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Methadone Addiction & Abuse

Methadone, a synthetic opioid, can lead to addiction when abused, resulting in withdrawal symptoms, potential overdose, and health issues. Treatment includes medication-assisted therapy and inpatient or outpatient rehab, focusing on underlying causes and relapse prevention strategies.

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Methadone is a synthetic analgesic medication that works as an antagonist to opioids. This medication produces a pain-relieving effect. It can be abused, induce tolerance and dependence, and eventually lead to addiction. 

Treatment for methadone addiction can be complicated because the drug itself is used as a form of medication-assisted treatment (MAT) for dependence to other drugs, such as opioid-based pain medications like oxycodone or hydrocodone, as well as illicit drugs like heroin. 

What Is Methadone?

Methadone is a synthetic opioid, meaning it is created in a laboratory and manufactured rather than existing naturally in the environment. It is federally classified as a Schedule II narcotic, meaning that it was developed for legitimate medical purposes and is legal for distribution. 

This differs from heroin, for example, which is not federally legal. Other substances like this are considered Schedule I substances under the Controlled Substances Act since they have no legitimate medical uses. 

Methadone is predominantly used for two purposes:

  • Pain relief: Methadone works similarly to other opioids by blocking opioid receptors in the brain. This creates a positive affective state and the perception that damaged or irritated tissue that once signaled a pain response is no longer painful. As a result, methadone can very effectively relieve pain.
  • Treatment for substance abuse: Methadone was developed as an alternative medication to provide withdrawal symptom relief for individuals with addictions to substances like opioid-based pain relievers and heroin. The administration of methadone allows for relief from withdrawal symptoms and cravings while high concentrations of other drugs are eliminated from the body. 

Statistics on Methadone Abuse

Methadone can be abused because of the positive and pain-relieving effects it produces. Abuse refers to the consumption of methadone in any way other than how it was prescribed, such as consuming excessive amounts of the medication or consuming it too frequently. 

Here are some recent statistics related to methadone abuse:

  • Methadone overdoses kill approximately 5,000 people every year.
  • The rate of deaths caused by methadone abuse and overdose has increased sixfold since the 1990s when it was almost exclusively used within hospital settings. 
  • Methadone is four times as likely to cause a death related to overdose as oxycodone and twice as likely as morphine to do so. 
  • Most people who use methadone for addiction treatment don’t misuse the medication, but buprenorphine is often preferred for addiction treatment due to its lower abuse potential and additional convenience for patients.

Who Abuses Methadone?

Anyone can abuse methadone if the medication is not tightly controlled and monitored. Abuse most commonly occurs when one has been prescribed the medication to be taken outside of the hospital environment and then begins to develop tolerance and then dependence. 

Tolerance refers to a state in which the body has adapted to the presence of methadone, and more of the drug is needed to achieve a clinical effect. Dependence then occurs, in which physiological adaptations have been made in the body to accommodate the presence of methadone, and more is needed to achieve a state of equilibrium and homeostasis. 

According a peer-reviewed study of the profiles of individuals who abused methadone, the following trends were observed:

  • The youngest person was 26, and the oldest person was 64.
  • Most patients began abusing methadone prior to the age of 20.
  • Approximately one in six individuals had been abusing methadone or other drugs for over 20 years. 
  • Individuals who abused methadone were significantly more likely to have HIV and/or hepatitis B/C.
  • Individuals who abused methadone were significantly more likely to have a mental health issue, such as anxiety. 

What Are the Causes of Methadone Addiction?

A methadone addiction occurs following tolerance and dependence, in which the body has physiologically adapted to the presence of methadone by altering neurotransmitter and hormone levels and creating the sensation that more methadone is needed in order to maintain a state of balance. This causes users who have been addicted to methadone for an extended period of time to feel like they need methadone merely to feel normal. 

Methadone addictions commonly begin with a legal prescription. Then, the person may begin to abuse the medication because of the positive effects it produces. 

What Are the Signs & Symptoms of Methadone Addiction?

A sign is an observable characteristic that marks the presence of a physical condition, such as an addiction to methadone. Signs of addiction differ from just use, as they pertain more to behaviors that illustrate a dependence on the mediation. 

Common signs of a methadone addiction include the following:

  • An excessive preoccupation with obtaining methadone
  • Anxiety, irritability, or worry in the absence of methadone
  • Multiple unsuccessful attempts to discontinue methadone use
  • Stealing or purchasing methadone from someone else illegally
  • Financial difficulties due to seeking methadone illegally
  • Visiting multiple doctors seeking a methadone prescription

Symptoms are subjective experiences associated with being addicted to methadone that may not be observable to others. Examples include the following:

  • Withdrawal symptoms when methadone is not consumed
  • Agitation and irritability when methadone is not available
  • Feeling like you need methadone to feel normal
  • An uncontrollable compulsion to consume methadone
  • The inability to enjoy previously enjoyable activities without methadone

How Does Methadone Impact the Mind & Body?

