Opioid addiction in America has reached crisis levels. The Department of Health and Human Services reports that in 2019, approximately 10.1 million Americans aged 12 or older misused opioid drugs. In response, doctors are using medication-assisted treatment, an approach that uses both medications and behavioral therapy to treat opioid addiction, to treat over 1.27 million Americans. Methadone is one of the primary drugs used in medication-assisted treatment. Its use in fighting opioid addiction is so impactful that the World Health Organization includes it on the list of essential medicines. Here, we explain how methadone is used to treat opioid withdrawal and addiction.
Opioid dependence is a precursor to addiction.
According to the U.S. National Library of Medicine, opioids alter brain chemistry and over time, and opioid dosage will need to be increased in order to maintain the drug's effects. This phenomenon is called tolerance. Dependence, which develops during long-term opioid usage, causes physical and psychological withdrawal symptoms to develop when the drug stops being used.
Opioid dependence can be the precursor to opioid addiction. The U.S. National Library of Medicine notes that, while all patients who use opioids on a long-term basis will develop dependence, only a small percentage of this population will exhibit the compulsive, continuing need for opioids that is the hallmark of addiction.
Opioid addiction, also called opioid use disorder, is considered a chronic brain disease. Whereas opioid dependence mainly concerns tolerance and withdrawal, opioid addiction features compulsions, cravings, and dysregulation of the ability to choose, according to Johns Hopkins Medicine.
Opioid withdrawal symptoms are predictable and often uncomfortable.
There are a set of predictable symptoms, which can be serious, that occur during opioid withdrawal. These include the following, according to Mayo Clinic:
- Sweating, chills, or runny nose
- Nausea, diarrhea, or vomiting
- Intestinal cramping
- Mood swings or anxiety
- Body aches, joint pain
- Heart rate and blood pressure changes
- Insomnia or restlessness
- Confusion or hallucination
- Thoughts of suicide
In a person with opioid use disorder, these withdrawal symptoms are accompanied by the psychological burden of an intense compulsion to use again. “Cravings for opiates are often severe during acute withdrawal,” Christian Small, MD, an Addiction Medicine Specialist and President at Headlands Addiction Treatment Services, tells WebMD Connect to Care.
Methadone therapy uses opioids to fight opioid addiction.
Methadone is itself an opioid drug. The primary difference between methadone and other opioids is that it’s slow acting and doesn’t produce euphoria. This means that methadone can eliminate opioid withdrawal symptoms and intense cravings, but it doesn’t perpetuate the addiction cycle, according to the National Institute on Drug Abuse.
Methadone is used beyond the physical withdrawal stage as part of long-term addiction therapy. “The duration of methadone treatment is variable and largely depends on the individual circumstances and goals of the patient. In general, outcomes are better for individuals who engage in methadone treatment over the long term rather than for short durations,” Small says.
People on long-term therapy receive their medication at a methadone clinic. The dose is given in a liquid, powder, or diskette form. It’s reported to be safe and effective if used properly. For best results, methadone treatment should be combined with behavioral health therapies to form a comprehensive treatment plan, according to the Substance Abuse and Mental Health Services Administration.
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