Frequently Asked Questions:

• What is Opioid Addiction?
• What is methadone?
• Does Methadone just substitute one addictive drug (such as, heroin or prescription pain medications) with another (methadone)?
• What are the benefits of Methadone Maintenance Treatment?
• How long will I need to be on methadone?
• What dose of methadone might I need?

What is Opioid Addiction?

The disease of addiction has been defined in many ways by the use of terms, slogans and misperceptions.  Opioid addiction is consistent with that of other addictive disorders in terms of its definition:  a maladaptive pattern of pathological use marked by a physiological and psychological inability to quit or control use and as a result the individual’s social, emotional, behavioral, interpersonal relationships, and/or employment have been compromised. 

The onset of addiction can be rapid and severe, depending upon the amount and frequency of use.  Individuals who are opioid dependent will “crave” more of the drug and will experience symptoms of withdrawal if they do not receive their regular “fix” or dose.  Opioids stimulate the “pleasure center” by releasing an excess of dopamine in the body.  Once the brain’s chemistry is altered, it causes users to need an opioid continuously.

As a result of the chemical dependency, individuals who are addicted to prescription pain medications/opioids or heroin can develop an expensive habit that often times results in spending excessive amounts of money on a daily basis.  Most individuals are unable to keep up the expense of supporting their dependency.  Consequently, individuals typically resort to unhealthy lifestyle choices in an effort to support their addiction.

What is methadone?

Methadone is a synthetic agent that works by "occupying" the brain receptor sites affected by heroin and other opioids, including prescription pain medications.

Methadone maintenance treatment, a program in which addicted individuals receive daily doses of methadone, was initially developed during the 1960s as part of a broad, multi-component treatment program.

Does methadone simply substitute one addictive drug (such as heroin or prescription pain medications) with another (methadone)?

Methadone Maintenance Treatment (MMT) is a form of drug replacement therapy, using a medication (methadone) to overcome the compulsive need for other opioid drugs (such as heroin or other abused opioids). While the person is, indeed, physiologically dependent on methadone, the pharmacologic actions of methadone are quite different from addictive opioid agents – methadone is not a mere substitute.

An analogy is how prescribed insulin is used as replacement or “substitution” therapy in an individual with diabetes. The person remains “dependent” on insulin; however, a chronic disease condition is kept under control and effectively managed by the administration of a licensed, prescribed medication.

With adequate methadone, addictive behaviors cease. Persons on methadone may not be “drug-free”; however, they are being helped to overcome the debilitating influence of illicit opioids and lead to healthier, more 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 drug, avoidance of obligations in pursuit of drug, and use despite personal harm – are eliminated during MMT.

What are the benefits of Methadone Maintenance Treatment (MMT)?

The benefits of methadone as a component of a comprehensive treatment program for opioid addiction have been validated by dozens of clinical studies and confirmed by numerous authorities in the addiction treatment field. These include:

1. A stable maintenance dose of methadone does not make the patient feel either “high” or drowsy (somnolent), so the person can socialize, work or go to school, and generally carry on a normal life.
2. In most cases methadone can be taken orally once daily or in split doses, helping to limit exposure to injection-borne diseases like hepatitis and HIV.
3. At adequate doses, methadone’s gradual, long-lasting effects eliminate opioid withdrawal and craving, unlike the rapid ups and downs of short-acting opioids which lead to strong desires for more drugs.
4. Daily drug-seeking becomes unnecessary and the blocking effect of methadone will make other opioids undesirable.
5. Once a stable dose is reached, it will not take increasingly more of the medication to achieve the same results.
6. When properly prescribed by an experienced practitioner, methadone is safe and effective with minimal side effects.
7. The main goals of methadone maintenance treatment are:
   • Eliminate withdrawal
   • Eliminate cravings
   • Block the effects of other opioids (heroin or prescription pain medication)

How long will I need to be on methadone?

How long any one person needs to be in Methadone Maintenance Treatment differs from one person to the next, however time in treatment is a critical factor for ongoing addiction recovery. Typically, methadone-maintained patients must attend a treatment program each day to receive their oral dose of methadone; however, stable and compliant patients are usually allowed to eventually take home a number of doses, thus reducing their clinic visits. Appropriate psychosocial therapy and other support services are integral components of ongoing MMT.

Credible and authoritative sources have concluded that patients treated for fewer than 3 months in MMT 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.

What dose of methadone might I need?

What dose you need is completely individualized. What dose works for one person might not work for you. Since each person has his/her own individual metabolism your dose will be carefully adjusted by a medical practitioner to meet your needs.