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Methadone to overcome heroin addiction?

Discussion in 'Heroin' started by Teresa, Dec 2, 2014.

  1. DrJFJMD

    DrJFJMD Member

    Medication Assisted Treatment is NOT replacing one addiction for another. With all due respect, It is ignorance such this that that has created the stigma associated with persons suffering from opioid dependence from seeking out treatment in the form of medications such as Subtext or Methadone. These medications have pharmacokinetic profiles that differ from heroin, morphine, hydromorphone, oxycodone and almost every abused illicit opioid. These medications have half-lives of >24 hours which in turn allows once daily dosing. When former opioid addicts begin to become stabilized on these medications, their brains also begin to heal. Pharmacological therapy with methadone, buprenorphine w/naltrexone, buprenorphine or other medications directly offsets or reverses some of the brain changes associated with addiction, greatly enhancing the effectiveness of behavioral therapies. Although researchers do not yet know everything about how these medications work, it is clear that they are all truly active treatments, rather than simply substitutes for the addictive opioids.

    Both methadone and buprenorphine are long-acting opioid medications. Unlike morphine, heroin, oxycodone, and other addictive opioids that remain in the brain and body for only a short time, methadone and buprenorphines' effects last for days. Methadone and buprenorphine causes dependence, but—because of their steadier influence on the mu opioid receptor—they produce minimal tolerance and alleviate craving and compulsive drug use. In addition, methadone and buprenorphine therapy tend to normalize many aspects of the hormonal disruptions found in addicted individuals (Kling et al., 2000; Kreek, 2000; Schluger et al., 2001). For example, it moderates the exaggerated cortisol stress response set off with abuse of opioids with short half-lives, which in turn increases the danger of relapse in stressful situations.

    In closing, Opioid dependence and addiction are most appropriately understood as chronic medical disorders, like hypertension, schizophrenia, and diabetes. As with those other diseases, a cure for drug addiction is unlikely, and frequent recurrences can be expected; but long-term treatment can limit the disease’s adverse effects and improve the patient’s day-to-day functioning.

    The mesolimbic reward system appears to be central to the development of the direct clinical consequences of chronic opioid abuse, including tolerance, dependence, and addiction. Other brain areas and neurochemicals, including cortisol, also are relevant to dependence and relapse. Pharmacological interventions for opioid addiction are highly effective; however, given the complex biological, psychological, and social aspects of the disease, they must be accompanied by appropriate psychosocial treatments. Clinician awareness of the neurobiological basis of opioid dependence, and information-sharing with patients, can provide insight into patient behaviors and problems and clarify the rationale for treatment methods and goals.

    Methadone as well as buprenorphine treatment reduces relapse rates, facilitates behavioral therapy, and enables patients to concentrate on life tasks such as maintaining relationships and holding jobs. Pioneering studies by Dole, Nyswander, and Kreek in 1964 to 1966 established methadone’s efficacy (Dole et al., 1966). And similarly with buprenorphine (when it's pharmacokinetic and pharmacologic profile where revealed and studied with respect to opioid abuse treatment). Patients are generally started on a daily dose of 20 mg to 30 mg, with increases of 5 mg to 10 mg until a dose of 60 mg to 100 mg per day is achieved. The higher doses produce full suppression of opioid craving and, consequently, opioid-free urine tests (Judd et al., 1998). Patients generally stay on methadone for 6 months to 3 years, some much longer. Relapse is common among patients who discontinue methadone after only 2 years or less, and many patients have benefited from lifelong methadone maintenance. Buprenorphine patients are generally started on 2 to 8 mg (sublingually) when they are being seen for the first time. Daily doses can increase to a maximum of 32mg per day after which no further benefit can be obtained due to its' partial agonist profile.
    deanokat likes this.
  2. Donnchadh

    Donnchadh Active Contributor

    There are as many different opinions on methadone as there are people who decide to use it to help them get off own opinion on methadone and it's purely my own I didn't want to use it as I felt strong enough in myself to go without it. Having said that I know lots of people who have decided to use it and it is working ok for them like I always say every body is different and every recovery is different it's not a one size fits all so I think it's totally unfair to criticise anyone who decides to use methadone at least they're talking the first tentative steps to recovery and if they follow the instructions carefully they'll eventually be able to stop methadone.give them plenty support and encouragement instead of knocking least they're away from the criminal aspect of the drug world So fair play where it's due
  3. Gmjr44

    Gmjr44 Member

    I have read some of the most uneducated, ignorant statements regarding this HARM REDUCTION treatment. While they're definitely cases of people using the clinic for all the wrong reasons and still using while on it there are also a lot of cases like my own and my twin brother. Methadone does not have to be forever and I understand that. It saved my life. After losing my fiancee and my daughter Olivia's father when she was a mere 6 months old, I could have relapsed and went in the opposite direction that I did go in. I have been on my clinic for under 4 years and am now starting a slow taper off of it as I have my recovery system in place as well as tons of support. It did make me go from 110 lbs all my life to 190 while still working out 6 days a week and eating clean. I am ready for my self confidence back in that way. I am taking classes to become a Credentialed Alcohol And substance abuse counselor as well as beginning to speak to adolescents at up to 5 schools per month. I also have have an interview on Friday with a company who does harm reduction for IV drug users. It all began with methadone. You just have to want it. Have to want a better life and not rely on it forever. Don't get discouraged by reading all the negativity. Focus on positive stories as mine if you are focused on getting better and moving forward. If this is you, then methadone maintenance will help rather than harm. Try to keep your dose at 90 or below. As addicts when we are offered more we take it-- don't. It will be better in the long run. Stay positive and if anyone would like to talk just shoot me a reply here and then maybe email. I'm a 36 year old female, so women might be best, but I don't discriminate when it comes to helping people. Keep fighting the good fight, everyone!
    deanokat likes this.
  4. deanokat

    deanokat Community Organizer Community Listener

    Right on, @Gmjr44! I'm glad methadone has helped you so much! Good luck with your job interview on Friday!! :)
    Gmjr44 likes this.
  5. Sammmmm

    Sammmmm Member

    If it's ok to ask why did you start using again when you were on methadone, my husband was on methadone and started using again couldn't understand why he would do that and when I would ask him why he wouldn't tell me just got mad and walked away