Spice FAQ

Posted on by Melany Heger

What Is Spice Drug Used For?

Spice is a drug used to get high. It is a synthetic cannabinoid, which is a machine-made drug mimicking the chemical compounds found in marijuana [1].

In the UK, Spice is banned. Spice is one of the many drugs previously called “legal highs” [2].

Legal highs are machine-made drugs designed to work like cocaine, ecstasy and speed.

 

The way these drugs were made, manufacturers tweaked them in order to evade The Psychoactive Substances Act (PSA).

Up until 2016, legal highs were allowed for sale in the UK.

After amending the law in May 2016, Spice was made illegal.

The new law also meant “headshops” that sell drug paraphernalia are scrutinised.

 

“Not Safe for Human Consumption”

To get around the law, manufacturers of Spice and other Legal High products alter the chemical components of their merchandise.

Spice products are also presented in colourful packaging with the label “not fit for human consumption”, which seemingly warns the public of its adverse effects.

But the packaging and the warning appear to be very misleading.

 

The majority of Spice users are young people, who are led to think that the effects of Spice are similar to weed. After all, Spice could hide under the name, “Fake Weed”.

But Spice and other legal high products pose a health hazard to individuals who experiment with them.

The sad truth is there are many A&E incidents due to Spice usage. This is heart-breaking, especially for the parents and family members of young users.

 

How Addictive Is K2 Spice?

Spice tends to be as addictive as the “natural” drug it was designed to mimic, cannabis.

However, in a recent report, commissioners have been actively campaigning for Spice to be categorised as a “Class A” drug [3].

Class A drugs include heroin and cocaine, which are highly addictive and dangerous drugs.

 

Officials have also urged to government to make the use of Spice a public health issue.

The process of manufacturing Spice varies from manufacturer to manufacturer, because of this variance, how negative it affects individuals differs for each kind of product.

In the illegal market, Spice can be sold under the following labels:

  • >> Synthetic marijuana
  • >> Herbal incense
  • >> Herbal smoking blend
  • >> Mr. Happy
  • >> Mojo
  • >> Bliss
  • >> Genie
  • >> Scoobie Snax
  • >> Mamba
  • >> Fake Weed

 

Physical signs of addiction to Spice are [4].

  • >> Developing a tolerance for Spice – need more and more of the drug in order to feel high
  • >> Withdrawal symptoms when cutting down or trying to stop the usage of Spice

 

Unlike physical signs of addiction, some individuals ignore psychological dependence symptoms, labeling these behaviours as “acting out”.

As a result, psychological signs of addiction to spice sometimes overlooked.

 

These psychological symptoms, which are originally for Cannabis Use Disorder are [4].

  • >> Using more Spice than initially planned
  • >> Trying but being unable to cut down the usage of Spice
  • >> Spending way too much time obtaining and using Spice
  • >> Not enjoying activities previously enjoyed, preferring usage of Spice instead
  • >> Continued usage of Spice even if problems at work or school are caused by it
  • >> Not fulfilling financial and/or family obligations
  • >> Financial problems due to buying Spice

 

Some individuals chose to have professionally assisted detox in a drug rehab clinic in order to deal with the physical and psychological issues associated with Spice addiction.

The chance of relapse is lower when professional help is sought, improving the outlook of a person trying to recover.

 

How Does Spice Drug Work?

Spice affects the same parts of the brain cannabis does [5].

Having the same effect on the brain’s receptors as THC but in a stronger more unpredictable manner, Spice specifically works by:

  • >> elevating mood – producing feelings associated with happiness
  • >> making individuals fee relaxed
  • >> altering how individuals perceive things, which can make persons more aware or vigilant
  • >> creating a sense of detachment
  • >> affecting the part of the brain that distinguishes reality from fantasy, which can lead to having hallucinations.

 

In addition, Spice works in parts of the brain controlling a person’s:

  • >> Memory
  • >> Sexual activity
  • >> Pain management
  • >> Moods
  • >> Appetite
  • >> Attention

 

How Long Does It Take For Spice to Kick In?

By smoking Spice, the effects usually start to kick in between 5 to 30 minutes.

By swallowing spice, the effects are noticed 4−6 hours afterward [6].

 

How Long Does K2 High Last?

The high felt after taking Spice lasts several hours; with some individuals, the effects can be felt up to seven hours after using the drug [4].

