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Methadone Maintenance

History of Methadone

Methadone is an synthetic opioid drug which was first used in World War II for the treatment of pain. Today, methadone is sometimes prescribed to treat chronic pain. During the last three decades, methadone has become a popular choice for treating those addicted to other opioid drugs such as heroin, oxycodone, morphine, and hydrocodone. Methadone Maintenance Treatment (MMT) is a reliable way for those with an opioid addiction to stop and not restart the use of opioids. For many, methadone treatment provides an opportunity to regain balance in both lifestyle and priorities.

How does methadone treat opioid dependence?

Methadone binds to the to the brain's receptors for opioid drugs, also known as opioid receptors. At the proper dose, methadone fills these opioid receptors and relieves the need for another opioid drug. When a patient is taking methadone at a proper dose, it does not have any other effects. Methadone does not fuel addiction when taken properly as it does not provide a high. It does not change how you feel or who you are. These properties are what allows methadone to free the patient from the driving force of opioid dependence and gives them the opportunity to focus on their recovery from addiction.

Once a patient has become accustomed to taking methadone, a single dose will last from 24 to 36 hours. This means that there no longer a need to take another opioid every few hours. The patient no longer has to search for drugs and deal with the emotional roller coaster of being up and down all throughout the day. A stable dose of methadone provides protection from relapsed use of addictive opioid drugs.

How do you start Methadone Maintenance Treatment?

Methadone maintenance treatment is offered by clinics that specialize in opioid replacement therapy, commonly known as methadone clinics. There are well over 1,000 of these clinics throughout the United States and Canada. Our Methadone Clinic Directory provides a list and map of methadone clinics in the US and Canada to easily find a clinic near you. You could also ask a doctor or nurse, or contact your local Addiction Services or Crisis Center for direction to a local methadone program.

Call 1-800-755-9603 to find the nearest clinic or to speak with a drug abuse counselor.

What is a Methadone Maintenance Treatment program?

In a Methadone Maintenance Treatment program, a patient is prescribed a dose of methadone to take each day. After taking methadone each day for some time, it chemically treats the physical and mental symptoms of opioid withdrawal. Methadone Maintenance Treatment usually allows the patient access to help for other health issues he or she may have. Preventative care, medical attention, education, or counseling about recovery of health are often offered for patients enrolled in a treatment program.

When you first begin methadone treatment, you will usually have an interview, physical examination, and blood test. You will also likely need to produce a urine sample testing positive for opioid drugs. At most clinics you do not have to stop using drugs to begin Methadone Maintenance Treatment. Often the nurse or clinician performing the interview and exam will explain to you the benefits, side effects, and precautions of taking methadone. You may be required to read and sign a treatment contract and will receive information about the policies and guidelines of the clinic.

Once your enrollment is complete, you will have to see a doctor before you begin taking methadone. Most commonly, the methadone at clinics is dispensed as a liquid which is mixed with some juice. You will need to attend the clinic or pharmacy daily to receive your dose of methadone, and you will be observed by the pharmacist or nurse when you drink your methadone.

You will not be allowed to receive any take-home doses of methadone until you demonstrate your reliability by attending the clinic regularly and providing several months of clean urine samples. Methadone is a safe and effective drug to take when you are properly monitored, but it can be dangerous to take outside of proper supervision. Those who enroll in methadone treatment are often in deep addiction and accustomed to the reckless use of dangerous drugs. Reliability and responsibility are not hallmarks of addiction.

For some people, the craving for opioids disappears rapidly after starting to take methadone. For other people, it may take some time until the cravings begin to lessen. When you first begin taking methadone, you will be started at a lower dose, likely in the range of 20-30mg. Over time, the dose will be safely increased to a level that will treat all symptoms of opioid withdrawal as well as the cravings for opioids. The rate that the dose is increased varies from clinic to clinic and from person to person. It usually takes a few days until the full effects of an increase in dose can be felt, so increases in dose only occur every few days to a week.

Once a you are on a stable dose of methadone, you will remain on that dose for an extended period of time. The length of time spent in this phase varies from patient to patient, but is usually no less than 1-2 years. This gives the brain an opportunity to heal, and gives you a chance to stabilize your lifestyle and regain your health. After some time spent at this dose, you and your doctor may decide it is time to begin to slowly taper your dose. In order to ensure minimal withdrawal effects, the tapering process is done slowly over a period of several months. During this process, as with the rest of your treatment, it is important to be honest with your doctor about how you are feeling.

It is important that you feel you are ready to get off methadone before beginning to taper. If something or someone is pressuring you to get off methadone but you don't feel like you are completely ready then it is not a good time to start tapering. Many patients will continue treatment indefinitely, and that is okay too.

Methadone Clinic Directory

The Methadone Clinic Directory contains listings and contact information for over 1,000 methadone clinics throughout North America. The listings are organized by state or province and display the clinic locations on an interactive map. If you are having any difficulties with the directory, please contact us at opiateaddictiontreatment@gmail.com.



References
  • Preston A. The Methadone Handbook. 3e. Island Press, 1996. druglibrary.eu [Link] [PDF]
  • Craven J. About Methadone Maintenance (Section 1.2) in: Handbook of Recovery. SupportNet Studios, 2005. supportnet.ca [Link]
  • Joseph H, Stancliff S, Langrod J. Methadone maintenance treatment (MMT): a review of historical and clinical Issues. The Mount Sinai Journal of Medicine Oct-Nov 2000; 67(5-6):347-64. [PubMed] [PDF]



Related Pages

Methadone
Methadone is a synthetic opioid that is most commonly used as a maintenance treatment for opioid addiction. Methadone is also used in managing severe chronic pain, due to its long duration of action, high potency, and very low cost.
Buprenorphine
Buprenorphine is a semi-synthetic opioid analgesic used to treat opioid addiction as well as moderate acute and chronic pain. Available since the 1980s, it was only in 2002 that it was approved for maintenance treatment in opioid addicted individuals.
Buprenorphine Treatment
What is buprenorphine (Suboxone, Subutex)? How does buprenorphine treat opioid addiction? Why is buprenorphine combined with naloxone? Learn about buprenorphine treatment, a relatively new method of medication-assisted treatment.
Opioid Dependence
Read about how prolonged opioid abuse leads to physical and psychological dependence, and what that means for the user.

Updated October 30, 2013