desired for an individual addicted to the rapid-acting opioids. While methadone provides a relief from the symptoms of withdrawal such as aches, chills, and cramps and the mental effects of craving for the high, it does not produce a high itself. Further, since methadone at an adequate dose binds the opioid receptors in the brain, there is no much room for the other opioids to bind themselves. In this manner, methadone is said to block the other opioids if taken.

The First Pharmacological Treatment for Narcotic Addiction: Methadone Maintenance

Dole, Vincent; Nyswander, Marie; Kreek, Mary Jeanne.

Heroin abuse surged in the United States in the early 1960s, becoming a major public health problem. At the time, most people attributed addiction to a lack of willpower, or to antisocial or criminal behavior. The urgency of dealing with these issues came to the attention of Rockefeller researcher Vincent P. Dole (1913-2006) in 1962, when he was acting chairman of the Health Research Council of the City of New York’s committee on unresolved health problems, which was grappling with the heroin problem in New York. Dole proposed that addiction was an illness, a “metabolic” disease with behavioral manifestations. He was so committed to understanding this problem that he changed the focus of his laboratory, where he had studied obesity and metabolism, to heroin addiction and new pharmacological approaches for chronic treatment.

In late 1963 Dole recruited two additional researchers to the project: clinical investigator Mary Jeanne Kreek and psychiatrist Marie Nyswander (1919-1986). In early 1964, this team began studies with heroin addicts at the Rockefeller Hospital which, within six months, established the mode of action and potential effectiveness for maintenance treatment of methadone, a synthetic drug that had been used for short-term detoxification in a few clinics. The researchers also contrasted methadone’s effects to the action of short-acting opiates such as heroin and morphine.

These early studies determined that methadone is long-acting in humans, relieves the addicts’ craving for heroin, and prevents withdrawal symptoms. In addition, methadone itself does not produce euphoria, and through the mechanism of cross-tolerance, it prevents addicts from feeling any “high” from an injection of heroin—a phenomenon the team called “narcotic blockade.” The former heroin addicts needed to take one oral daily maintenance dose which allowed them to function normally. In 1965, translational studies of methadone maintenance treatment involving additional patients were conducted by Nyswander at what was then Manhattan General Hospital.

Early in the research, in 1964, Kreek planned and initiated long-term prospective studies of the physiological effects and medical safety of methadone maintenance. This work was central to the approval in 1973 by the FDA of methadone for the long-term pharmacotherapy for opiate addiction.

-Rockefeller University Hospital

Methadone was approved for use in the mid-1900s and has been used as a major drug to help addicts ever since. Its counterpart is a drug called Suboxone which was approved in America in 2002.  Just like methadone it blocks the receptors in the brain from reacting to euphoric like effects from drugs.

The common side effects of methadone are sweating, constipation, decreased sexual function, drowsiness, increased weight, and water retention. These are usually mild and can be lessened with assistance from my doctor. There are no known serious long-term effects from taking methadone.