Methadone and Other Medications in Treatment

Use of Medications Like Methadone in Drug Addiction Treatment

Fighting off the chains of addiction can be a challenging uphill battle, but it becomes more manageable in some cases with the application of certain medications. Physicians and treatment centers have prescribed methadone to battle opioid addictions for more than 40 years, and similar drugs also play a role in medication-assisted treatment.

Methadone is perhaps the most widely known of these medications. It’s a synthetic opioid available for treatment in 47 states, according to the National Institute on Drug Abuse. Treatment centers must be specially licensed to administer methadone, and it is most commonly used to control opioid addictions, including those associated with heroin, morphine and codeine, as well as prescription pain relievers such as oxycodone and hydrocodone. It’s an agonist — it activates the brain’s receptors in a way that’s similar to the effect of opioids.

Buprenorphine is also a synthetic opioid and a partial agonist. Physicians can prescribe buprenorphine with special permission from the Drug Enforcement Administration. Naltrexone is somewhat different. An antagonist rather than an agonist, it blocks the brain’s receptors, effectively forming a medicinal fortress around them to prevent opioids from reaching them and producing the desired effects in a user.

Medically Managed Withdrawal

One of the first steps in recovering from an addiction is detoxification, which may include medically managed withdrawal as the addictive substance leaves the patient’s system. Methadone, buprenorphine and naltrexone can assist with this process.

Methadone prevents withdrawal symptoms and controls cravings by simulating the addictive substance. As a partial agonist, buprenorphine may prevent these symptoms in some patients, but merely reduce them in others. Naltrexone is less effective for detoxification and is more likely to be prescribed after detoxification to assist with long-term recovery, although it has proven to effectively treat emergency overdoses.

Does One Drug Substitute for the Other?

The rumor that methadone is simply a substitute for an illegal, addictive opioid has no basis in fact. Its effect on the brain is slower and more gradual than heroin, eliminating the immediate “rush” associated with snorting, injecting or smoking that drug. Methadone does not produce an immediate skyrocketing high, but rather restores the brain to an equilibrium where the patient no longer desires or craves the abused substance because the methadone has effectively tricked the brain into believing it’s already experiencing the desired effect.

When Relapse Occurs

Methadone and buprenorphine intercede if an individual receiving medication-assisted treatment relapses and uses again. It prevents the sought reward — that initial, strong surge of euphoria —by tempering it. Naltrexone blocks the opioid experience entirely.

The Success Rate of Medication-Assisted Treatment

The National Institute on Drug Abuse indicates that maintenance with synthetic opioids and antagonists is most successful when used in conjunction with counseling, therapy and support groups. Patients receiving mediation-assisted treatment tend to be more open and receptive to these other programs and forms of treatment.