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Methadone Maintenance Therapy (MMT) – Treatment for Heroin Addiction

Holy Methadone!

Oh no, not methadone! Isn’t Methadone just replacing one scary drug with another? Aren’t you just going to become addicted and dependent on yet another substance? Don’t methadone clinics just provide heroin addicts with a place to obtain a “free high”? Aren’t you just relying on a “crutch” by taking methadone?

The above are some of the stigmas associated with methadone maintenance therapy. In reality though, if and when used properly, methadone treatment in conjunction with counseling can be a valuable tool and treatment to help patients successfully overcome and conquer heroin addiction. So what is methadone and how does it work?

What is Methadone

Methadone is a synthetic “analgesic” (another word for pain reliever) drug that is provided as a substitute to heroin in order to help opiate addicts overcome and beat their addiction. Like morphine, oxycodone and even heroin, methadone is an opiate. However, methadone has a longer “half life” of 48 hours, which means that at 48 hours, half of the quantity of methadone ingested is still in your system. So if methadone is still an opiate, why would it be provided as a treatment to help with opiate / heroin addiction?

Methadone has been used since the 1980's as a manintanance method for heroin addicts

How does Methadone Maintenance Therapy Work?

Methadone can help to reduce or even eliminate cravings for heroin / opiates and withdrawal symptoms related to heroin and/or opiate use without creating the “high” or feelings of elation associated with drug addiction. It is also prescribed and issued by a licensed physician.

Methadone is rarely prescribed as a “take home” drug. In most cases, methadone patients must physically go to a clinic and become part of a program that also provides individual and group counseling. Regular and random urine tests are also administered in order to assure those taking methadone are not also taking other toxic and illegal drugs such as benzodiazepines (ex: Xanax, Klonopin, etc.), cocaine, other opiates, etc. Being part of a program that administers random drug tests and provides individual and group counseling in addition to medication helps prevent patients from abusing methadone, getting “high” and potentially even inadvertently overdosing and killing themselves.

To start, methadone is provided at low quantities (20 to 30 milligrams). This significantly reduces the chance of an accidental overdose. The quantity or “dose” is gradually brought up approximately 10 milligrams (mgs) at each doctor appointment typically up to 2 times a week, making it possible to increase the quantity up to 20 mgs per week. The patient and physician will work together to get the patient to the right dose, typically referred to as the “blocking dose”. At this blocking dose, cravings for heroin are minimal and withdrawal symptoms are practically non-existent.

MMT patients typically reach their blocking dose within a month and with maybe the occasional change, usually stay around the same dose for a couple of years. When the patient, the doctor and the counselor feels the MMT patient is ready, a gradual taper is initiated by the physician (typically 1 to 3 mg per week) until fruition.

Methadone Abuse

Regrettably, despite all the checks and balances provided by MMT (Methadone Maintenance Therapy) programs, there are people at methadone clinics who find workarounds and abuse it, using MMT as a way to obtain a “free high” or even just as a temporary measure to eliminate withdrawal symptoms until they obtain enough money to resume taking their opiate drug of choice. Many people involved in MMT are also mandated to be there rather than out of a true desire to recover and live a sober lifestyle. But does that mean that methadone clinics are a sham and should be banned? What about those who truly want to recover and live a clean and healthy lifestyle away from drugs?

Why Methadone Maintenance Therapy Works When Done Right

MMT is a multi-modal approach to heroin addiction treatment. In other words methadone, while it’s a legitimate treatment for heroin, is just one of the several tools that MMT clinics provide. Both private and state regulated methadone clinics have decided and agree that counseling (both individual and group therapy) is just as if not more important than medication. Medication is just one tool. Counseling is another that helps provide recovering addicts with additional tools and strategies to stay clean and live a sober life both while they are at the clinic and when they leave. But what is the purpose of methadone?

Methadone helps to keep patients comfortable and prevents withdrawal and cravings. This allows patients to undergo counseling and develop tools and strategies to help them stay away from heroin or other opiates. This may include a change in their daily routines, getting back to taking care of their health and hygiene, developing proper eating habits, getting enough sleep/rest, finding a job, regularly showering, daily tooth brushing, grooming , etc.

Methadone Works
How Long is Methadone Treatment Required?

The average amount of time people typically spend undergoing methadone maintenance therapy is approximately 3 to 5 years. However, some people decide to stay involved a bit longer while others may leave sooner. But what about those patients who’ve been on methadone for 5 or even 10 years? Aren’t they just abusing the program?

As mentioned above, there will always be those who abuse any treatment program whether it’s MMT, Suboxone or others. However, there are simply some methadone patients who require longer treatment than others. In fact, it could be argued that some may even require it for the rest of their lives.

Methadone patients are in control of their own recovery and under the guidance of a licensed physician, they ultimately decide what quantity or “dose” is appropriate for them. MMT patients are also encouraged to taper off the medication rather than going cold turkey. Stopping methadone abruptly can cause unwanted side effects similar to those of heroin and/or opiate withdrawal. A typical methadone patient will reduce the quantity of medicine by 1 to 3 milligrams (mg) each week.

At lower quantities, methadone patients may slow their taper down to prevent or minimize feeling any unwanted side effects or withdrawal symptoms. While every patient is different, “slow and steady wins the race”. In other words, most methadone patients who taper slowly feel very little to no unwanted withdrawal or side effects and inevitably leave the program feeling great and drug free.

Recovery Continues After Methadone Stops

But recovery does not stop after methadone maintenance therapy. Those who are successful typically resume some kind of individual or group counseling like an IOP (Intensive Outpatient Program), AA (Alcoholics Anonymous), NA (Narcotics Anonymous) or others. Because addiction is a disease that can only be sent into remission, there is always a chance that someone could slip or even relapse. See Heroin Addiction Recovery 101 to learn the difference between a slip and relapsing. Thus, anyone who has almost completed methadone maintenance therapy are encouraged to continue with some kind of individual or group counseling that can help them stay dedicated to recovery each and every day.

To discuss methadone maintenance therapy with real methadone patients, visit our “Methadone Maintenance Therapy Discussion Forum” which is one category of our Heroin Addiction & Recovery Discussion Forum.

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