|
|
How often will I need to go to the clinic?
Federal and State regulations outline a schedule of attendance based on the amount of time in treatment and compliance with program guidelines. New patients must attend seven days per week for observed dosing for at least 30 days. After that time, patient may qualify to attend Monday through Friday with take home doses for the weekend. Attendance is then reduced one day at a time per 90 day period. After one year a patient may qualify for once per week attendance. State regulations permit twice monthly attendance after two years of continuous treatment.
How does methadone work?
Methadone is an opiate agonist which has a series of actions similar to those of morphine and other narcotic medications. Individuals dependent on opiate drugs will experience withdrawal symptoms and narcotic craving if the concentration of opiates in the body falls below a certain level. The proper dose of methadone both wards off acute withdrawal symptoms and markedly reduces chronic narcotic craving by stabilizing blood levels of the drug and its metabolites, thereby permitting "normal" functioning. In MMT, tolerance is deliberately induced to a stable dose of methadone that is sufficiently high to block the euphoric action of other opiates.
Does methadone make patients "high" or interfere with normal functioning?
No. Used in maintenance treatment, in proper doses, methadone does not create euphoria, sedation, or analgesia. Methadone has no adverse effects on motor skills, mental capability, or employability.
What is the proper dose of methadone?
Each patients' dose must be individually determined because of differences in metabolism, body weight, and opiate tolerance. The proper maintenance dose will suppress signs and symptoms of opioid withdrawal, extinguish opioid drug craving, and block the reinforcing effects of illicitly obtained opioids. Doses of 80-100 mg and sometimes higher are required for most patients. Although too much methadone, as with any drug, can be harmful, insufficient doses of methadone are largely ineffective. Blood levels can be drawn to help determine adequate dosing.
Is methadone more addictive than other opioids?
Physical dependence and tolerance to a drug are part of addiction, but they're not the whole story. Addiction is characterized by compulsive use of a drug despite adverse consequences. The MMT patient is diagnosed with opioid dependency prior to initiating treatment. The medication serves to stabilize the patient. Thus, they are no more dependent on their treatment medication than the terminal cancer patient who is physically dependent on morphine, or the diabetic who is dependent on insulin. They do not seek out the drug in the absence of withdrawals symptoms or pain, and their lives do not revolve around drug use.
Is methadone harder to kick than other opioids?
Symptoms of abrupt withdrawal from all opioids are qualitatively similar when the amount of drug used is pharmacologically equivalent. Withdrawal from heroin tends to be intense and fairly brief, while methadone withdrawal is less acute but longer lasting. Withdrawal symptoms can be ameliorated by tapering the dose over an extended period of time. This is known as a medically supervised withdrawal.
Is methadone treatment for life?
Many patients consider medically maintained stability as an acceptable treatment goal. Some patients remain in methadone treatment for more than ten years, and even for rest of their lives, but they constitute a minority (5-20%) of patients. Others choose a medically supervised withdrawal as a transition to an abstinence based lifestyle.
How long should treatment last?
Generally, the length of time spent in treatment is positively related to treatment success. The duration of treatment should be individually and clinically determined, and treatment should last for as long as the physician and the individual patient agree is appropriate. Federal and State regulations require annual evaluation of patients to determine whether they should continue in MMT.
Is methadone a desirable street drug, with high potential for abuse?
Though methadone is emerging on the illicit drug market, most buyers of diverted methadone are active opiate users who won't or can't get into a methadone treatment program. The extent of abuse associated with diverted methadone is small relative to heroin and cocaine, and primary addiction to methadone is rare. While methadone, like almost any drug, can cause overdoses if used improperly, overdose deaths attributed to methadone alone are few compared to heroin deaths. The Drug Abuse Warning Network found, in their 1994 sample of emergency room incidents, 15 methadone deaths, 251 heroin\morphine deaths, and undoubtedly the result of accidental or inappropriate consumption of illegally obtained methadone. ALTR follows strict diversion control policies to assure that medication from this clinic is not re-sold on the illicit market.
Does methadone interfere with good health?
Research has shown that the most significant impact to ones health as a result of long term methadone treatment is a marked improvement in general health. This is compared to opiate dependent individuals not receiving treatment. Methadone has been demonstrated throughout many years of clinical study as having a favorable safety profile. Concerns about methadone's effects on the immune system, kidney's, liver, bones, or heart have been laid to rest. Methadone's most common side effects - constipation and sweating - usually fade with time, and are not serious health hazards.
Is it safe to take methadone during pregnancy?
MMT during pregnancy does not impair the child's developmental and cognitive functioning, and it is the medically recommended course of treatment for most pregnant opiate-dependent women.
Is methadone maintenance appropriate for all drug users?
No. Methadone is a treatment for opiate dependence and is not appropriate for individuals who use but are not, and have not been, dependent. Opiate dependent individuals who also abuse benzodiazepines (anti-anxiety medications), muscle relaxers, or other central nervous system depressants are closely screened and may be inappropriate for methadone treatment.
|