Spice can stay in the body longer than a month, as it has been documented that storage is primarily through a person’s fatty tissues.

After 41 days in the body, half of the amount used is excreted (drug half-life). About half of the remaining Spice in the body would need some more time to be completely eliminated [7].

The effects of Spice can be felt for up to 24 hours after use. But most research efforts show that Spice is felt most intensely 1 to 8 hours after being smoked [7].

What Are The Side Effects Of K2 Spice?

The side effects of using spice are: [4]

  • >> vomiting (with or without blood)
  • >> nausea
  • >> hallucinations
  • >> heart palpitations
  • >> seizures
  • >> extreme anxiety
  • >> high level of irritability
  • >> violent behaviours such as destruction of property, harming other persons
  • >> suicidal thoughts

 

To understand addiction to Spice better, we need to know that individuals who use Spice are motivated by:  [7]

  • >> wanting to get “high”
  • >> avoid detection from drug testing
  • >> [previous] legality of Spice
  • >> curiosity
  • >> liking the effects
  • >> readily available in “headshops” or internet sources
  • >> for relaxation
  • >> lower cost than other mind-altering substances

In addition, some individuals are more at risk of using Spice than others [4].

 

Usually, these at-risk individuals are described as:

  • >> Previous or current users of cigarettes, marijuana, alcohol, and other addictive substances
  • >> With less than 10 years of formal education
  • >> Has a family member who has a substance abuse problem
  • >> Has a family member with depression, anxiety or bipolar mood disorder
  • >> Has a family member with mental health disorder associated with personality difficulties.
  • >> (Examples of personality problems are: borderline personality disorder, antisocial personality disorder, and narcissistic personality disorder)

Can You Die From Spice?

Individuals have been reported to die from using spice.

In 2018, Spice was on 60 deaths certificates in England and Wales [8].

There have been 27 cases of deaths due to Spice overdose between 2015 to 2016 [9].

Recently, nine minor age individuals collapsed after inhaling Spice through vaping [8].

Can K2 Cause Permanent Psychosis?

Using spice could trigger acute psychosis, not permanent psychosis [10]:

Acute psychosis lasts for a short time, progresses quickly and is obviously noticed.

Signs of acute psychosis are: [11]

  • >> Being awake, but in a “zombie-like” condition
  • >> Hallucinations -seeing, hearing, and noticing objects that are not really present; sometimes talking to persons who do not actually exist or are already deceased
  • >> Dissociation – feeling separated from one’s own body, “floating above my body”
  • >> Disorganised thinking or thoughts
  • >> Changes in mood and behaviour, especially hyperactive thoughts
  • >> Persecutory delusions “someone is out to get me”
  • >> Delusions of reference “the person in TV is talking to me”; “they are always gossiping about me”
  • >> Delusion of grandeur – feeling exceptionally wealthy, strong, powerful etc. without factual evidence
  • >> Sexual delusions – including beliefs that s/he is being sexually pursued even by persons they do know personally
  • >> Fantastic delusions –  common themes are science fiction, religion, and supernatural phenomena

 

In the US, “spiceophrenia”  was a term created by Addiction Specialists to describe how Spice-induced psychosis is similar to schizophrenia, a psychiatric disorder.

The populations most affected by Spice misuse are teenagers and young adults [11].

Research has shown that using “regular cannabis” in adolescence is likely to increase the risk of risk of psychosis in individuals [4].

It could be argued that this risk of psychosis in adult life is magnified by the usage of synthetic cannabinoids like Spice.

Aside from psychosis, individuals under the age of 21 who use cannabis and Spice are a high risk for long term cognitive impairments (brain function damage).

The damage is potentially irreversible and could mean:  [12]

  • >> problematic decision-making skills
  • >> tendency to take inappropriate risks
  • >> impulsivity
  • >> difficulty remembering information presented (working memory damage)

Does K2 Have Withdrawal Symptoms?

K2 or Spice has withdrawal symptoms. These behaviours are most severe when individuals try to quit Spice on their own (or “quitting cold turkey”) [4].

These withdrawal symptoms mean that a person trying to stop Spice use will express how awful s/he is without using Spice.

Sometimes, the person will continue using Spice “just to feel normal”.

