Whether you’re currently struggling with an addiction, care about an addict or simply want to know more about what’s being done to deal with the opioid crisis, chances are good you’ve heard about methadone clinics.
In the United States, an estimated 350,000 people receive daily methadone doses from one of the 1460 or so federally regulated methadone clinics. In spite of the increased adoption of methadone as a treatment for addiction and the ever-growing opioid death rate in America, methadone clinics continue to be the target of protests and debates over the belief that methadone clinics are simply government-approved drug dealers.
What Is Methadone?
Methadone is a long-acting synthetic opioid analgesic (pain reliever) drug that is used to treat severe pain, such as in patients with advanced forms of cancer. It’s also widely used to treat opioid addiction thanks to the fact that when taken at the right dose, methadone is highly effective in reducing cravings and withdrawal symptoms among people who are addicted to fentanyl, heroin, hydromorphone, and oxycodone.
Unlike opioid drugs, methadone use does not produce the typical “high” that opioids do. Following the initial induction period, patients who take methadone under medical supervision typically report that they feel normal. Because methadone has a much longer half-life than opioids, patients usually take a dose once daily.
Methadone was developed in the late 1930s by German chemists who were searching for a powerful, nonaddictive painkiller that could be used as an alternative to morphine. First named Hochst-10820, methadone was successfully used to reduce heroin withdrawal symptoms among WWII soldiers in the United Kingdom during the 1940s, and it became legal as a prescription medication in the U.S. in 1947.
The Effects of Methadone
While methadone is chemically similar to addictive opioids like heroin and morphine, the effects it has on users is significantly different.
The most notable characteristic of methadone is that it is highly effective in altering how both the brain and the nervous system respond to pain — it lessens the perception of pain signals without producing the tell-tale euphoric high that is associated with traditional opioids. Methadone also blocks the euphoric effect of other opioids that may be taken concurrently, which provides people struggling with opioid use disorder (OUD) a powerful deterrent against taking codeine, oxycodone or other opioids while on methadone.
When prescribed by a licensed addiction specialist and taken in the proper dose, methadone tends to produce few side effects; however, users may feel uncomfortable during the first week or so of their methadone treatment. Symptoms like light-headedness, nausea, constipation, and diarrhea are relatively common; however, the intensity of these symptoms is significantly milder than patients with OUD would experience if they went “cold turkey” off all forms of opioids.
Some people who use methadone report experiencing weight gain related to both water retention and increased caloric intake, while others complain of dry mouth, difficulty urinating and vision problems — all issues usually resolved by modifying the dose of methadone.
Methadone and Addiction Treatment
Methadone has been widely used in addiction treatment programs since the 1960s following the establishment of the world’s first methadone maintenance treatment program in Vancouver, British Columbia, Canada, in 1959. During the 1960s, methadone was used to treat heroin addicts in New York. In 1964 the U.S. Food & Drug Administration (FDA) approved methadone for use in medication-assisted treatment (MAT) programs for people diagnosed with OUD. Methadone is one of only three drugs (the others are buprenorphine and naltrexone) that are FDA approved for the treatment of OUD.
In the United States, methadone is often distributed under the brand names Dolophine (tablets) and Methadose (concentrated liquid). When dispensed at a methadone or MAT clinic, Methadone is often mixed with juice and consumed on-site — this ensures patient compliance with the prescription and prevents the resale of methadone on the street.
The Stigma of Methadone Clinics
Despite the fact that the death toll from the opioid crisis in America continues to rise, methadone clinics continue to be highly controversial and stigmatized among lawmakers, government officials, the general public and even some members of the recovery community.
According to the California Society of Addiction Medicine (CASM), “anti-methadone biases related largely to ignorance of the phenomenon of tolerance, which eliminates any euphoric effects from daily methadone doses.” Simply put, “Patients do not get high” from methadone that is dispensed at MATs — a fact that is often overlooked by anti-MAT advocates. Adding to the misinformation about MATs and methadone is the “lack of understanding of the changes in brain chemistry that occur after chronic exposure to opiates,” which CASM reports is “felt to be the cause of the extremely high relapse rate associated with non-methadone treatments of narcotic addiction.” [this link has since been removed from their website]
Methadone use as part of a medically supervised OUD program is similar to how nicotine patches and gum are used to help tobacco users quit smoking — something that is widely accepted among medical professionals and the public alike.
Unfortunately, the stigma around methadone clinics and MATs for opioid addicts has been linked to a number of deaths, including that of Robert Lepolszki of New York, who died of an opioid drug overdose in 2014 at the age of 28. In 2013 Judge Frank Gulotta Jr. ordered that Lepolszki, who was arrested on drug-related charges, be terminated from his methadone treatment program — an order that Lepolszki’s parents feel deprived their son of the medication (methadone) he needed to save him from an opioid overdose.
Judge Gulotta defended his order to terminate Lepolszki’s access to methadone, stating that MATs “are crutches — they are substitutes for drugs and drug cravings without enabling the participant to actually rid him or herself of the addiction.”
Want to Learn More About Methadone? Call Us
To learn more about opioid use disorder, methadone and treatment options for people who are addicted to heroin, hydromorphone and other opioids, call us here at FHE Health, start a live online chat or complete our online contact form. Our team of compassionate, professional addiction and mental health experts are available to take your call 24/7, 365 days a year.