Sommaire
MAIN TYPE
Methadone is a synthetic opioid and narcotic drug that acts on opioid receptors in the brain and other parts of the central nervous system.
Methadone is legally produced and has a number of legitimate medicinal and therapeutic uses. It is perhaps best known as a legal heroin substitute used to treat drug addicts, but it is also used as an analgesic for patients with chronic pain.
Chemically, it is not identical to heroin, but it has many of the same effects and can be used to prevent the more severe symptoms of heroin withdrawal. This is because it acts on the same opioid receptors in the brain but does not create the same “high” as heroin.
Opioids work by binding to opioid receptors in the brain and other parts of the central nervous system. This prevents pain signals from reaching the brain and induces a state of euphoria. However, opioids can be very addictive, both physically and psychologically. From a physical standpoint, the body craves the substance to which it has become accustomed. From a psychological point of view, the individual can become accustomed to taking the substance and crave the sensations it provides.
When used as a heroin substitute, methadone can help an addict to recover gradually. It prevents the most intense negative effects of heroin withdrawal, under the strict supervision of a doctor or clinic who will help the patient to reduce the dose safely.
Methadone is manufactured legally but is tightly controlled. It is usually a green liquid that is taken orally but can also be ingested in pill form or injected. In addition to treating heroin addiction, methadone is prescribed to patients suffering from chronic pain in some countries.
However, it is also found on the black market and can be abused by individuals without a prescription. The possession or sale of methadone outside of official and licensed channels is strictly illegal in many countries. In the United Kingdom, it is a Class A drug, punishable by up to seven years in prison and life imprisonment for sale. In the United States, methadone is a Schedule II drug and possession is illegal without a prescription.
OTHER TYPES
Methadone is legally produced for pharmaceutical use by several companies and therefore exists under different brand names, including: Dolophine, Amidone, Methadose and Heptadon.
Street methadone, which is distributed and used illegally, goes by different slang names: dollies, juice, fizzies, done and meth (not to be confused with “crystal meth”).
Street methadone is particularly dangerous because it is often impossible to determine its purity level. Sometimes heroin addicts in methadone detoxification programs sell some of their supply, or traffickers buy it illegally. To make the sale more profitable, they often dilute the substance in water or fruit juice.
In addition, methadone can be combined with other illegal drugs, such as MDMA (ecstasy). On the street, this special combination is called “chocolate chip cookies.
MAIN EFFECTS
As part of a legitimate detoxification program, methadone use is carefully monitored and regulated for specific effects. Under these circumstances, the main effects of the drug are a reversal of withdrawal symptoms from heroin as well as a sense of detachment and relaxation.
The main reason that methadone use is closely monitored and controlled by practitioners is that it is highly addictive. Although the drug does not provide the intense euphoria of heroin, it does create a psychologically appealing state of mind and physical sensations. In addition, a chemical dependency can develop as with many other opioids. Tolerance also increases, requiring the user to take larger doses to achieve the same effects.
Without proper medical supervision, methadone has a high risk of abuse and dangerous consequences.
Because of the tolerance that develops when taking methadone, a person who takes someone else’s dose is at risk of overdose. This problem is compounded by the inability to know the potency of street methadone and the lack of knowledge about the effects and quantities of the drug.
A methadone overdose is very dangerous and can be fatal. Symptoms include difficulty breathing, blueing of the extremities, seizure and nausea. Failure to treat a massive overdose can result in coma and respiratory failure.
Short-term use of methadone can cause agitation, nausea, constipation and other side effects, while long-term use can cause breathing difficulties.
PRODUCING COUNTRIES
Methadone is legally manufactured by pharmaceutical companies in developed countries around the world. After being discovered by scientists in Nazi Germany prior to World War II, the drug entered commercial production shortly after the war as an analgesic. It is now produced under license in laboratories around the world, for example in the United States, France, Belgium, India and China.
Unlike opiates such as codeine and morphine, which are made from poppies, methadone is a fully synthetic, man-made opioid. As a result, its production is not dependent on opium crops.
Most of the methadone sold illegally on the street comes from traffickers, who obtain it from patients with legal prescriptions, either as a substitute for heroin or as a painkiller. It can also be stolen or diverted from pharmacies, detoxification centers, and other places authorized to store and distribute the drug.
The ease with which methadone enters the black market depends greatly on controls and restrictions on the therapeutic use of the drug. For example, in countries where recovering addicts are allowed to take large stocks of the drug home without supervision, there is a greater chance that the drug will end up on the street. Methadone can also be exported from one country to another.
Illegal distribution and use of methadone carries severe criminal penalties, including long prison sentences, but the drug continues to be bought and sold on the street.
FACTS AND STATISTICS
FACTS
- Methadone is a narcotic opioid.
- It was first developed synthetically as an analgesic by German scientists in 1937.
- It was not commercially produced until after World War II and its potential for use as a treatment for opioid addiction was discovered later, in the 1960s.
- It is used legally, by prescription, in many countries as a substitute for heroin and as an analgesic.
- Methadone interacts with opioid receptors in the brain.
- Its effects are similar to heroin, without the intense “high”. It provides a feeling of warmth, relaxation and detachment.
- Methadone can also be purchased illegally on the street and used for recreational purposes. This unauthorized use and sale is illegal in the United Kingdom, the United States and many other countries.
- Although methadone can be used to treat heroin addiction, it can be highly addictive, especially when used without proper supervision.
- Its use for this purpose has sparked controversy, with some people claiming that it is simply replacing one addiction with another.
- This supervised methadone treatment has been shown to be much less dangerous than not treating heroin addiction, as it reduces the risk of overdose, needle exchange diseases or death. It is also known to reduce heroin-related crime in communities, including theft.
