What is Methadone?

What is Methadone?

Methadone is a synthetic opioid that is used medically as a painkiller and as a substitute for addiction to narcotics such as heroin.

(RS)-6-(Dimethylamino)-4,4-diphenylheptan-3-one

Methadone is listed under Schedule I of the Single Convention On Narcotic Drugs 1961 and is regulated in the same basic fashion as morphine in most countries as a result. In the United States, it is a Schedule II Narcotic controlled substance with an ACSCN of 9250 and a 2013 annual aggregate manufacturing quota of 25 metric tons, down from just under 30 in 2012. One intermediate in the manufacturing process, 4-cyano-2-dimethylamino-4,4-diphenyl butane, is also listed as a Schedule II Narcotic Intermediate controlled substance with ACSCN 9254 and a quota of 32.5 metric tons.

A Brief History

Methadone was first developed by German chemists in the late 1930s, during the time that the Allies cut off the opium supply to Nazi Germany. After WW2 the patents and research records were requisitioned by the Allies, brought to the US and produced by a drugs company. By 1947 it was introduced to the USA as a painkiller.

Today, abuse of methadone results in about 5,000 overdose deaths per year in the United States while in Scotland the casualty rate is equally grim: 247 deaths were attributed to methadone in 2011 while 206 died from heroin overdoses. Over a quarter of a million people in the UK are given daily doses of methadone by the NHS.

The Effects of Methadone

Methadone has similar effects as morphine, but in the case of methadone they last much longer. This can increase the risk of overdose leading to death.While methadone can reduce the craving for other opioid drugs the patient’s addiction can be transferred from the initial drug to methadone itself.

Oral doses of methadone are used to “stabilise” opioid addicts patients by making the withdrawal symptoms more tolerable. In addition, higher doses of methadone can block the euphoric effects of heroin and similar drugs. Under strict medical supervision, methadone can be used to reduce their use of opioids.

Methadone Withdrawal Symptoms

There are several withdrawal symptoms associated with methadone addiction. While not everyone will suffer from all of these symptoms, one or more of them is common.

Psychological and Physical Withdrawal Symptoms

Lightheadedness

Excess sweating

Depression and anxiety

Nervousness

Aches and pains

Uncontrollable shaking

Strong cravings (often leading to relapse)

Nausea, vomiting and diarrhea

Dilation of the pupils

The strongest methadone withdrawal symptoms begin to make their appearance in the first 24 -72 hours after the individual has stopped using. The withdrawal symptoms generally last a period of about a week, depending on the severity on the individual’s addiction.

Methadone Maintenance Therapy

Methadone maintenance therapy has been the most systematically studied, and most politically polarizing, of any pharmacotherapy for the treatment of drug addiction patients. The early studies showed methadone could interrupt illicit opioid use and reduce the associated costs to society, especially criminal acts carried out by heroin addicts in search of their next fix. Methadone maintenance really took off in the 1980s when it began to be prescribed in many countries to heroin addicts as part of the “Harm Reduction” measures that were being introduced to stop the spread of HIV and AIDS.

The Problem with Methadone Maintenance Therapy

Methadone maintenance therapy is supposed to be administered under strict medical supervision and with psychological (“talking”) therapies -- with the aim of reducing the consumption of any opioids. But the cost of organising outpatient therapy for so many people (there are nowhere near enough therapists to serve such a huge number of methadone addicts) means that methadone tends to be distributed by chemists without any of the accompanying therapy. The only contact the patient has with the health service is with their GP, who tend to give out prescriptions that cover long periods of time and who don't have the time or experience to offer counselling about the effects of methadone.

A study by Professor Neil McKeganey, chief researcher for Glasgow University’s Centre for Drug Misuse Research, showed that only 3.4% of drug addicts in Scotland recovered from drug addiction after using methadone.

The Side Effects of Methadone

Methadone can cause a wide range of side effects including drowsiness, weakness, nausea, insomnia, itching, lack of appetite, mood swings, skin rashes, difficulty urinating, insomnia, headaches. When taken in larger doses it can cause slow breathing, irregular heartbeat and death.

Methadone Detoxification

There is no medical “cure” for methadone addiction withdrawal symptoms -- just medical attention to make sure the individual gets through the process as safely as possible. Withdrawal symptoms are the chief reason why individuals are advised to go through the methadone addiction detox process while in professional (residential) care. The chance of relapse is simply too high if the individual attempts to go it alone.