Will I Become Addicted to Methadone?
Question by MarciKent: Will I become addicted to methadone?
I want to get clean, but am scared of the detox pain. I have been doing enough heroin to become sick if i don’t do any; everyday for about two months now. I want to use methadone to ease the dope sick but I do not want to replace the heroin addiction with methadone addiction. How many doses of methadone can i take before becoming addicted and needing the methadone everyday? I know the withdraw symptoms from heroin will last 3 to 5 days tops. I’m thinking of taking a small dose of methadone for only 4 days then stopping. That way I will not feel the dope sick but will not become addicted again, right? Please only informed experienced answers. I already hate myself for putting myself in this position. I don’t need any judgmental or hateful comments.
Best answer:
Answer by Sparrow
The first thing you have to understand is that MMT- Methadone Maintenance Therapy- when used for opiate addiction is not a “quick fix”, or a short term solution. For that, you need to seek other routes~ opiate withdrawal may feel like dying, but it won’t kill you (save in conjunction with an underlying condition exacerbated d by it). SO it’s either cold turkey, or detox- detoxes are usually in hospital like settings and last 4-5 days; during which they wean you down with mild narcotics in decreasing doses, like Ultram and Bupranex. The actual meds vary by institution, but bear in mind detox is not considered recovered. After detox, the best chance at recovery requires residential rehab- upwards of 6 months’ worth- followed by a halfway house, then IOP (Intensive Outpatient Therapy) and Aftercare~ and this may all take more than 1 year. A year in which you can’t work, live with your family, or do anything else but focus on recovery.
If you’ve never tried it, I always say go it first- but if you’ve done the detox, rehab and so one dance, a few times and it didn’t stick- MMT is a lifesaver.
MMT has the highest success rate among opiate treatments- but the best chance of sobriety comes to those who spend a MINIMUM of 2 years on the program. The program involves taking your daily dose, and doing some counseling, but otherwise, you are able to immediately start over-
I’m assuming you’re familiar, but in case not- opiate addiction, unlike other drugs, causes a physical dependence. If an addict suddenly stops using opiates, they become severely ill. Methadone is an opioid agonist- not an opiate, but a synthetic drug that works on the same receptors in the brain that opiates do, and therefor “tricks” the brain into thinking it’s getting opiates.
There is a lot of science behind it- but the long and short of it is that our bodies produce endorphins- natural pain killers- in small amounts, as needed. Opiates- drugs derived from the poppy plant- (heroin, vicodin, Darvon, oxycontin, morphine, dilaudid, etc.)- when taken, cause an influx of these endorphins. When a person takes opiates on a regular basis, the human body, which is extremely adept at conserving it’s natural resources- recognizes that the person is providing them with more than enough synthetic endorphins through opiates- and the body stops producing it’s small amounts. So when an opiate addict suddenly stops using opiates, the body goes into an endorphin-deficiency, causing the person to become very ill.
Until the last decade, addiction was not recognized as a disease. Since then, the medical community has found evidence of “addictive” genes, in the form of THIQ- a chemical produced from opiates & alcohol by certain people thought to contain the addictive gene. Those without the Addictive gene don’t process the opiates or alcohol the same way, and therefore, do not turn any portion of them into THIQ, the way a person with the addictive gene does. THIQ is believed to be part of the reason that an addictive-prone person develops such strong cravings & is unable to stop using, compared to the non-addictive prone.
Methadone, when used to treat opiate addiction, and taken in the prescribed, stabilization dose, does NOT impair cognitive ability, motor function, or logic. The very basis of why methadone has been successful in treating opiate addicts is because it works in a time released capacity- rendering it incapable of producing feelings of euphoria or, in laymen’s terms, unable to get you high.
Now- someone who has never taken methadone before, who takes a large enough dose, may experience marked drowsiness- but that’s why Methadone Maintenance Clinics (MMT) follow strict regulations that entail starting every new patient/opiate addict off at the very low dose of 20-30mg, regardless of their height, weight, or tolerance level to opiates. From there, each patient is seen by the clinic physician on a weekly basis, and given the small increase of 2 -5 mg once a week, until they are “stabilized”- meaning they’re feeling normal- not in acute physical withdrawal from the sudden lack of opiates in their system. From that point on, there is a blood test called a peak and trough, that measures the serum levels of the methadone in the patient, to ensure their dose is of a therapeutic level, and not so high as to cause drowsiness.
