Methadone is a synthetic opioid developed around the time of the second world war. Clever German chemists created the drug as a defense against Allied military moves to cut off their supplies of natural opium. This was needed to produce morphine for injured German troops. This article will discuss: Why is methadone used as a treatment for heroin addiction?
Making a synthetic painkiller wasn’t a problem at all for master German chemists. With little effort they created methadone from precursor compounds, producing a truly stellar painkiller effective by mouth and better than morphine in many ways. The German methadone creators christenened the new drug Dolophine after Adolf Hitler. It’s sometimes said that it was named Dolophine after the Spanish word for pain dolor, but this is probably untrue. Why would the Germans give their chemical triumph a Spanish name?
How does Methadone Work?
Methadone is not chemically related to the natural and semi-synthetic opiates and opioids derived from opium like morphine, codeine, oxycodone, buprenorphine and hydrocodone. However, it acts on the same brain opioid receptors as all opioids do, producing the classic effects of pain relief, sedation, euphoria, nausea and addiction. Methadone is unpredictable when compared to most other opioids with a highly incomplete cross-tolerance profile. Cross-tolerance refers to the fact that all opioids will cause a tolerance to all other opioids when taken on a regular basis.
In other words, if you’re tolerant to morphine, you will also be tolerant to other opioids to some relative degree. This is partly how medication-assisted treatment or MAT works. If you’re addicted to heroin, its cross-tolerance to methadone plays a role in relieving withdrawal symptoms and drug cravings. This is a positive effect.
However, methadone doesn’t display the same consistent degree of cross-tolerance that other opioids tend to do. This is mainly why the drug isn’t used much outside of pain management and OUD or opioid use disorder. Doctors unfamiliar with methadone don’t like its unpredictable nature. Its inconsistent cross-tolerance activity can make it hard to determine the safe and correct dose.
Methadone is a wonderfully effective tool for MAT and pain management but only when prescribed by medical professionals familiar with it. This is one reason why Suboxone has become much more common than methadone in the past decade or so. It’s safer and can be taken in the privacy of home.
Methadone and MAT
Methadone is highly effective for MAT because it works on the same brain receptors that heroin does. It’s a full narcotic and stops withdrawal symptoms in their tracks virtually 100 percent if the time. While Suboxone can’t help everyone who needs it, mainly because it’s not a full narcotic but a partial one, methadone almost always works. It can also be given at any time during the withdrawal process. Suboxone cannot. Methadone is typically better at curbing drug cravings than Suboxone is as well.
How does Methadone Help with Heroin Addiction?
So, is methadone MAT the same as using heroin? No! Critics of MAT, including AA, make this ignorant claim, but they’re misinformed. Methadone is different from heroin in key ways:
- It’s highly active by mouth
- It’s long-lasting, with a single dose providing relief for at least 24 hours and often longer
- For MAT, it’s given as an oral syrup, typically an emerald green color, providing no chance for intravenous use
- Methadone causes very little euphoria, if any, in people tolerant to heroin and other opioids
- Methadone effectively blocks heroin and other opioids from causing a desirable high or rush
- Methadone is dispensed as a daily dose at specially authorized clinics, and it cannot be prescribed for at-home use for MAT except in extremely limited circumstances
- The drug is far less expensive than heroin and is covered by governmental medical aid programs
- Methadone is pharmaceutically pure and does not pose the health risks of illicit heroin
- Methadone is safe for use during pregnancy and indeed may prevent a miscarriage caused by severe opioid withdrawal
It’s true that Suboxone is becoming more common than methadone for heroin MAT, but methadone is still a valuable option for people not helped by Suboxone. Although Suboxone is also a great MAT tool, it won’t be able to help everyone. This is especially true for those taking very high doses of heroin over long periods of time. When Suboxone fails, methadone almost always works.
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