Methadone maintenance has been used to treat opioid dependence for more than 45 years (invented in 1937). Therapeutic dosing is contingent upon individual patient needs, and the therapeutic dosage range is generally between 25–150 mg. Such a dose would not be tolerated by an opioid-naive individual. The amount of oral Methadone that an addicted individual will require is dependent on the amount of illicit substance that they have previously been used to, but as a general rule 1 gram of street Heroin is roughly equivalent to 50 to 80 mg of Methadone. Methadone is taken either orally as DTF (Drug Tariff Formula) Methadone mixture 1 mg/1ml which is supplied as a red or clear liquid, but can now also be prescribed as a mixture containing 10 mg of Methadone in 1ml of liquid (blue color) or Methadone 20 mg in 1ml (brown color).
This is often used when a person is on a large amount of Methadone and is rarely permitted for consumption unsupervised, because these formulations are not as viscous as the 1 mg/1ml mixture, they are more prone to mis-use as they are easier to inject, and also due to the high risk of diverted medication causing an overdose in an individual that is not used to such a large dose. An individual who is prescribed 200 mg would only have to ingest 20ml of 10 mg/1ml mixture, thus making it easier to take. Methadone Maintenance can also be delivered by either IV or IM injection, and ampoules come in various strengths from 10 mg up to 50 mg, this method is often used for individuals who have a “needle fixation” and who would otherwise revert to using iv heroin. Methadone is widely distributed to body tissues where it is stored and then released into the plasma.
This combination of storage and release keeps the patient comfortable, free from craving, and feeling stable. With the emergence of several treatment options such as buprenorphine (Buprenorphine was approved by the Food and Drug Administration (FDA) in October 2000), and heroin treatment (Switzerland & U.K.) since 1990 some professionals no longer hold with the opinion of the General Accounting Office and maintain that buprenorphine is superior. This trend is being expanded in the Western U. S. in the Human Services field.
How does methadone work?
Methadone is an opiate agonist, which has a series of actions similar to those of morphine and other narcotic medications. When taken on a daily basis (every 24 to 36 hours), it eliminates physical withdrawal symptoms. Additionally, when you are an effective dose level, you no longer have cravings for opioids, and if you do use, methadone blocks the euphoric effect of opioid abuse.
How effective is methadone maintenance?
Opiate dependency is a chronic, relapsing, incurable but eminently treatable illness. The objectives of methadone maintenance treatment follow from this orientation: to improve function, lessen symptoms and discomfort, and lower the rate of mortality associated with addiction. When measured against each of these indicators, methadone maintenance is extremely effective. Compared to other major drug treatment modalities (e.g., drug free outpatient treatment, therapeutic communities and general chemical dependency treatment) methadone is the most studied treatment modality and has yielded the best results.
Methadone maintenance generally requires patients to visit the dispensing or dosing clinic daily, depending on state controlled substance laws. Most states allow Methadone clinics to close on Sundays and provide medication (take homes or exception doses)prior to the closed day/s. States may require or mandate drug testing, in clinic drug abuse groups and/or outside Alcoholics and Narcotics Anonymous meetings.
Generally, after 90 days take home medication and group meetings privileges are extended to more take homes and less mandated meetings, but the amount that clinics will let individuals take home has been reduced in recent years, this is as a result of Methadone diversion (selling the Methadone to other addicts) and to protect children who may be present in the household of the prescribed individual. Methadone, at constant daily milligram doses will stabilize patients and relieve all withdrawal symptoms. Patients will not feel the usual “high” or “euphoria” associated with methadone, other opiates, or heroin abuse.
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