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Methadone Abuse, Addiction, And Treatment Options

Jennifer Cousineau MSCP, LPCI, NCC

Medically reviewed by

Jennifer Cousineau, MSCP, LPCI, NCC

March 27, 2019

Methadone acts on the same opioid receptors as heroin and morphine and is used to manage chronic pain as well as treat opioid-dependent individuals. Sold under brand names that include Dolophine, Diskets, and Methadose, it is delivered orally or via injection. While still a standard in treating opioid addiction, methadone abuse continues to be a significant contributor to the opioid crisis, with sometimes deadly consequences.

What Is Methadone?

Methadone is one of few medications approved by the Food and Drug Administration for use as part of a medication-assisted treatment (MAT) program for opioid use disorder. Methadone clinics offer this medication as a way to maintain freedom from other highly addictive opioids, like heroin and oxycodone.

Methadone is a synthetic opioid that is used in treating opioid addiction and managing moderate to severe pain. Created in the 1930s, it was originally developed as a painkiller that was considered to be less addictive than morphine. It acts on the same receptors in the brain as morphine and fentanyl, but the way that it interacts with the body is different from other opioids.

When methadone attaches to the opioid receptors in the brain, it does not offer the same intense euphoria of other opioids and eases the discomfort of opioid withdrawal. If a person takes other opioids while taking methadone, they will not feel the familiar extreme rush due to methadone already in the body.

The long-acting element that makes methadone useful in treating addiction is also a key factor in what makes methadone dangerous. The drug can quickly build up in the system and the possibility for accidental overdose increases drastically, especially when abused. Methadone has a half-life that ranges from eight to fifty-nine hours, the painkiller effects last about eight hours.

Why Abuse Methadone?

Taking methadone in any way other than prescribed is considered abuse. Abusing methadone puts the person at risk for addiction and overdose. After the mild euphoria and pain relieving effects wear off, a person may not realize they still have a significant amount of methadone in their system, and take more. This can be the fast track to tolerance, dependence, and addiction.

Methadone has also become more readily available than other prescription opioids due to its low-cost and long-acting pain relieving properties. This increase in exposure seems to be directly correlated to the increase in methadone abuse, especially in populations that were not previously exposed to opioids.

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The opioid epidemic has made many doctors leery of prescribing common painkillers, and this has lead to methadone being prescribed as an alternative to drugs like Oxycontin and hydrocodone. In addition, some insurance companies prefer methadone to treat pain in patients, as it is a less expensive option than other painkillers.

Even though methadone does not cause the intense euphoria of heroin, it still can provoke feelings of calm, mild euphoria, and pain relief. The comfort that a person may associate with these feelings may be strong enough to maintain continued abuse, putting them at high risk for dependence and addiction.

Who Abuses Methadone?

Anyone who has a prescription for methadone is at risk for abusing methadone. Anyone who abuses opioids is at risk for abusing methadone. People with access to methadone is at risk for methadone abuse. This is why many methadone clinics require strict monitoring of clients, especially during the early stages of treatment.

Methadone abuse is taking methadone in a way that is not prescribed. This includes taking it without a prescription, at doses higher than prescribed, taking it earlier than prescribed, or adjusting a dose without doctor approval.

Even with regulated monitoring processes, methadone is still contributing to prescription painkiller deaths. Some individuals who take methadone as a way to manage addiction or chronic pain, may begin abusing their medication after developing a tolerance to their dosage and changing their dosage without doctor approval.

It is important that a person who is prescribed methadone take their methadone exactly as it is prescribed to them. It is equally important to be monitored by the prescribing doctor, and maintain communication regarding how well the medication is working, or if adjustments need to be made.

Methadone Abuse Signs

A tell-tale indication that someone is abusing their prescription for methadone is if they are clearly ‘high’ or intoxicated from methadone. At proper dosage, this medication should not result in intoxication. Some signs of methadone intoxication include:

  • confusion
  • forgetfulness
  • dizziness
  • nausea
  • impaired cognition
  • stumbling
  • coordination issues
  • sweating
  • flushed
  • itching skin

A person who is abusing methadone may become obviously distressed when the methadone is wearing off. The person may struggle with anxiety, become highly irritable or agitated, exhibit depression, and even complain of muscle aches or spasms.

