Methadone

Methadone is a long-acting opioid that has been available in Europe since the 1960s for the treatment of heroin/opioid dependence.

Taking methadone
Methadone is available as a syrup and is taken orally every day. A common daily dose of methadone is between 40 mg and 120 mg, although some people need higher or lower doses. It can take several weeks of dose increases to reach your ideal dose of methadone.

What might I like or dislike?

  • Methadone has been shown to be effective and can be taken safely for long periods of time. It stops you feeling withdrawal symptoms and you shouldn’t crave heroin/opioids as much.
  • Methadone can be sedating (ie producing the "nods" or a "gouch"), which some people like.
  • Methadone is taken every day to avoid withdrawal. This can make it easy to adhere to longer-term treatment programmes as missing a dose of methadone can cause withdrawal.
  • Although it is safer than using heroin on the street, you can overdose on methadone, especially if you have previously detoxed.
  • Methadone can interact with other drugs, including alcohol. As with buprenorphine, people have died after taking methadone and benzodiazepines together outside medically prescribed doses.
  • Methadone can interact with many other medications, causing unwanted side effects, so you may want to talk to your doctor if you have multiple prescriptions (eg some anti-retroviral medications used to treat HIV) though your doctor should quickly spot interaction effects and change your dose accordingly.

Myth-busting
There are often myths on the street about certain treatments and it is important to separate facts from fiction. Here are a few common myths you may hear about methadone.

  • “You’ll never get off it”. People do come off methadone successfully all the time and there are ways around most difficulties.
  • “It gets in your bones”. Some people feel that methadone gets in their bones: in fact, the data on this are very unclear but any effects seem to appear only after many years of treatment.

Are there any side effects?
Not everyone gets side effects; some of methadone’s more common side effects are:

  • sweating
  • respiratory depression
  • nausea, vomiting
  • constipation
  • lowered sex drive
  • aching muscles and joints
  • drowsiness
  • headaches
  • dry mouth syndrome: a lack of saliva, which some believe can cause tooth decay.

Side effects often wear off over time; any new medication can take time to adjust to.

Returning to treatment?
If you’ve had methadone before and experienced difficulty, you should discuss this with the doctor. It may be that you were on the wrong dose last time, or this may not be the medication for you.

As with all maintenance medications, the break from cravings and withdrawal that methadone should provide will allow you the opportunity to tackle any other health conditions that may have arisen through drug use, and focus on Staying healthy