The Centers for Disease Control and Prevention estimates that 980,000 individuals in the U.S. are addicted to opiates such as heroin and narcotic pain killers. The cost of untreated opiate addiction exceeds $20 billion a year. A medication called methadone is an effective treatment for people struggling with opiate addiction. German scientists synthesized methadone in 1947 and it was used as a pain medication; in the 1950s, however, doctors began using methadone for opiate addiction.
Methadone
Methadone is a synthetic opiate antagonist medication used to treat withdrawal symptoms in people addicted to opiates such as heroin and narcotic pain killers. When used appropriately and in proper doses, methadone does not produce feelings of euphoria or sedation and does not affect mental capacity or motor skills. A person must go to a methadone clinic in order to receive this medication. Most methadone clinics have early morning clinic hours where clients come for a once-daily dosing.
Regulation
The Office of National Drug Control Policy states that methadone maintenance programs are heavily regulated and monitored at both the state and federal level. Regulations restrict the use and availability of methadone. In May 2001, methadone ceased to be regulated by the the U.S. Food and Drug Administration; its oversight responsibility was replaced by the Center for Substance Abuse. Regulations from the Drug Enforcement Agency, however, do not permit most doctors to prescribe narcotic medication to treat opiate addiction. Only a small number of physicians in the U.S. may prescribe methadone for opiate withdrawal, and many states do not allow methadone treatment centers to operate. Some patients in search of methadone must drive to neighboring states to receive methadone. Strict morning hours can make it difficult for a patient to get to the clinic to receive his daily dose.
Dose
The dosage of methadone depends on body weight, opiate tolerance and metabolism. An effective maintenance dose is one that reduces cravings for 24 to 36 hours without producing feelings of sedation or euphoria. Doses between 60 to 100 mg are usually effective for most people; some people, however, may need higher doses. The Drug Policy Alliance states that doses below 60 mg are usually insufficient to fend off opiate withdrawal and cravings.
Duration of Treatment
The Drug Policy Alliance estimates that 5 to 20 percent of those on methadone maintenance therapy remain on it for more than 10 years, or for life; duration of treatment is usually determined on an individual basis, depending on therapeutic success. Patients receiving methadone maintenance therapy at clinics work with doctors and treatment professionals clinically to determine an appropriate duration of treatment. The National Institute on Drug Abuse states that 12 months of treatment is the minimum for optimal treatment success, as most people with less than 12 months of treatment return to abusing opiates.
Benefits
Methadone maintenance programs help opiate users refrain from using IV drugs, which reduces the risk of the person acquiring transmittable diseases, including hepatitis C and HIV/AIDS. A person in a methadone treatment program also reduces his risk of acquiring other diseases such as STDs, tuberculosis and other bacterial infections. Reduced criminal activity, improved family stability and employment performance, decreased mortality and a reduction in sexual-risk behaviors including prostitution are other benefits of methadone maintenance programs, according to the Centers for Disease Control and Prevention.
References
- Drug Policy Alliance: Methadone Maintenance Treatment
- PubMed Health: Methadone
- Medically Assisted Treatment: Methadone Treatment Approaches
- Herion Detox: An American History of Methadone
- Centers for Disease Control and Prevention: Methadone Maintenance Therapy
- NAMA: New Federal Regulations: What Do They Mean For Patients?