Spice withdrawal symptoms include, but are not limited to:

  • >> diarrhoea
  • >> loss of appetite
  • >> nausea
  • >> vomiting
  • >> anxiety and restlessness
  • >> depression
  • >> chest pain
  • >> problems breathing
  • >> fast heart beat
  • >> hypertension
  • >> excessive sweating
  • >> aches and pains all over the body
  • >> having difficulty falling asleep and staying asleep
  • >> hypertension
  • >> headaches or migraines

The most intense period for Spice withdrawal is the first week [4].

After one week, symptoms usually taper off.

However, if a person has been using Spice for a prolonged period of time, the effects can last for up to a month.

There is a risk of complications when withdrawing from Spice, especially when it is done without professional help.

The safest recourse would be to use a supervised detox facility for Spice withdrawal.

References

  1. National Institute on Drug Abuse. (2018). Synthetic Cannabinoids (K2/Spice) Available at: https://www.drugabuse.gov/publications/drugfacts/synthetic-cannabinoids-k2spice
  2.  BBC. (2016, 26 May ). Legal highs ban comes into force across the UK. Available at: https://www.bbc.com/news/uk-36384729
  3. Barnes, T. (2018, 29 August). Spice should be upgraded to Class A drug, say police and crime commissioners. The Independent. Available at: https://www.independent.co.uk/news/uk/home-news/spice-class-a-drug-classification-police-commissioners-legal-highs-effects-law-britain-a8513681.html
  4. Spaderna, M., Addy, P. H. & D’Souza, D C. (2014). Spicing things up: Synthetic cannabinoids. Psychopharmacology (Berl), 228(4), 525–540.  Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799955/#R9
  5.  National Institute on Drug Abuse. (2018). Synthetic Cannabinoids (K2/Spice). Available at: https://www.drugabuse.gov/publications/drugfacts/synthetic-cannabinoids-k2spice
  6. Huestis, M. (2007). Human Cannabinoid Pharmacokinetics. Chemistry & Biodiversity, 4(8), 1770–1804.  Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689518/
  7.  Lovett, C. Wood, D. M. & Dargan, P. I. (2015). Pharmacology and Toxicology of the Synthetic Cannabinoid Receptor Agonists. Available at: https://www.srlf.org/wp-content/uploads/2018/08/1509-Reanimation-Vol24-N5-p527_541.pdf
  8.  Byrne, P. (2019, August 18). Spice crisis deepens as 9 kids collapse after taking zombie drug and deaths surge. Mirror.co.uk. Available at: https://www.mirror.co.uk/news/uk-news/spice-crisis-deepens-deaths-surge-18960424
  9. Financial Times. (2019, January 10). UK to reconsider classification of synthetic drug spice. Available at: https://www.ft.com/content/c1be11c8-d83d-11e8-a854-33d6f82e62f8
  10. Papanti et al. (2013). “Spiceophrenia”: a systematic overview of “spice”-related psychopathological issues and a case report. Human Psychophramacology, 28(4), 379-89. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23881886
  11. Kulhalli, V. Isaac, M. & Murthy, P. (2007). Cannabis-related psychosis: Presentation and effect of abstinence. Indian Journal of Psychiatry, 49(4), 256–261. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910348/
  12. Patel, J. & Marwaha, R. (2019).Cannabis Use Disorder. Available at: https://www.ncbi.nlm.nih.gov/books/NBK538131/

Prescription Medicines FAQ

Posted on by Melany Heger

What Is The Difference Between A Prescription Drug And An OTC Drug?

Over-the-counter (OTC) drugs can be bought at a pharmacy or supermarket without a prescription. Prescription drugs are for conditions that are more serious, or need precise dosage and intake instructions given by a health care professional.

In the UK, the NHS has a list of conditions that do not need prescriptions. To obtain these medications, one can simply approach the prescribing professional at a local pharmacy [1].

The NHS is limiting the unnecessary amount of prescriptions given due to budget concerns.

 

Common conditions that do not need prescriptions are:

  • >> Sore throat
  • >> Fever and flu
  • >> Burns (minor)
  • >> Indigestion or heartburn
  • >> Hay fever
  • >> Diarrhoea
  • >> Constipation
  • >> Dry eyes
  • >> Travel sickness

 

Some individuals get addicted to OTC drugs. The most abused OTC drugs are those containing codeine [2] and Dextromethorphan (DXM) [3].

If taken continuously for three days, drugs containing codeine can be addictive [2].

If there are concerns regarding OTC addiction, a source of help would be an addiction clinic such as Abbeycare Scotland.

