Opiate addiction is devastating for users as well as their family and loved ones. Such a powerful dependence impacts the lives of addicts and those close to them in every aspect: physically, mentally, and emotionally. It’s extremely difficult to get clean from opiates without proper treatment, and for those that do seek treatment, sometimes it takes more than one round to recover. In search of a solution, many opiate dependent individuals end up enrolling in a methadone maintenance program. But these programs are controversial, and some people can end up more severely addicted to methadone than they were to their original drug of choice.

The Basics of a Methadone Maintenance Program

The philosophy behind offering a methadone maintenance program is that using drug replacement therapy can help reduce the negative consequences of addiction and allow opiate users to function at a higher level. Methadone clinics work by giving patients doses of methadone each day (sometimes with additional methadone to take home) to ward off drug cravings and withdrawal. Methadone is itself an opiate. However, it lasts longer than other types of opiates (therefore works better to prevent withdrawal in patients) and is less likely to cause euphoria than other opiate drugs, especially when used in small amounts by someone who already has a high tolerance.

After enrolling in a methadone maintenance program, a patient will receive their dose daily. They may either slowly wean off of methadone or will continue taking it for years (or even for life) as a replacement for street opiates. The arguments for methadone maintenance are that it keeps people off the streets, reduces the rate of HIV or hepatitis C transmission (because it reduces needle use and sharing), allows addicts to function normally and hold jobs, and that it reduces the use of illicit drugs like heroin. Some people believe that because it is administered in a controlled environment, methadone maintenance is an effective way to prevent overdose or the many other physical dangers of opiate addiction.

Side Effects of Methadone

Despite the fact that some people support the idea of a methadone maintenance program, there are significant downsides to this method of treatment. First and foremost, methadone is habit-forming and addictive. Using it long term creates a severe physical dependence on the drug and painful withdrawal symptoms when someone stops taking it.

Methadone is sometimes used for short periods of time as a part of some detox programs, but when taken for an extended period of time, it will cause withdrawal symptoms similar to those caused by heroin. If someone decides to get off of methadone, they will experience a severe withdrawal and could be at risk of relapsing. Addiction is caused by many factors, including some emotional and mental conditions. If someone is enrolled in a methadone maintenance program but receives no treatment for any underlying factors that may have caused them to develop an addiction when they wean off of methadone they will be in the exact same place- untreated, and vulnerable to relapse.

In addition to not doing anything to address the underlying causes of addiction or co-occurring disorders and being highly addictive, methadone has some significant side effects. These include:

  • Sedation, chronic fatigue, drowsiness
  • Changes in sleep patterns
  • Changes in appetite and weight gain
  • Tooth decay
  • Muscle weakness
  • Diarrhea or constipation
  • Confusion
  • Abnormal heartbeat or pulse
  • Respiratory problems
  • Memory loss and impaired cognition
  • Mood changes
  • Seizures

People can also fatally overdose on methadone, especially if it is taken in combination with other drugs, like alcohol or benzodiazepines. Because comprehensive treatment is not always a part of a methadone maintenance program, patients may still use other drugs while on methadone and put themselves at risk of a fatal overdose by doing so.

Comprehensive Treatment

Enrolling in a methadone maintenance program may have some benefits or seem like a good way to treat addiction. However, it’s a risky move and one that can result in an even worse drug dependence or a host of serious side effects. Truly breaking free from addiction doesn’t come from becoming dependent on a replacement drug.

While there may be a place for methadone in some cases- such as reducing rates of transmissible blood infections or in a harm reduction campaign- there is a better option for many patients. It is possible to be free of opiate addiction without using another drug, through comprehensive addiction treatment. If you want help for addiction to opiates, methadone, or any other substance, call the Discovery Institute today at 888-616-7177 for information on our treatment programs.

Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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