Battling a substance addiction is not without its challenges. To navigate those brought on by opioid withdrawal, certified methadone treatment centers used methadone in therapeutic doses to help people end their chemical dependence with fewer obstacles. Some methadone users even have take-home doses that last only for a specified, predetermined time. However, even with these restrictions in place, the drug still carries a high potential for addiction. The longer one uses it, the harder it is to quit, something many users find out as they battle post-acute symptoms for years down the line.
Methadone is an opioid pain reliever medication that shares the same drug class as codeine, hydrocodone, oxycodone, and morphine. It is prescribed to help people who are experiencing pain after an injury, surgery, or chronic illness, such as cancer. Methadone changes how the brain and central nervous system perceive and respond to pain, which gives people relief from discomfort. Methadone works similarly to morphine and can be taken in the form of a tablet, a liquid, or a powder. Recreational users also inject the drug, which provides a strong high. It also can expose them to infectious diseases such as HIV (human immunodeficiency virus).
This powerful drug is also used in treatment programs for people in recovery from chronic opioid misuse. This method of treatment, called replacement therapy or methadone maintenance, helps them cope with the withdrawal symptoms they feel during medical detox, which is designed to make these symptoms more manageable. According to WebMd, “methadone replaces the opioids in your system with milder effects.” These milder effects work slowly and are not as potent as those of other drugs, such as morphine, codeine, heroin, hydrocodone, and oxycodone.
Before someone can take home a dose of methadone, they first must meet certain federal eligibility criteria. If this arrangement is in place, then the users likely have been with a methadone maintenance program for some time.
Street names for methadone include dollies, dolls,fizzies, jungle juice, phyamps, red rock, and tootsie.
Methadone users feel a rush of euphoric and relaxing sensations when they use the drug, which causes them to seek it out again at any cost. As the National Institute on Drug Abuse (NIDA) explains, addiction changes the brain’s structure as well as how it functions. Methadone is used to help people who are in addiction treatment, but its potent effects can be as addictive as the drugs that users are trying to recover from.
General signs of methadone addiction include:
Physical and psychological signs of methadone addiction include:
People with existing substance use problems or who are predisposed to substance abuse and addiction have a greater chance of developing methadone addiction. Overall, users may find it difficult to end their physical and psychological dependence on the drug, especially if they are trying to do it on their own without professional medical help.
The detox process can be lengthy with some estimates saying it can take at least a month or more to rid the body of the drug. Even after use has stopped, some people will experience difficulty achieving and maintaining mental and emotional clarity, normal sleep schedules, and other post-acute withdrawal symptoms after having a methadone addiction.
Intense withdrawals that occur when use is stopped are a sign that someone has methadone dependence. When this happens, it means the body is reacting to not having the drug in its system at the usual amounts. As a result, users will struggle with physical symptoms such as appetite loss, elevated blood pressure, nausea and vomiting, and mental symptoms, such as agitation, insomnia, concentration difficulties and paranoia, among others. The more extensive a person’s methadone addiction is, the longer it will take the brain to completely restore itself and begin producing these chemicals on its own once again.
Do-it-yourself detox is not recommended. Also not recommended is quitting methadone abruptly after long-term use. This is dangerous and can lead to relapse. The best and most effective way to get through this tough period is to seek drug addiction treatment at a licensed, reputable facility that specializes in helping people end their drug and alcohol dependence.
When one enters addiction treatment, the first order of business is to achieve medical stability safely. Withdrawal is uncomfortable, and it also can bring challenges that recovering substance users may not be aware of or prepared for. Medical detox is the first step of recovery. During this process, methadone users are weaned off the drug safely under the supervision and guidance of medical and addiction care professionals 24/7 for a period of three to seven days or longer, if needed. Clients’ vitals are monitored as body is rid of all the addictive substances that have been used.
A medical professional may decide to taper clients off methadone, a process that involves reducing the dosage gradually as withdrawal symptoms occur. Medications also may be given to combat symptoms of withdrawal. Among them are clonidine and buprenorphine, which both help clients handle the psychological changes that come with methadone dependence. Naloxone also may be used to block the brain from feeling the drugs’ opioid effects.
After methadone detox is completed, and clients show they are stable in mind and body, they will receive several treatment care options that should be based on the results of their initial evaluation. These options generally fall into two groups: inpatient (residential) treatment or outpatient treatment program.
If one enters an inpatient (or residential) program, they commit to at least a 30- to 90-day stay at a facility where they can live on site as they continue with their recovery. This is a structured setting where people are monitored around the clock and receive prompt medical treatment for health ailments. These settings also offer support for recovery from everyone involved, including like-minded peers who are in recovery themselves. Addiction education, group and individual counseling, a post-treatment plan to avoid relapse are all part of the inpatient program.
Outpatient programs are less intense and extensive as a residential or detox program. Nonetheless, the topics discussed in outpatient programs will be based on the issues you may have faced during active addiction if similar situations arise while in recovery.
Intensive outpatient programs are not as restrictive as inpatient ones, but they are no less effective. People who are not far along in their methadone dependence and those who have a mild case of it may find this to be a suitable option that offers more flexibility and privacy. There’s also less of a time commitment, which allows more time for attending to personal duties, such as a job or school. This arrangement is also ideal for people who have completed previous higher levels of care and those who have recently relapsed and need more time in rehab.
Outpatient services still require a weekly commitment of at least nine hours of therapy, and clients could meet anywhere from three to six times a week. The IOP schedule depends on the severity of one’s addiction as well as if there are co-occurring disorders present. IOP clients also can find support in sober living homes and other kinds of transitional housing that promotes sobriety.
Recovering methadone users may want to consider attending 12-step meetings, joining an alumni program that connects them to people on the same recovery path, or continuing individual therapy, group therapy, or family therapy. Since managing addiction is a lifelong process for many people in recovery, doing all of these can only help boost the chances of staying away from substances and triggers that lead to substance abuse.
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Methadone’s therapeutic effects do not mean it can be used without care or supervision. It is a dangerous drug when misused. Even regular doses of it can be habit-forming and addictive. Clients who participate in methadone replacement therapy are monitored while taking the medication in a medical facility. A medical professional will adjust the dose if it becomes apparent that it is too high. When clients are not in a monitored setting, they can take too much methadone and not know it. This is because the drug’s effects are so mild that users may feel comfortable taking more than prescribed. This, unfortunately, can lead to overdose, and that can be fatal.
There are people, however, who abuse methadone recreationally, and they intentionally take more than they should, which also puts them at risk of an overdose. This risk is increased when people use methadone along with other drugs such as alcohol, benzodiazepines, and other opioid pain medications. This commonly happens among people who take substitute drugs such as methadone or buprenorphine while in treatment. They use opioids and/or alcohol to strengthen the effects of the opiate/opioid they are withdrawing from.
A person who has overdosed on methadone may exhibit these signs and symptoms:
Overdose is a medical emergency that should be treated promptly. Permanent injury, coma, and death are the possible outcomes if the person isn’t treated right away. If the affected person has had a seizure, collapses or has trouble breathing, or loses consciousness, call 911 for immediate help. The Poison Control hotline can also be reached at 1-800-222-1222.
National Institute on Drug Abuse. (March 6, 2018). “Opioid Overdose Crisis.” Retrieved August, 2018, from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
NIDA. (January, 2018). “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse. Retrieved July 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
Patafio, Michaela. (n.d.). “What Is Methadone?” WebMd. Retrieved August 2018, from https://www.webmd.com/mental-health/addiction/what-is-methadone#1