methadone

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Methadone

 

Definition

Methadone is a powerful narcotic drug in the same class as heroin. This class is known as the opioids.

Purpose

Methadone, formerly known as dolophine, is a psycho-active drug, meaning that it affects the mind or behavior. It belongs to the class of opioids, drugs that share some of the analgesic properties, and mimic the action of some of the body's naturally occurring chemicals called peptides, such as endorphins and enkephalines.
Methadone is used to relieve chronic pain in cancer patients and as a maintenance drug to control withdrawal symptoms in people undergoing treatment for opiate addiction.
In opiate addiction treatment, methadone blocks the opioid receptors of the brain that bind opiates such as heroin. The blocking of these receptors leads to two major effects:
  • because these chemical receptors remain blocked by methadone for up to 24 hours, even if a person addicted to heroin takes heroin after the administration of methadone, this person is not likely to feel the same effects of the heroin as he or she previously felt;
  • because the action of methadone is associated with slower and less intense withdrawal symptoms than those of heroin, the patient can experience milder opiate effects while the addiction is being treated and avoid the unpleasant withdrawal symptoms associated with heroin.
Methadone has also been shown to reduce cravings for heroin while not altering a person's mood.

Precautions

Methadone magnifies the effects of alcohol and other central nervous system depressants, such as antihistamines, cold medicines, sedatives, tranquilizers, other prescription and over-the-counter (OTC) pain medications, barbiturates, seizure medications, muscle relaxants, and certain anesthetics including some dental anesthetics. Alcohol and other central nervous system depressants should not be taken or consumed while methadone is being taken.
Methadone is a powerful narcotic. It can cause some people to feel drowsy, dizzy, or light-headed. People taking methadone should not drive a car or operate machinery.
Intentional or accidental overdose of methadone can lead to unconsciousness, coma, or death. The signs of methadone overdose include confusion, difficulty speaking, seizures, severe nervousness or restlessness, severe dizziness, severe drowsiness, and/or slow or troubled breathing. These symptoms are increased by alcohol or other central nervous system (CNS) depressants. Anyone who feels that he or she, or someone else, may have overdosed on methadone, or a combination of methadone and other central nervous system depressants, should seek emergency medical attention for that person at once.

Description

A typical adult dosage for methadone is 5-20 mg as an oral solution, 2.5-10 mg as an oral tablet or injection, every four to eight hours as necessary for pain. When used for detoxification, methadone is initially given in a dose of 15-100 mg per day as an oral solution. This dose is then decreased until the patient no longer requires the medication. The injection form of methadone is only used for detoxification in patients who are unable to take the medication by mouth.

Preparation

No preparation is generally necessary prior to the intake of methadone as a pain reliever. In cases of maintenance treatments, it is important to be sure that the patient is not currently intoxicated by alcohol, heroin, other opioids, or taking other central nervous system depressants.

Aftercare

Patients receiving methadone should be monitored for adverse reactions to this drug, and/or possible accidental overdose.

Risks

Methadone can interfere with or exacerbate certain medical conditions. For these reasons, it is important that the prescribing physician be informed of any current case, or history of:
  • alcohol abuse
  • brain disease or head injury
  • colitis
  • drug dependency, particularly of narcotics
  • emotional problems
  • emphysema, asthma, or other chronic lung disease
  • enlarged prostate
  • gallstones or gallbladder disease
  • heart disease
  • kidney disease
  • liver disease
  • problems with urination
  • seizures
  • underactive thyroid

Side effects

The most common side effects of methadone include:
  • constipation
  • dizziness
  • drowsiness
  • itching
  • nausea
  • urine retention
  • vomiting
Less common side effects of methadone include:
  • abnormally fast or slow heartbeat
  • blurred or double vision
  • cold, clammy skin
  • depression or other mood changes
  • dry mouth
  • fainting
  • hallucinations
  • hives
  • loss of appetite
  • nightmares or unusual dreams
  • pinpoint pupils of the eyes
  • redness or flushing of the face
  • restlessness
  • rigid muscles
  • ringing or buzzing in the ears
  • seizure
  • severe drowsiness
  • skin reaction at the site of injection
  • stomach cramps or pain
  • sweating
  • trouble sleeping (insomnia)
  • yellowing of the skin or whites of the eyes

Normal results

Normal results after the administration of methadone to treat chronic pain is the alleviation of that patient's pain, at least to the point where the pain is bearable.
Normal results of methadone treatment to control heroin addiction, is that the patient reduces heroin intake almost immediately upon starting methadone treatments, followed by complete abstinence, usually within two weeks after starting treatment.

