FAQ and Resources
1. What are opioids?
Opioids are a class of drugs that include both natural and synthetic substances. The natural opioids (referred to as opiates) include opium and morphine. Heroin, the most abused opioid, is synthesized from opium. Other synthetics (only made in laboratories) and commonly prescribed for pain, such as cough suppressants, or as anti-diarrhea agents, include codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), meperidine (Demerol), fentanyl (Sublimaze), hydromorphone (Dilaudid), and propoxyphene (Darvon).
2. What does it mean to be addicted?
Dependence on opioids involves significant physiological and psychological changes, which make it extremely difficult for an individual to stop using the opioids. Recurrent use of opioids causes actual changes in how the brain functions. An individual who is addicted to opioids cannot simply just stop using, despite significant negative consequences related to their use. Marital difficulties, including divorce, unemployment, and drug-related legal problems are often associated with opioid dependence. People dependent on opioids often plan their day around obtaining and using opioids.
3. What is methadone?
Methadone is a psycho-active drug, meaning that it affects the mind or behavior. It belongs to the class of opioid drugs that share some of the analgesic properties, and mimic the action of some of the body's naturally occurring chemicals called peptides, such as endorphins and enkephalines. Methadone is used as a legally prescribed drug to control withdrawal symptoms in people undergoing treatment for opiate addiction.
4. Why would I take methadone instead of pills or heroin?
Because it is legal and it works. Methadone is a liquid, pharmacologically pure synthetic agent that works by “occupying” the brain receptor sites, affected by heroin and other opiates. Methadone:
- Blocks the euphoric and sedating effects of opiates;
- Relives the craving for opiates that is a major factor in relapse;
- Relieves symptoms associated with withdrawal from opiates;
- Does not cause euphoria or intoxications itself (with stable dosing), thus allowing a person to work and participate normally in society;
- Has a 24-36 hour affect before withdrawal symptoms begin
With adequate methadone, addictive behaviors cease. Persons on methadone are being helped to overcome the debilitating influence of illicit opioids and lead more healthy, normal lives in recovery. It also is important to note that the behavioral hallmarks of true addiction – such as unsuccessful efforts to cut down on drug abuse, the endless search for more drugs, avoidance of obligations in pursuit of drugs, and use, despite personal harm – are eliminated during Methadone Maintenance Treatment.
5. How long does a patient need to stay in Methadone Maintenance Treatment?
Time in treatment is a critical factor for ongoing addiction recovery. Credible and authoritative sources have concluded that patients treated for fewer than 3 months in Methadone Maintenance Treatment generally show little or no improvement. Studies have routinely demonstrated reductions in illicit opioid use of up to 80% or more after several months, with the greatest reductions for patients who remain in treatment more than a year.
6. How do you know how much methadone I will need to stabilize?
The first thing that every patient needs to know and understand about treating ANY disease, is that each patient is an individual. Your dose is determined by YOU and YOUR body, not your friend or your spouse or the guy sitting next to you. In order for the methadone to work you need to be on the right dose. How that dose is determined is how YOU respond to the medication and finding that “magic” place where we are able to medically control your withdrawal symptoms and your cravings.
7. What are the side effects of methadone?
When methadone is taken under medical supervision, long-term maintenance causes no adverse effects to the heart, lungs, liver, kidneys, bones, blood, brain, or other vital body organs. Methadone produces no serious side effects, although some patients experience minor symptoms such as constipation, water retention, drowsiness, skin rash, excessive sweating, and changes in libido. Once methadone dosage is adjusted and stabilized or tolerance increases, these symptoms usually subside.
8. How can I get off of methadone?
Since methadone creates a physical dependency on the drug, stopping it abruptly would lead to intense withdrawal symptoms and drug craving. The accepted way of discontinuing methadone is called medically supervised withdrawal (MSW). Its main objective is to relieve or prevent uncomfortable withdrawal symptoms and craving while the patient gradually achieves an opioid-free state. During MSW, the daily dose of methadone is decreased by small amounts over time, taking many weeks or months.
Websites that offer scientific conclusions and information regarding methadone and the treatment of opioid addiction.
Executive Office of the President - Office of the National Drug Control Policy
Substance Abuse Mental Health Services Administration
Journal of the American Medical Association
Center for Disease Control (CDC)
National Institute on Drug Abuse
The mission of the National Institute on Drug Abuse (NIDA) is to lead the Nation bringing the power of science to bear on drug abuse and addiction.
In November 1997, the National Institutes of Health (NIH) convened a Consensus Panel on Effective Medical Treatment of Heroin Addiction. The panel of national experts concluded that opiate drug addictions are diseases of the brain and medical disorders that indeed can be treated effectively. The panel strongly recommended (1) broader access to methadone maintenance treatment programs for people who are addicted to heroin or other opiate drugs; and (2) the Federal and State regulations and other barriers impeding this access be eliminated. This panel also stressed the importance of providing substance abuse counseling, psychosocial therapies, and other supportive services to enhance retention and successful outcomes in methadone maintenance treatment programs. The panel’s full consensus statement is available by visiting the NIH Consensus Development Program Web site at consensus.nih.gov.