 

Is it Illegal To Misuse Prescription Drugs?

Possessing prescribed drugs without a prescription is illegal in the UK.

Using prescription medicines in a non-medical manner is also illegal in the UK.

If a person is given prescriptions for medicines, he or she can only use these medicines as advised by a health care professional.

Penalty for possession of these drugs for non-medical use is up to 5 years in prison with no limit on the amount of fine imposed [4].

 

The most misused prescription drugs are:

  • >> Opioids/narcotics/painkillers such as Dilaudid, Vicodin, Percodan, and OxyContin
  • >> Benzodiazepines such as Valium and Xanax
  • >> Stimulants such as Ritalin and Adderall
  • >> Prescription grade Codeine

 

Prescription misuse can lead to addiction to prescription drugs. Some cases can also lead to overdose with lethal consequences [5].

 

How Long Does It Take To Flush Medication Out Of Your System?

The time taken depends on what kind of drug is taken, how much of it is taken and how long an individual has been taking it.

For psychoactive drugs (drugs that can change moods and consciousness), the following are to be considered:

  • >> For benzodiazepines such as diazepam (Valium or Xanax), the effects of the medicine wane within 2 to 4 days [6].
  • >> For Rohypnol® (Flunitrazepam) – half of the effect is gone within 18-26 hours, but it is not totally eliminated in the system a few more hours [7]
  • >> For Adderall® Concerta®, Ritalin®, which are prescribed stimulants, the effects are gone approximately 10 hours after swallowing (for adult individuals) [8].

 

With regards to medication prescribed to treat other diseases like high-blood pressure, high-cholesterol, diabetes, and acid reflux, consult other authoritative sources.

To know the specific time needed to flush these medicines out, it could be helpful to be familiar with the concept of “half-life” in medicine.

When a medication hits its “half-life”, it means that from this time on, it has half the power it has from the point it was most effective. After half-life, the effect of the drug gradually decreases [9].

Knowing the half-life of a particular medicine can help predict the approximate amount of time the total effect of the medicine will wear off.

 

Factors that affect how long a drug stays in the system are [10]:

  • >> The type of drug used – some medications have a longer half-life than others, while some stay in the system for a long time because they are metabolised slowly by the body
  • >> The amount used – consider the dosage taken
  • >> How long an individual has been taking the drug
  • >> Body weight – generally speaking, if a person has a lot of body fat, s/he could be less affected by the drug taken
  • >> Age – younger people and the elderly generally are generally more affected by strong medication
  • >> Being hydrated or dehydrated – being well hydrated makes drug elimination somewhat faster
  • >> Body’s metabolism – an important factor as it determines how long the liver and kidneys filter the chemicals out of the bloodstream

 

Because withdrawal from prescription drugs could be risky, many individuals prefer to consult an addiction clinic whilst undergoing the process.

 

Tips on flushing out medicine from the system:

  • >> Drink up to 64 oz. of water or clear liquids a day to help your liver and kidney filter the drugs
  • >> Engage in aerobic exercise to promote sweating
  • >> Eat foods rich in fibre such as porridge oats, brown rice, and wheat bread
  • >> Try green juices, green tea, and lemon water, all of which have natural detoxifying effects on the body

 

How Long Do Detox Symptoms Last?

The usual amount of time for detox symptoms to disappear is within three to ten days. This amount of time generally applies to opiate drugs [11].

Drug detox from prescription medicines depends on several factors, but in general, the timeline would be:

Day 1 to Day 3

Initial symptoms include flu-like symptoms, insomnia, and anxiety

Day 4 to 7

This is the time when detox symptoms peak. Expect:

  • >> Cravings for prescription drugs
  • >> Irritable mood
  • >> Persistent insomnia
  • >> Fever and chills
  • >> Abdominal cramps
  • >> Vomiting/nausea

Day 7 to 10

A management team should be able to assist an individual to transition from drug withdrawal to the therapeutic stage on intervention at this point.

Some facilities offer medication such as buprenorphine, methadone or naloxone to help relieve withdrawal symptoms.

 

Some individuals ask why buprenorphine, methadone or naloxone is used to treat opioid addiction, since these medications are in the same family as the prescription medicines they are addicted to.

These medications used in medical detox work because like the addictive substance, they bind with opioid receptors in the brain. The brain’s receptors are occupied with the substitute drug, preventing further ties with the unwanted drug.

