What Is Methadone?
Methadone is a synthetic opiate drug, working on the opioid receptors in the brain, to produce a feeling of euphoria. It’s most commonly prescribed in pain management, or as a substitute medication for individuals addicted to (e.g.) heroin, and wishing to recover.
Methadone is extremely addictive, some users say even more so than heroin itself, and it has a half life of anywhere from 8-60 hours typically.
Methadone is a controlled medication, and often, individuals prescribed methadone will be asked to consume it under pharmacist supervision.
Why Is Methadone So Addictive?
From a biochemistry perspective, Methadone is a full mu opioid receptor site agonist. This means, the chemical occupies all of the available opiate receptors available, until saturation. This has the effect of a greater opioid feeling of euphoria associated with the drug, than e.g. Buprenorphine, which is a partial agonist, occupying receptor sites only partially.
In non-essential use, i.e. use of methadone where no pain exists, addiction can embed itself quickly.
Receptor areas in the brain quickly become habituated, meaning, it takes increasing amounts of the drug to produce the same euphoric effects.
Repeated use at this level, will usually lead to physical dependence on the drug at this stage, with users suffering withdrawal including shaking, breathing difficulties, and heart problems. Emotional withdrawal symptoms can include depression, disorientation, night terrors, and continued low mood long after withdrawing from the physical drug.
Increasing Methadone Prescriptions Over Time
For individuals starting out on Methadone, they’ll often be prescribed 10-30mls per day by an Addiction Doctor. With fewer treatment options in community rehabs, in many cases the prescription for methadone is simply increased over time, e.g. some users moving from 30ml daily to 100ml+, with few other treatment possibilities available.
At this level, in some individuals, motor functions can begin to become impaired, symptoms include slurring of speech, restricted or exaggerated physical gestures, shaking, etc.
Methadone – The Numbers
In Scotland in 2014, nearly half a million prescriptions of methadone were dispensed by pharmacists.
In the US, overdoses on methadone kill around 5000 people annually, according to the Centers for Disease Control and Prevention (CDC).
Methadone is used as a substitute medication for many opiate addictions, not just heroin. This could include, e.g. those who have undergone surgery, received powerful amounts of morphine, and have then become addicted to opiates following discharge.
If the individual becomes physically addicted, opiate use will continue, long after the physical injury, or surgery, has healed.
At Abbeycare we’ve helped hundreds of clients with methadone detox, including those (e.g.) suffering physical injury from car accidents, surgery problems, unhealed wounds, etc, which have all led to opiate, and ultimately, methadone addiction.
Whilst it is widely prescribed within the NHS for opiate misuse, withdrawing from Methadone usually carries greater withdrawal symptoms, than from an alternate opiate substitute such as Burenorphine or Suboxone.
In withdrawal, the body must re-calibrate, and once again get used to having no methadone in the system, occupying those same receptor sites in the brain, and creating euphoric feelings.
Removing methadone from the system however carries risks.
Upon ceasing methadone intake, most individuals will begin to feel symptoms after 24 hours. Symptoms normally peak after 3-4 days, and can include:
– Muscular aches and pains
– Agitation, anxiety, irritability, depression
– Heart Arrythmia
– Dilated pupils, disorientation
– Motor symptoms such as twitching or shaking involuntarily
– Fatigue, exhaustion
Without medication, withdrawal symptoms can be lengthy, and will correlate usually to the amount of intake, and duration over which this has occurred.
Detoxing from methadone alone, without medical supervision, is not recommended.
Even under controlled circumstances, in a professional setting, withdrawal symptoms must be closely monitored, before administering any detox medication, as applying medication too early can result in precipitated withdrawal, with symptoms markedly worse than normal withdrawal. Precipitated withdrawal can induce protracted symptoms, especially the emotional symptoms of withdrawal such as depression, anxiety, agitation, and the psychological elements of craving.
Risk Of Relapse Following Withdrawal
Risk of relapse, risks in event of relapse following treatment, importance of rehab and head work, especially in higher doses, difficult to detox from in the community
Following opiate detox some will opt for an opiate antagonist medication, in addition to other aftercare options.
Naltrexone is a drug which works as an antagonist – it occupies the same opiate receptor sites, but does not have the chemical effects of an agonist drug such as methadone.
By occupying these same places in the brain where methadone or heroin would usually activate feelings of euphoria, Naltrexone works to dis-associate the euphoric feelings of opiate use, from their intake. i.e. it works as a deterrent medication – those using heroin or methadone whilst taking an antagonist medication will usually suffer symptoms such as vomiting, diarrhoea, etc, and certainly won’t experience the feeling of euphoria brought by the opiate drug alone.
Antagonist drugs alone are usually not recommended as the only means of aftercare, or in isolation from appropriate therapeutic intervention during treatment, as below.
