Methadone allows people to feel normal and not experience withdrawal symptoms from abruptly stopping the use of opioids. It has a low potential to cause the euphoric effects of other opioids. Without having the negative effects of recreational doses of opioids, the person is able to concentrate on getting the other aspects of their life in order. Over time they are able to reduce, and then eliminate, the methadone to prevent the extreme withdrawal symptoms that so often cause people to fail.
How does Methadone work in the body?
Methadone is a synthetic opioid used to treat opioid withdrawal and increasingly chronic pain. Methadone binds to the same “Mu” opioid receptors as heroin and other opioids, but causes less euphoria and respiratory depression. With Methadone already filling the receptors, there are fewer places for another opioid to bind. This effect blocks the “high” of any opioids taken after the Methadone, and is used to limit the appeal for someone to relapse and take another opioid.
Unlike all other strong opioids Methadone is also a NMDA receptor antagonist like ketamine. It is believed that the NMDA action of Methadone is what decreases much of the craving for opioids, tolerance, and withdrawal symptoms. In my opinion the most promising treatment for addiction is another NMDA agonist, Ibogaine. Ibogaine is believed to reset the brain’s neurotransmitters that cause addiction.
How long has Methadone Replacement Therapy been in use?
Methadone was discovered in Germany in 1937.In 1964 Methadone was first used to treat opioid addiction in the United States. Today there are over 1396 Methadone Maintenance Programs in the United States serving 254,000 patients a year.
How long does Methadone last and how often do I have to take it?
Methadone has a highly variable half-life of between 15 to 60 hours, and an average half-life of 22 hours. Methadone dosing varies significantly from patient to patient depending on metabolism and other factors. There are cases of people with fast metabolisms eliminating Methadone in as few as 4 hours, and those with slow metabolisms taking as long as 130 hours. It is this long half-life that allows people to dose only once a day at a local clinic.
How long do I need to be on Methadone Replacement Therapy?
Methadone replacement therapy is typically a long term option. For Methadone Substitution Programs, 12 months is considered the minimum for a successful outcome, although some people find it beneficial to stay on them for years. 20% of those who start a Methadone maintenance program will find themselves still participating 10 years later.