 

When an individual takes buprenorphine, methadone or naloxone under supervised detox, he or s/he does not feel euphoria, only relief from prescription medication withdrawal.

 

Giving the substitute drug is a form of gradual weaning off prescription medication. The end goal is abstinence.

Usually, a rehab clinic will work with the patient to make a personalised treatment plan to treat prescription drug addiction [11].

 

Can you detox while on medication?

Individuals can safely take medication while on drug detox provided that they are cared for in a facility with good standards. In the UK, certification from CQC is considered the industry standard [12].

 

Professionals well-versed in professionally assisted detox will routinely screen individuals for the usage of other medications.

 

Drug interactions happen, and without proper guidance, the results could pose serious health risks.

 

There are many conditions that require the usage of medication even whilst in detox. These conditions include:

  • >> HIV
  • >> Liver disease
  • >> Alcohol dependence
  • >> Hepatitis
  • >> Staph infections
  • >> Tuberculosis

How Is Prescription Drug Misuse Prevented?

To prevent prescription drug misuse, open communication with a health care professional is important. The following information should be relayed:

  • >> Medical history – past diseases, current complaints
  • >> Current diseases
  • >> Other medications taken, even vitamin supplements
  • >> Eating and sleeping habits
  • >> Psychological concerns about taking medicines such as need for treatment, fears of drug dependency, concerns about side effects, etc.
  • >> Scheduling problems about taking medication

 

Note that some people are more at risk of prescription drug misuse. If the following are present, it could help to be extra aware:

  • >> Past or present addictions to other substances such as alcohol and cigarettes
  • >> Family history of alcoholism or drug use
  • >> Psychological problems such as anxiety and depression
  • >> Being in environments where drug use is an accepted norm
  • >> Easy access to prescription drugs

 

If one is parent, preventing the misuse of prescription drugs can be done by:

  • >> Being vigilant with the amount and type of prescription medicine available at home (know how many there are exactly).
  • >> Some teenagers get access to prescription medications because the medicines were prescribed to their parents. Safeguard these types of medication properly.
  • >> Dispose of unused medications in the right place. Most pharmacies are obliged to take back unwanted medicines from patients for disposal.
  • >> Frame talks about drugs as a health issue to remove the shame and stigma.
  • >> Talk about real-life examples of drug problems in a neutral tone. Instead of stigmatising an individual with a drug use problem, adopt a problem-solving approach or a humane approach.

 

References

  1.  National Health Service. (2018). Why can’t I get a prescription for an over-the-counter medicine? Available at: https://www.nhs.uk/common-health-questions/medicines/why-cant-i-get-prescription-over-counter-medicine/
  2.  Gil, N. (2018). Young, Female & Addicted To Legal Pills. Available at: https://www.refinery29.com/en-gb/2018/02/190957/young-women-non-prescription-drug-addiction
  3. National Institute on Drug Abuse. (2019). Commonly Abused Drugs Chart. Available at: https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts
  4. United Kingdom Government. (2013). Drugs Penalties. Available at: https://www.gov.uk/penalties-drug-possession-dealing
  5. National Institute on Drug Abuse. (2019). Misuse of Prescription Drugs. Available at: https://www.drugabuse.gov/publications/misuse-prescription-drugs/overview
  6. Federal Drug Administration. (2011). Valium. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/013263s083lbl.pdf
  7. Drugbank.ca (2007). Rohypnol. Available at: https://www.drugbank.ca/drugs/DB01544
  8. Medical News Today. (2018). Adderal (amphetamine/dextroamphetamine). Available at: https://www.medicalnewstoday.com/articles/326219.php
  9. Smith, Y. (2016). What is the Half-Life of a Drug? Available at: https://www.news-medical.net/health/What-is-the-Half-Life-of-a-Drug.aspx
  10. Drugs.com. (2019). How long do drugs stay in your system? Available at: https://www.drugs.com/medical-answers/how-long-do-drugs-stay-in-your-system-55200/
  11. Gupta, M. & Attia, F. (2019). Withdrawal Syndromes. National Center for Biotechnology Information. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459239/
  12. Care Quality Commission. (2019). Treatment and Rehabilitation. Available at: https://www.cqc.org.uk/category/service-types/treatment-and-rehabilitation-substance-misuse

Methadone FAQ

Posted on by Melany Heger

What Are The Effects Of Methadone?