There has been a lot of propaganda in the press lately about the dangers of Methadone- the bulk of which is directly related to a few celebrity deaths that were caused by the mixing of methadone and alcohol, or methadone & other medications. What is not so well known is that NONE- ZERO- of those cases involved opiate addicts taking methadone in a methadone maintenance program. All of them were the result of a personal physician prescribing methadone for pain, to patients who abused the medication by taking it with other drugs, creating a lethal reaction. The Harrison Drug Act made it illegal for physicians- general practitioners- to prescribe methadone to patients for opiate addiction. Only MMT clinics, which are strictly regulated, may prescribe it for addiction. MMT clinics require frequent, SUPERVISED, random drug screens (so anyone on methadone for opiate addiction cannot be abusing other meds, or they would be kicked off the program); as well as one on one counseling, group treatments, state required classes, state required physicals and blood tests, as well as anything else the individual’s counselor feels they need. They must complete treatment plans and goals on a monthly basis, demonstrating they are moving forward with employment, housing, etc., and they are not permitted to take many medications, even when prescribed by a physician, if there is any chance of an interaction. For example, benzodiazepines are well known for their ability to interact with methadone in a way that induced euphoria- (i.e., a buzz)- and are a major no-no. The MMT clinic will prescribe another medication that will not interact, if necessary, but using the benzo’s will result in being kicked off the program. A general practitioner, on the other hand, can prescribe methadone to whomever he sees fit for pain management, and there are no other regulations.
When you decide to get off it is up to you- there’s no pressure either way. It entails being weaned down from your stabilized dose. So, for example- if you ended up stabilized at 100mg, and you’ve been taking that for 2+ years, daily, then you would begin by having your dose decreased 2-5mg, every week. As you get lower, in the 4-50 range, you may change to decreasing only 1-2mg, every week, or every other- methadone’s long half-life means it takes a longer time to leave the system. I know many people who were going down 5mg a week, every week, and felt fine- but then at 40mg, started feeling sick. This is because they were only then feeling those initial decreases, as the residual supply left their body.
One you get down to about 10-20mg, your clinic physician will send you to a detox- this is imperative- as methadone withdrawal takes longer and can be slightly harder to get through. You’ll have a physician monitoring you throughout the whole thing, and the detox will get you through the last leg of the journey.
I understand your hesitation, and the concern you have about swapping one for another. I had it too- and for many years, I let it convince me methadone was bad. When I ran out of options, and I’d tried everything else out a few times, I was backed in a corner and had to go on it- and I’ve been clean ever since.
The one thing MMT does that detox doesn’t, is remove the cravings. While acute physical withdrawal is hell, the chronic, mental withdrawal, and the lingering physical withdrawal symptoms like insomnia, leg cramping and that awful crawling out of your skin feeling. Those can take upwards of a year to dissipate without methadone.
In the near decade I have now had sober, I have turned my life around. I a m a mother, a wife, a business owner, and a tireless advocate for the rights of addicts and MMT. Only you can determine what will be the right road for you, but don’t allow the myths and stigmas of the medicine to dissuade you from taking it.
I have tons more information on it if you want; feel free to email me with any questions- I can also give you information on other types of treatment besides methadone, too. Some other resources:
* http://www.facebook.com/erinmsantana#!/group.php?gid=106559159942&ref=ts
(This is a group on Facebook about MMT education. If you have any questions, feel free to email me; i am the admin for the group).
* http://www.methadone.org/ (NAMA_ National Alliance for Medication Assisted Recovery , is one of the leading sources of information and education on methadone for MMT)
*http://www.drugtext.org/library/books/methadone/section4.html (The Methadone Briefing is an excellent resource that breaks down the myths and stigmas regarding methadone).
*http://www.whitehousedrugpolicy.gov/publications/factsht/methadone/index.html (ONDCP- a factsheet on methadone from the Office of National Drug Control policy).
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