Key terms

Analgesic — Any agent that relieves pain.
Central nervous system (CNS) depressant — Any drug that tends to reduce the activity of the central nervous system. The major drug categories included in this classification are: alcohol, anesthetics, anti-anxiety medications, antihistamines, antipsychotics, hypnotics, narcotics, sedatives, and tranquilizers.
Endorphins — Any of several opiate peptides naturally produced in the brain that bind to certain neuron receptors and have the effect of relieving pain.
Enkephalines — Peptide produced by the body that have analgesic properties.
Morphine — Morphine is the naturally occurring opioid in the opium poppy, Papaver somniferum. It is a powerful narcotic analgesic, and its primary clinical use is in the management of moderately severe to severe pain. After heroin, morphine has the greatest potential for addiction of all narcotic analgesics.
Narcotic — Any drug that produces insensibility or stupor and/or generally causes effects similar to those caused by morphine.
Opiate — Any narcotic analgesic derived from a natural source, such as morphine from the opium poppy.
Opioid receptors — Receptors located in the brain and various organs that bind opiates or opioid substances.
Opioids — One of the major classes of semi or fully synthetic psycho-active drugs that includes methadone.
Psychoactive drugs — Any drug that affects the mind or behavior. There are five main classes of psychoactive drugs: opiates and opioids (e.g. heroin and methadone); stimulants (e.g. cocaine, nicotine), depressants (e.g. tranquilizers, antipsychotics, alcohol), hallucinogens (e.g. LSD), and marijuana and hashish.
Receptor — A molecular structure on the surface that selectively binds a specific substance resulting in a specific physiological effect.

Resources

Periodicals

Sadovsky, Richard. "Methadone Maintenance Therapy." American Family Physician July 15, 2000.

Organizations

National Alliance of Methadone Advocates (NAMA). 435 Second Avenue, New York, NY, 10010. (212) 595-6262. http://www.methadone.org/.
National Clearinghouse for Alcohol and Drug Information. 11426-28 Rockville Pike, Suite 200, Rockville, MD 20852. (800) 729-6686. http://www.health.org/.

methadone

 [meth´ah-dōn]
a synthetic opioid analgesic with pharmacologic properties similar to those of morphine and heroin and equal potential for addiction; used as an analgesic and as a substitute opiate in the treatment of heroin addiction.

methadone

/meth·a·done/ (meth´ah-dōn) a synthetic opioid analgesic with actions similar to those of morphine and heroin, and almost equal in potential for addiction; the hydrochloride salt is used as an analgesic and in the management of heroin addiction.

methadone

(mĕth′ə-dōn′)
n.
A potent synthetic narcotic drug, C21H27NO, that is less addictive than morphine or heroin and is used as a substitute for these drugs in addiction treatment programs. It may also be used for chronic pain management.

methadone

A synthetic, relatively long-acting oral opioid analgesic used primarily for narcotic detoxification and controlled maintenance of heroin addiction.

Uses
Severe pain; antitussive.
 
Adverse effects
Lightheadedness, dizziness, anorexia, nausea and vomiting, dry mouth, sweating, drowsiness, hypotension, decreased intestinal motility, respiratory depression.

Inducers of methadone metabolism
Phenytoin, carbamazepine, rifampicin, fluconazole, some protease inhibitors—all via CYP3A4 induction.

Overdose effects
Respiratory depression, stupor, coma, loss of short-term memory.
 
Methadone overdose, autopsy findings
Airway obstruction, pulmonary oedema, aspiration of vomit, bronchopneumonia, cardiac arrest/failure.

Street terms
Amidone, dollies, dolls, done, fixer, fizzies, juice, juicer, medecina, meth-a-done, pixie, synthetic heroin, wafers.

methadone

Dolophine®, Methenex® Substance abuse A synthetic, relatively long-acting oral opioid analgesic Uses Severe pain; narcotic detoxification, controlled maintenance of addiction Effects ↓ intestinal motility; respiratory depression; analgesic; antitussive Overdose effects Respiratory depression, stupor, coma, loss of short-term memory. See Heroin, Opioids.

methadone

A synthetic narcotic painkilling (analgesic) drug with properties similar to those of MORPHINE. It is also used as a substitute for HEROIN in attempts to manage addiction, but is widely abused. A brand name is Physeptone.

methadone

a synthetic opioid agonist used for analgesia and sedation. Commonly used in horses.

Patient discussion about methadone

Q. I would like to chat with someone w/any knowledge of fibromyalgia being treated with Methadone my best friend has severe fibromyalgia and has been treated with Methadone for the past several years. She has developed severe chronic anemia in these years. She now has lymphoma. I want to know if she is the only one and if methadone can affect bone marrow.

A. I have never ever heard or read anywhere about methadone causing anemia, nor is that something that an opiate medication would normally cause. We all have a tendency to blame everything that happens to us, health-wise, on methadone sometimes--but in this case, you probably need to look elsewhere for the cause.
the Anemia is probably due to the Lymphoma. if not-her life is out of balance, she might changed her diet and may have shortage of iron or B12.

More discussions about methadone