Taking methadone could delay and/or eliminate heroin withdrawal symptoms [1].

Methadone is a synthetic opioid like heroin, tramadol and fentanyl. Primarily, it causes:

  • >> Pain relief
  • >> Sleepiness or drowsiness
  • >> Sedation

 

When an opioid dependent individual takes methadone, it does not cause feelings of euphoria. Rather, withdrawal symptoms and opioid cravings are relieved.

Withdrawal symptoms curbed or eliminated by taking methadone include insomnia, carvings for heroin, fever and moodiness.

Taking methadone can also lead to some side effects. These are [2]:

  • >> Some difficulty breathing or shallow breathing
  • >> Lightheadedness or feeling faint
  • >> Allergic skin reactions
  • >> Chest pains
  • >> Fast heartbeat
  • >> Some may feel confused or disoriented

 

Side effects should be reported immediately in case they are signs of serious trouble.

Total abstinence from heroin is challenging. As this is the case, some individuals rely on methadone to stabilise before undergoing a rehab programme like that at Abbeycare Scotland.

 

How Often Can You Take Methadone?

Methadone is usually taken only once a day.

The typical dosage for methadone is 20 to 30 mg.

This dose is often enough to make withdrawal symptoms tolerable. An additional 5 to 10 milligrams is given if the first dose is not working.

A total daily dose usually does not exceed 40 mg [3].

 

Methadone works by stopping cravings for heroin and other opioids such as oxycodone and fentanyl.

In the UK, methadone is used in Methadone Maintenance Therapy (MMT) by the NHS.

 

Some addiction clinics also use methadone as part of its in-patient programme.

Methadone helps with opioid cravings by reducing the withdrawal symptoms of heroin, morphine and other prescription drugs.

 

Examples of these withdrawal symptoms are:

  • >> Irritability and moodiness
  • >> Anxious feelings
  • >> Feeling tired or fatigued
  • >> Depression
  • >> An increased heart rate
  • >> Muscle pains or cramps
  • >> Stomach pains
  • >> Nausea
  • >> Fever and chills
  • >> Vomiting
  • >> Diarrhea
  • >> Tremors
  • >> Muscle spasms

 

Methadone is dispensed by the NHS and other private facilities because there is a risk of diverting the drug for illegal use.

A single dose usually lasts for 24 to 36 hours. NHS clinic services are free, and will often provide other helpful services for people who seek to limit or stop drug use.

 

How Long Does It Take For Liquid Methadone To Absorb?

After swallowing liquid methadone, it can usually be absorbed by the body in as little as one hour.

But due to differing metabolism and other factors, some individuals could respond differently to the drug, taking up to 7 hours for full absorption [4].

Because methadone is not immediately absorbed by the body, some individuals may not feel complete relief from withdrawal symptoms a short time after they take it.

 

If methadone is being taken as part of a drug rehab programme, there is a need to be in touch with addiction experts during the process.

Drug detox using methadone has caused deaths because of complications with existing heart problems [5].

 

The WHO lists methadone as one of its essential medications because of its proven efficacy. Specifically, methadone is used two ways:

  1. Methadone Management Therapy (MMT)
  2. Methadone-assisted detoxification

 

For MMT, authorities view opioid addiction as a lifetime disease.

Using this way of thinking, methadone is used as a maintenance drug very much like how individuals with diabetes use insulin—as a drug that they have to take to keep functioning properly [6].

 

In the UK, MMT is used by the NHS. It is believed that long-term opioid abuse causes a form of damage in the central nervous system that makes individuals who want to stop using it feel sick.

 

By using methadone, individuals who quit opiates such as heroin and fentanyl tend to be able to cope better.

The second way of using methadone typically treating it as part of medically assisted detox, where methadone is the only the first part of a structured rehab programme.

 

After detox, individuals in a rehab programme usually attend therapy sessions, then rehab aftercare.

Some individuals misunderstand the use of methadone in MMT as “substituting one drug for another”.

 

There can be shame and stigma if an individual seeks methadone treatment because of this way of thinking.

Current research [6] proves that methadone could be effective in helping individuals stop using heroin and other illegal drugs.

 

In fact, MMT may prevent the spread of HIV through lessening the need for needle sharing.

MMT tend to curb criminal behaviour associated with drug use. The WHO has listed methadone as one of its essential medicines [6].

 

Is Methadone Free To Addicts?