Low Dose .v. High Dose
Individuals prescribed methadone in the community will typically have their prescriptions increased over time, due to the habituation effects outlined above.
Generally, anything over 30mls is considered within the health care system to be a “high dose” and will require specialist help under withdrawal, or detox, when appropriate.
Methadone Detox & Rehab
Few detox options for methadone exist in community rehabilitation settings, normally.
As methadone withdrawal can be uncomfortable as well as dangerous, seeking private methadone detox and rehabilitation is a positive option, cost permitting.
Due to our distinct market position, Abbeycare Scotland offer a unique methadone detox program, unavailable elsewhere.
Many clinics and detox providers use Clonidine or other symptom management medications only. Others use methadone itself to taper detox very slowly over time.
However, our past clients have found neither of these are particularly effective or comfortable for the individual.
Our specialist Suboxone detox allows a tapered withdrawal from methadone, in a safe, supervised, clinic environment, and is fully compatible with a range of aftercare options and therapeutic follow up support.
Many client experience Suboxone as a more comfortable alternative to detoxing from methadone.
This treatment allows us to detox even from high doses of methadone (>30mg daily). Although variable, this specialist detox typically takes a minimum of 14 days.
Working with local specialists, our protocol combines buprenorphine and naloxone to provide:
- Effective, comfortable detox from methadone – even at doses of 30mg daily or greater
- Reduced side effects and cravings following methadone withdrawal
- A custom/specialist detox program with lower risk of complications, as compared to other programs
Although much depends on historical usage levels, severity of dependence, etc, high levels of methadone use, even greater than 30mg daily, are no longer a barrier to full and effective detox.
Studies suggest that this form of detox from methadone can be effective in:
- Reducing methadone withdrawal symptoms
- Improving commitment to the detox process
- Increasing detox completion rates
Your methadone detox program is custom prepared, and especially tailored to your personal needs.
Our methadone protocol is usually administered in oral tablet form. Much like standard prescriptive detox, methadone detox is prescribed in a tapered dose, personalised specifically to your needs. Any final doses of methadone before detox begins are managed carefully by our doctor to ensure maximum safety and comfort during the process.
Therapeutic Work & Aftercare
There are significant safety issues for those detoxing from methadone, especially higher doses, in a short period of time.
Those who are newly detoxed from any opiate misuse, run greater risks of overdosing, should they unexpectedly relapse when returning to the community.
For this reason, it is essential that those undertaking Methadone detox commit to undertaking the appropriate therapeutic work and aftercare planning required, to maintain abstinence in the long term.
This means, looking at the issues underlying the addiction in the first place. It means understanding yourself, the reasons you became addicted in the first place, and a thorough evaluation of triggers, conditionings, and underlying beliefs associated with substance misuse.
We’ll work with you, to plan appropriate aftercare.
This means, matching your needs, regarding all aspects of your life currently, including your addiction, to appropriate supports that you’ll have, after treatment.
This ensures, that no matter what stressor arises in your life, you have support to deal with it.
For some, detoxing and subsequent rehab for methadone, will result in a changed social circle, renewed values in life, a change in living situation, employment, or other life corner-stone.
However, this fundamental life-work is required, to overcome methadone addiction for good.
Clinic Treatment For Methadone
During your stay, after detox has begun, you’ll be expected to take part in the day to day agenda in the clinic, in every aspect.
This includes attending therapy sessions, goal setting, motivational work, 12 step work, physical fitness, holistic care.
Can this process be used to detoxify from heroin use?
Yes, this method may be suitable for some as a detox from heroin, depending on your personal circumstances,
usage history, etc. These can be assessed when you contact us.
I’m on high dose methadone, is this suitable for me?
Yes. This method of detox is suitable even for those on doses of methadone greater than 30mg/daily.
Is this a quick fix?
No. This detox protocol allows detoxification from high doses of methadone, however this is not a quick fix and does not address the underlying drivers of addiction, unless you actively participate in our therapeutic program.
Can you detox me from methadone at home?
No. Due to the safety issues and medical supervision required, only a residential stay in our clinic is appropriate.
How long will detox take?
The duration of detox varies greatly, and depends on multiple factors, including the severity and duration of methadone usage, your physical and emotional health, and other circumstances. As a general guide, you should expect this form of detox to last at least 14 days or more. As above, we recommend a stay duration of 28 days to allow ample time to undertake the therapeutic program elements necessary for long term abstinence.
Upon admission our doctor carries out a full assessment:
- Physical health examination and history checks
- Mental health and wellbeing
- Your usage history, current levels of intoxication, duration and dosages used historically
…to provide a personalised detoxification fitted to your needs precisely.
To begin detox from methadone get in touch with Abbeycare now:
Need help? : 01603 513 091