The Dangers Of Legal Methadone Use And Abuse
Medically reviewed by
Dr. Anna PickeringApril 3, 2019
Methadone is an opioid medication, with effects similar to heroin, but without the associated euphoria. For this reason, the drug is used primarily to help heroin-addicted people get off of heroin in a way that still allows them to function in society, but without some of the severe side effects associated with heroin withdrawals. The drug may also be used to manage chronic, severe pain.
Legal use of many drugs still carries a great risk of side effects, complications due to medication interactions, and risk of addiction.
Methadone works by preventing the excitatory neurotransmitter glutamate from binding to its receptors. This results in both pain reduction and sedation in patients using the drug. Multiple studies have shown that methadone is an effective opioid agonist in reducing cravings for other opioid drugs.
It serves this function by binding to opioid receptors, rendering them unavailable to heroin or other opioid drugs. While it binds with the same receptors, it does so without the extreme euphoric effects associated with the use of the other drugs. By occupying these receptors, physical cravings for those drugs is significantly reduced or eliminated.
Common Side Effects Associated With Methadone Use And Abuse
Methadone is not without some significant side effects. Sedation or fatigue, swelling, gastrointestinal upset including constipation, nausea, and vomiting, increased sweating, dizziness, hallucinations, changes in weight (usually weight gain), dry eyes, and skin rashes are commonly reported as side effects for methadone maintenance treatment. These side effects may be more severe for patients who abuse the substance.
Deaths associated with the use of the drug, outside of accidental overdose, are most often reported in early use of the medication in individuals sensitive to the substance. Increases in deaths from methadone follow a similar increase in abuse of heroin.
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Methadone Maintenance Treatment
Though it is used to combat one form of addiction, methadone is highly addictive, and physical dependence is formed rapidly. It also carries similar central nervous system depressant risks to heroin, and accidentally taking more than one dose in a day could prove fatal. Other risks include changes in the rhythm of the heart, which can result in dangerous arrhythmias leading to stroke or heart failure.
While methadone maintenance can be an effective treatment for those suffering from an addiction to heroin, sadly some dealers target clinics where the drug is dispersed, sometimes thwarting a person’s recovery efforts intentionally to earn a new client. This puts those individuals at higher risk of accidental overdose and other harm.
Even someone on methadone maintenance at the prescribed dosages may become physically dependent on the substance and suffer withdrawal symptoms similar to heroin. Withdrawal from either drug requires a comprehensive treatment plan, including medical management of withdrawals.
Methadone Abuse
Methadone is one of the most widely abused substances on the planet and its use is increasing. Methadone-related deaths have increased hundreds of times over since 1990, and are far more common among polysubstance users and most often caused by severe respiratory depression.
Methadone is highly addictive, and it is not uncommon for someone to quickly develop a physical dependence to the substance. Signs of methadone addiction include heavy sedation, weakness, and significant changes in sleep cycles. The individual may also experience exaggerated symptoms from use of the drug including constipation, nausea, and vomiting.
Due to the length of time methadone remains active in the system, it is critical anyone using this medication is monitored for signs of methadone overdose.
Methadone Toxicity
One of the true dangers in methadone is in the difference between the effects felt by the individual, and in the actual time it takes for methadone to be flushed from the system. If someone is taking methadone for pain management, for instance, and the effects of the analgesic last for four to eight hours, they might take a second dose while the drug is still active in their system, causing sedation and potentially fatal respiratory depression.
For the individual addicted to methadone, this is of equal concern. If they begin to experience withdrawal symptoms from the drug and take a subsequent dose, or a higher dose, they may experience similar fatal respiratory results.
Signs of methadone overdose include muscle spasms, slowed or irregular breathing, difficulty breathing, pale and clammy skin, stomach cramping, weak pulse, dangerously low blood pressure, sedation, confusion, and coma. If someone is exhibiting these symptoms, seek medical attention immediately.
Treatment for Methadone Addiction
Residential treatment for methadone addiction is recommended along with behavioral therapies that focus on coping strategies to reduce the onset and potency of drug cravings. These programs may be as short as 60 days or as long as a year or more. Due to the severity of methadone withdrawals, pharmacological therapies, including the use of suboxone and subutex, may also be used in the early stages of recovery.
Ongoing meetings and counselling is recommended long after completion of a residential program. Evidence suggests the use of cognitive behavioral and motivational therapy in the early stages of recovery as a way to successfully transition someone from residential care to life outside of treatment.
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