For individuals with an opiate use disorder, the biggest challenge to achieving sustained recovery is overcoming intense cravings. For this reason, relapse rates are very high for those who have completed detox and withdrawal. Controlling substance cravings is the key to maintaining sobriety.
Methadone is a long-acting substitute opioid that binds to the same opioid receptors in the brain as other opiates, providing an opportunity to focus on treatment and recovery. Because the methadone satisfies the same physiological function as the substance did, individuals in recovery are better able to resist powerful cravings, thereby reducing the risk of a relapse.
What is it, and How Does it Work?
Methadone is a synthetic opioid that is prescribed for individuals in recovery from a heroin dependency or opioid use disorders. Methadone is a Schedule II controlled substance, requiring that its use as maintenance therapy remain strictly regulated. Methadone is dispensed from designated clinics following strict guidelines in order to reduce the risk of misuse.
Methadone works by replacing the opioid or heroin, satisfying the brain’s reliance on an opioid, and therefore avoiding withdrawal symptoms once the body adjusts. Unlike other opioids, methadone does not produce a euphoric effect. The treatment goal is that, over time, the individual no longer exhibits drug-seeking behavior and is able to stabilize while in recovery. Methadone maintenance therapy lasts for a year at minimum, but some remain on the program for several years.
5 Consequences of Methadone
A methadone maintenance program can provide important benefits in recovery. These include being able to work and be productive again, to resume family responsibilities, to participate in ongoing recovery efforts, to improve relationships, and to obtain a reduced sentence for a related legal issue.
There are also negative effects associated with methadone use in recovery. Here are 5 common results of methadone maintenance therapy:
- Side Effects. Methadone therapy may lead to some adverse side effects. These could include:
- Stomach distress
- Constipation
- Sweating
- Nausea
- Itchy skin
- Slowed breathing
- Decreased sexual libido
- Restlessness
Long-term methadone effects can include heart arrhythmias and respiratory or lung problems.
- Drug Interactions. Methadone can cause negative interactions with certain drugs. These include:
- Antidepressants
- Antipsychotics
- Benzodiazepines
- Tramadol
- Erythromycin (antibiotic)
- Antifungal agents
- Methadone Misuse. Like all opioids, methadone has addictive properties, and can be misused. Signs of methadone misuse include:
- Increased tolerance
- Taking higher doses than prescribed
- Obtaining methadone from illicit sources
- Injecting methadone
- Combining methadone with other substances, such as alcohol or benzodiazepines
- Dependence. Methadone can lead to both physical and psychological dependence over time. When attempting to quit using methadone, withdrawal symptoms will emerge.
- Brain Changes. Long-term use of methadone may cause changes in brain cells that can affect cognitive function, memory, and learning abilities.
Medication Supported Recovery Alternatives
Methadone is not the only drug prescribed in Medication Supported Recovery (MSR) maintenance plans. Individuals may also benefit from buprenorphine or naltrexone, two medications that also block cravings and reduce the risk of relapse in recovery.
- Buprenorphine: Buprenorphine is a synthetic opioid agonist that binds somewhat imperfectly to the brain’s opioid receptors. Similar to methadone’s effects, buprenorphine causes the brain to believe it has been satisfied with an opioid. The medication occupies and blocks the receptors for an extended period, which reduces cravings. Buprenorphine comes in tablet or sublingual film, and also recently as a monthly injectable.
- Naltrexone: Naltrexone is sold under the brand names Vivitrol and Revia. It is a non-narcotic opioid antagonist, not a synthetic opioid like methadone or buprenorphine. Naltrexone binds to the brain’s opioid receptors and effectively blocks any euphoric effects, reducing the desire to begin reusing the drug. Naltrexone comes in various forms, such as oral tablets, an implant, a patch, or an injection.
Regardless of whether the MSR plan involves methadone, naltrexone, or buprenorphine, successful recovery hinges on participating in the full range of continuing care actions that support sobriety. These include ongoing outpatient therapy sessions, support groups, and social support provided through a recovery community. Combined, these efforts contribute to building a strong foundation upon which to build a new, healthier life in recovery.
Ashley Addiction Treatment, formerly Father Martin’s Ashley, is a nationally recognized nonprofit leader in integrated, evidence-based treatment for substance use disorders and is accredited by The Joint Commission. We offer both inpatient and outpatient programs, holistic addiction treatment, drug detox, relapse prevention plans, family wellness programs and a variety of other services tailored to each patient’s needs. Our driving principle — “everything for recovery” — reinforces our mission to heal each individual with respect and dignity, and reflects on our ongoing commitment to meet new challenges. For information about our comprehensive programs, please call (866) 313-6307.