Methadone Tolerance

Over time, a person who is prescribed methadone may feel as though the amount they are taking doesn’t seem to have the same effect anymore. This is referred to as tolerance. Methadone tolerance occurs much more quickly when a person is abusing methadone.

When a person who is abusing methadone develops tolerance, they may believe the solution is to just take more methadone, or they may abuse other substances in addition to methadone. Both of these options can easily result in overdose.

If a person taking methadone believes that they have developed tolerance to their current dose, it is important to seek the advice of the prescribing medical office. Adjusting doses of methadone without medical supervision is extremely dangerous, and in some cases, fatal.

Methadone Dependence

It is common for a person to become dependent on methadone, as it is used to treat opioid addiction. Dependence occurs when the body needs methadone in order to feel ‘normal’, and symptoms of withdrawal emerge without it.

While some individuals are able to start a methadone program and eventually be weaned off methadone, others remain on methadone for several years. Research studies have included individuals who have been on methadone maintenance treatment programs for 30 years.

Dependence is not the same as addiction. A person can be dependent on methadone without being addicted. Addiction is a disease that changes the brain and the behavior of the person struggling with addiction.

Methadone Addiction

Addiction to methadone looks very similar to addiction to other opioids. When a person is struggling with addiction, they may display the following:

  • doctor shopping
  • running out of methadone before prescription refill
  • lying to doctors to get more methadone
  • spending significant amounts of time and money on methadone
  • avoiding social situations where they cannot use methadone
  • acquiring new social circles of people who also abuse substances
  • craving methadone
  • using methadone in unsafe situations
  • methadone is negatively impacting responsibilities
  • methadone use is causing health problems
  • continued use knowing methadone is causing problems
  • withdrawal symptoms emerge if methadone is stopped

Methadone Overdose

Many of the deaths related to methadone overdose are accidental. Those who were treating chronic pain with methadone made up more than 60% of the accidental overdoses from those with prescriptions. Rates of methadone abuse, addiction, and overdose spiked when rates of methadone prescriptions for chronic pain increased.

Some symptoms of methadone overdose are:

  • shallow breathing
  • bluish tinted skin
  • nodding off
  • stupor
  • vomiting
  • coma
  • seizures
  • death

If a person is displaying any of these symptoms, seek medical assistance immediately. Many emergency medical responders carry medications that can be used to reverse opioid overdose. Seeking assistance quickly may save a life.

Methadone Withdrawal

Methadone withdrawal symptoms are less severe than other opioids, and can take up to three days to set in. These withdrawal symptoms can be uncomfortable, but more manageable than other opioids, and include:

  • sweating
  • fever
  • racing heartbeat
  • tremors
  • excessive lacrimation (watery eyes)
  • runny nose
  • restlessness
  • anxiety
  • mood swings
  • depression
  • insomnia

Attending a medically supervised detoxification program is one way to manage the symptoms of methadone withdrawal.

Treatment For Methadone Abuse

An individual seeking substance abuse treatment for methadone addiction will benefit most from an opioid use treatment program. These programs are required to provide comprehensive substance abuse treatment.

Opioid use treatment programs include medically supervised detoxification, substance abuse treatment, medical care, psychological assessment, co-occurring diagnosis care, vocational and educational services, as well as complete aftercare planning services.

There are other medications that can be used to manage opioid use disorder and methadone addiction. Contact us today, so we can help start the process toward sobriety.

Food and Drug Administration - Methadone prescribing label

The BMJ - Methadone tolerance testing in drug misusers

The BMJ - Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies

Harm Reduction Journal - Opioid tolerance in methadone maintenance treatment: comparison of methadone and levo-methadone in long-term treatment

American Journal of Forensic Medical Pathology - The methadone epidemic: methadone related deaths on the rise in Vermont

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