Clinically, methadone modifies the way the central nervous system perceives pain by blocking opioid receptors

Abuse of methadone and addiction to the medication can have a range of adverse symptoms on the mind and body, such as these:

  • Constipation
  • Impairments in balance and muscle coordination
  • Nausea and vomiting
  • Confusion
  • Loss of memory
  • Lightheadedness and dizziness
  • Fatigue and drowsiness

Withdrawal Symptoms 

Withdrawal occurs because of the body’s adaptation to the presence of methadone and the lack of equilibrium caused when methadone is no longer consumed. As the body once again seeks homeostasis, new adaptations occur as hormonal and neurotransmitter levels change, resulting in adverse symptoms like these:

  • Shakiness and tremors
  • Anxiety
  • Nausea and vomiting
  • Chills
  • Fever
  • Aches and pains
  • Sweating
  • Cramps and gastrointestinal discomfort
  • Diarrhea
  • Elevated heartbeat
  • Irritability
  • Difficulty sleeping
  • Depression
  • Hallucinations

Can You Overdose on Methadone?

Yes, you can overdose on methadone. Signs and symptoms of a methadone overdose include the following:

  • Bluish tint to the fingertips and lips
  • Respiratory difficulties and shallow breathing patterns
  • Clammy skin
  • Convulsions
  • Extreme lethargy
  • Vomiting
  • Coma
  • Death, in severe cases

The risk of overdosing on methadone increases with the dosage you have taken, as well as if you have also consumed another substance like alcohol. Consuming methadone with another substance can also significantly increase the risk of a cardiovascular event, such as a stroke or myocardial infarction. 

Seek medical attention immediately if you think you or someone you know may be overdosing on methadone. 

Treatment Options for Methadone Addiction

Treatment for a methadone addiction can be complicated because one of the main clinical uses for the medication is to treat addiction to opioids, such as heroin or morphine. 

Accordingly, one of the most common ways to treat methadone addiction is to prescribe an alternative form of medication-assisted treatment, such as buprenorphine. This medication can provide relief from withdrawal symptoms as you undergo detoxification and methadone is eliminated from your system. 

In conjunction with another MAT, it is also highly recommended that you undergo inpatient rehabilitation and then outpatient rehabilitation. If you only take a new form of MAT, it’s highly likely that you will relapse to opioid misuse. Therapy is needed to deal with the underlying factors that led to your methadone abuse.

Inpatient rehabilitation lasts between 30 and 90 days and provides you with 24-hour medical and psychological support to help you cope with the difficulties of withdrawal and cravings to use methadone. During inpatient rehabilitation, you will participate in counseling sessions that will help you learn new skills and develop tools to cope with relapse triggers. 

Outpatient rehabilitation is an extension of inpatient rehabilitation. This form of treatment can help you reintegrate into your independent living environment while continuing to participate in group and individual counseling. You’ll have ongoing support and guidance during this phase of treatment. While relapse is always possible with any chronic condition like addiction, it becomes much less likely when you have proper treatment and support options in place.

Updated April 2, 2024
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  2. Pharmacotherapy in the Treatment of Addiction: Methadone. (April 2011). Journal of Addictive Diseases.
  3. Drug Overdose Death Rates. (February 2023). National Institute on Drug Abuse.
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  7. Methadone Fast Facts. (September 2003). National Drug Intelligence Center.
  8. Medications to Treat Opioid Use Disorder Research Report: How Effective Are Medications to Treat Opioid Use Disorder? (December 2021). National Institute on Drug Abuse.
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  11. Methadone Use in Postoperative Pain Management: A Systematic Review. (December 2019). Rhode Island College.
  12. A Review of Novel Methods to Support the Transition from Methadone and Other Full Agonist Opioids to Buprenorphine/Naloxone Sublingual in Both Community and Acute Care Settings. (December 2019). The Canadian Journal of Addiction.
  13. Keeping Patients Safe From Methadone Overdoses. (August 2011). Pharmacy & Therapeutics.
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  15. Is Addiction Really a Chronic Relapsing Disorder? (January 2021). Alcohol: Clinical & Experimental Research.
  16. “It’s Like ‘Liquid Handcuffs”: The Effects of Take-Home Dosing Policies on Methadone Maintenance Treatment (MMT) Patients’ Lives. (August 2021). Harm Reduction Journal.
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