- Combining methadone with other legal or illegal substances, such as alcohol, can be extremely dangerous and increase the risk of overdose.
STATISTICS
- In the United States, the number of deaths due to methadone overdose jumped from 790 in 1999 to 5420 in 2006. The people most affected are white men between the ages of 35 and 54.
- Opioids, including methadone, accounted for 40% of poisoning deaths in the United States during this period.
- It is estimated that 73-80% of methadone overdose deaths in the United States are unintentional.
- Methadone is slow acting, as its full effects are often not felt for two to four hours. This poses a significant risk of overdose for those who take it for “recreational” purposes, as they may take another dose in the absence of the desired “high” effect.
- The effects of a single dose of methadone can last 24 hours. This is beneficial for recovering addicts who need sustained relief from heroin withdrawal symptoms, but it also means that side effects such as nausea and dizziness can be persistent.
- In Scotland, the mortality rate from methadone was reduced from 7 to 1 per 1,000 patient-years after the implementation of better treatment monitoring and prescription surveillance.
- In England, there were 1406 deaths from methadone alone between 2001 and 2008.
- In 2008, more than 147,000 heroin addicts in England were prescribed methadone or a similar substitute.
- In 2010, the cost of the Scottish methadone prescription program was approximately $24 million (£15 million).
SIGNS OF ADDICTION
Although methadone is used to treat heroin addiction, it is itself an addictive substance. As part of a therapeutic program, its use is usually closely monitored for this reason.
But it is not only recovering heroin addicts who can become addicted to methadone. This is also the case for people who take the drug by prescription for its pain-relieving properties.
In addition to these two legitimate user groups, individuals who use methadone recreationally without ever having used opiates or opioids before may also become addicted to the drug after purchasing it on the street. Finally, untreated heroin addicts who have purchased methadone on the street to compensate for a heroin shortage may also become “hooked.”
As with any other narcotic, methadone addiction is both chemical and psychological, both of which encourage use.
People who are addicted to the drug they take by prescription may lie to practitioners about the severity of their symptoms in order to get more of the drug. They may also become very hostile to the idea of reducing their dosage.
For street methadone users, there are side effects that may indicate their use and possible addiction. These may include an unusual sense of euphoria and satisfaction and sudden mood swings, nausea, urinary difficulties, decreased libido, loss of appetite, increased sweating and dizziness. However, it is important to remember that these symptoms can also be caused by other substances or conditions.
TREATMENTS
Although methadone can be used by prescription in certain circumstances, addiction to this drug is possible and dangerous, and should be treated like any other narcotic addiction.
Treatment for methadone addiction must address both the physical (the chemical dependency that has developed in the individual’s body) and psychological aspects of the addiction.
Like any other opiate/opioid addiction, there are different methods to help the individual get off of it. Whatever method is used, the process must be closely monitored and tailored to the individual as the withdrawal effects can be significant and the risk of relapse is relatively high.
In the most serious cases, the best solution is to admit the person to a detoxification center, where he or she can receive the care and treatment needed to end the addiction.
Detoxification is the first step in treatment. One approach is to gradually decrease the dosage to reduce the number and intensity of unpleasant side effects associated with withdrawal. Many former addicts have reported that detoxification is as hard or worse than quitting heroin.
Another option is rapid detox, which involves stopping methadone immediately. This is almost always done under hospital supervision, and medications may be given to the patient to alleviate the most severe withdrawal symptoms.
Methadone withdrawal symptoms include vomiting, nausea, suicidal thoughts, intense anxiety and depression, diarrhea, visual/auditory hallucinations and sleep disturbances. They are usually accompanied by an overwhelming urge to take the drug.
Unfortunately, these symptoms can last for quite a long time (from one month to six weeks). Even when the worst effects have passed, close treatment may be necessary for several months. In some cases, an extended stay (several months) in a detoxification center can help the patient recover and avoid relapse.
In addition to medical supervision, detox programs may include counseling, therapy and support programs with other recovering addicts. This part of treatment is as important as physically stopping the drug, as it helps the patient not only deal with the difficulties and obstacles of recovery, but also adopt a new drug-free lifestyle.
In some treatment programs, patients may take a substitute for methadone. In this case, again, care must be taken not to replace one addiction with another, which is why drugs that are not addictive and without major side effects are chosen. One of the common substitutes is buprenorphine, also known as Suboxone. This substance can be used throughout treatment to reduce cravings and help the patient deal with withdrawal effects more easily.
REFERENCES
- www.talktofrank.com/drug/methadone
- www.methadone.org/namadocuments/es05basic_pharmacology_2.html
- www.buprenorphine-doctors.com/what-is-opioid.cfm
- www.indro-online.de/historymethadone.htm
- www.methadonedetoxrehab.com/history/
- www.thegooddrugsguide.com/addiction-types/drug-addiction/methadone-abuse.htm
- www.isate.memphis.edu/opiate.html
- www.who.int/bulletin/volumes/86/3/08-010308/en/
- news.bbc.co.uk/1/hi/uk/7301717.stm
- www.patient.co.uk/health/Methadone-Replacement-for-Heroin.htm
- www.drug-overdose.com/methadone.htm
- www.cesar.umd.edu/cesar/drugs/methadone.asp
- www.drugs.com/methadone.html
- www.unodc.org/documents/hiv-aids/publications/Benefits_and_risks_of_pharmaceutical_opioids.pdf
- www.webmd.com/pain-management/news/20090930/alarming-increase-in-methadone-deaths
- www.straightstatistics.org/article/how-better-methadone-prescribing-has-saved-more-2500-lives
- www.bbc.co.uk/blogs/thereporters/markeaston/2009/10/addicted_to_methadone.html
- www.cdc.gov/nchs/data/hestat/poisoning/poisoning.htm