In the UK, the NHS provide a daily dose of methadone to individuals who utilise either of the two approaches utilised to stop heroin misuse [7].

These approaches are Methadone Maintenance Therapy (MMT) and detox with the assistance of methadone.

 

Because heroin dependence is a condition where individuals tend to relapse, abstinence could be hard to achieve for many.

The NHS decided to prescribe methadone and buprenorphine as a form of substitution treatment.

It is not about substituting one drug for another because although methadone can be addictive, substitution treatment can help stabilise individuals to be able to undergo rehab and talk therapies [8].

 

Substitution treatment also aims to offer a legal and safe heroin or opiate substitute so that addicted individuals can reduce risky behaviours.

 

How Long Does It Take To Stabilise On Methadone?

It takes about two weeks to stabilise an individual using methadone in Methadone Management Therapy [9].

There are no set rules on the duration of Methadone Management Therapy (MMT). But the longer an individual stays on the programme, the better the chances are for behavioural change.

 

In the UK, the NHS strongly believes that MMT is the solution to resolving the problem of heroin/morphine/fentanyl abuse. Aside from MMT, the other approach is to use methadone as part of drug detox [7].

Although long-term abstinence from illegal opioids is the end goal of methadone treatment approaches, some individuals are not able to achieve this goal.

This is because methadone is addictive, just like other opioids. Some individuals on MMT have gotten addicted to methadone and require a detox from methadone in order continue living a sober life [2].

 

The NHS methadone approaches work on the premise that there are support services after methadone administration—it appears that methadone alone cannot solve the problem.

The quality of the NHS treatment programme, including the capacities of the staff, the services of the local drug services, and the treatment methods used are important in determining the success of methadone treatment [1].

However, because waiting for approval by NHS for methadone detox service takes time, some individuals chose private rehab instead. In addition, methadone addiction could be a tricky issue to talk about with a professional who works for the NHS.

 

Detoxing from methadone addiction is a serious concern, and in a private in-patient rehab setting, there could be a greater chance of recovery than in public programmes because private rehab centre services are more comprehensive and timely [10].

Most of all, the admission process in most private rehabs take only a matter of days.

 

Likewise, unlike NHS services, private clinics offer:

  • >> A lower staff-to-patient ratio
  • >> Better amenities
  • >> Personalised treatment
  • >> Continuation in care
  • >> Rehab aftercare

 

There is another drawback to the methadone treatment offered to the public: some individuals who use illegal opioids do not want methadone treatment.

Some may have tried methadone treatment, disliked it, or found it ineffective.

 

Some individuals are unable to manage on the prescribed dose and some continue to use illegal opioids to ‘top-up’ their prescription.

And lastly, some individuals do not like to give up injecting drugs. Apparently, the ritual of injecting is an experience that sometimes becomes a focus for addiction [1].

 

References

  1. Stimson, G. V. and Metrebian, N. (2003). Prescribing heroin: What is the evidence? Joseph Rowntree Foundation.  Available at: https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/1859350836.pdf
  2. Substance Abuse and Mental Health Services Administration. (2015). Methadone. Available at: https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone
  3. National Alliance on Mental Illness. (2016). Methadone® Available at: https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications/Types-of-Medication/Methadone%C2%AE
  4. US Food and Drug Administration. (2015). Methadone Hydrochloride (marketed as Dolophine) Information. Available at: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/methadone-hydrochloride-marketed-dolophine-information
  5. Harvard Medical School. (2019). Treating opiate addiction, part I: Detoxification and maintenance. Available at: https://www.health.harvard.edu/mind-and-mood/treating-opiate-addiction-part-i-detoxification-and-maintenance
  6. Australian Government Department of Health. (2013). Four principles of methadone maintenance therapy. Available at: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-methrev-toc~drugtreat-pubs-methrev-4
  7. National Health Service. (2017). Heroin addiction: get help. Available at: https://www.nhs.uk/live-well/healthy-body/heroin-get-help/
  8. National Institute for Health and Care Excellence. (2007). Methadone and buprenorphine for the management of opioid dependence. Technology appraisal guidance. Available at: https://www.nice.org.uk/guidance/ta114
  9. Australian Government Department of Health. (2015). Induction to methadone treatment. Available at: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-meth-toc~drugtreat-pubs-meth-s3~drugtreat-pubs-meth-s3-3.1
  10. National Institute on Drug Abuse. (2013). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Available at: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment