Thursday October 2nd 2014

Methadone facts

Methadone facts, not myths

Misunderstanding surrounds the use of methadone for opiate addiction. Even doctors make uniformed comments to methadone patients doing well on the narcotic drug.  So how can we address these myths?  By presenting the methadone facts!

Methadone fact # 1: methadone does not cause teeth to rot

Methadone can cause dry mouth, but does not cause teeth to rot, a common myth among addicts. Most likely, many addicts in active addiction neglect dental hygiene. When they enter treatment with methadone, they’re able to take note of their physical condition, see the poor condition of their teeth, and perhaps blame it on the methadone.

Methadone fact #2: methadone does not act on the bones

Also, methadone does not get into the bones. This common myth likely comes from the severe bone and joint pain experienced during opioid withdrawal. I’ve heard addicts talking to each other, saying that this pain is “the methadone coming out of you.” This isn’t true.

Opiate information for doctors

Information about the true nature of opiates like methadone makes all the difference.  Better patient outcomes will be seen with better communication between doctors. I hear some doctors make critical comments to patients doing well on methadone. This is done usually out of ignorance of methadone and how it works.

Doctors are not usually taught much about addiction, much less its treatment, in medical school. So many times, if I have the patients’ permission, I can gently educate their other doctors about methadone. After all, at one time I needed this information, because like the others, I thought methadone was somehow a bad or undesirable medication.

 

Narcotic pain meds discussion (continued)

Methadone is a narcotic medicine surrounded by debate and misunderstanding.  What have you heard about methadone?  What myths are out there …being spread by former drug addicts or even medical professionals?  Please add to this list so that we can address these myths and continue to provide you with methadone facts.  See Dr. Burson’s other posts if you’re interested in learning more about methadone maintenance treatment dosage: mainly how 60 mg methadone hydrochloride  dose work and the common side effects of methadone treatment that one can expect.

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11 Responses to “Methadone facts
jamescook1380
6:36 pm February 21st, 2011

I am an anesthesiologist. Dr.Vorobiev Drug Clinic. Belgrade. Agree with the author that under proper medical supervision, under strictly following rules of treatment, with full patient”s cooperation and understanding the tasks of the treatment Methadone program works not bad. The problem is that in practice the most patients and many clinics dont adhere to rules of treatment. This attitude combined with side effects of Methadone and consequences of long- term use of Methadone discredits the method. To my opinion there is no an absolute treatment for opioid addiction. Subutex, Suboxone, Rapid detox with following Naltrexone program is a good alternative. And for a lot of patients it works also not bad. At our clinic we do over 200 rapid detox procedures a year. Reliable results. We use Naltrexone (Vivitrol) implant program to secure results of detoxification.

ANR Clinic
7:31 pm May 17th, 2011

Hi Dr. Burson, Thanks for the post. Very important tips. I would like to add further, that when treating opiate addiction, it is absolutely important to tell the treating doctor all the necessary information about the specific opiates you’ve taken.

jim brewer
1:32 am September 16th, 2011

i have been on methadone 14 years and i am fineley coming off i have 28 days left at 1 mg per day .methadone has tought me to live life again and live life to the fullest. i have a lot of gult being on it to long.it made me save in my world for a long time but the lower i got on methadone.my world world started to change real fast.but i am stonger now and awake for the first time in along time.thanks for all the drs input

KVLT
7:40 pm October 14th, 2011

methadone is a big-pharma racket keeping addicts vampire like unquenchable thirst at bay. I know people who detox with methadone with heroin because withdrawal of heroin’s full agonist is no where near as bad as methadones withdrawal. It is just a viable solution to keep addicts from using dirty needles and society safe from drug addicted fiends. But hey, if you think methadone is better for you than heroin, do it. Most likely you will be put on a methadone treatment plan with no end, just like heroin.

Louis
2:50 am January 2nd, 2012

@KVLT Yes methadone isn’t really sobriety, and yes it’s very addictive (I know this first hand), but when done right it’s an extremely useful tool in getting sober. In my case I was on methadone for about a year (peaked at 120mg once a day), and with a little will power it wasn’t that hard to get clean.

I stepped down 2mg a week, my last week was 1mg. The withdrawal from methadone isn’t easy (even after the step down I mentioned), but the thing is I was able to use my time while on it to mentally prepare myself for it. Fact of the matter is, it’s a controlled substance that when the patient is in the frame of mind of actually wanting to get sober, can be VERY helpful in cleaning up.

Methadone users wife
3:28 pm April 24th, 2012

Hi, I am married to a former Pain Pill/Meth addict who is now using Methadone (2 1/2 years now). The only thing that I can see that has improved is that he is not out trying to buy pain pills illegally.
He has NO libido – AT ALL, sweats like crazy and it is really gross, eats sweets like they are about to stop making sugar!
While I am happy he is no longer doing anything illegal, I am tired of this affecting my life.
I have tried to get him to go to a pain mgmt doc-he won’t, for fear he will have to “come down” from his dose -140 mg/day.
Oh-and he still says his ‘shoulder hurts’ his ‘back hurts’!! So…It is my opinion that Methadone is nothing but a legal way to abuse pain meds! And for you on it that are married – you might start looking for a partner that is also a methadone user-because like me-they will soon be leaving!!!!!

9:56 am April 27th, 2012

Hello Methadone users wife. It sounds like you are facing a tough decision: whether to stay with your husband, or not. Have you tried Al-Anon for support for yourself?

concerned mother
1:59 pm August 21st, 2012

Can a person on methadone be a crack user also?

11:34 am August 23rd, 2012

Hi concerned. Yes, someone can take methadone and cocaine at the same time. In fact, it’s possible that the stimulant effects of cocaine are used to counter the depressant central nervous system effects of an opiate like methadone.

Lindsay
11:55 pm October 22nd, 2012

Hi, I was addicted to snorting Oxycontin (80mg pills) for 3 years. After using this drug for one year, I was soon faced with the realities of being dependent on this drug as well as the physical and mental withdrawal symptoms when I would no longer have it in my system. For the years I was abusing this drug, I managed to meet the minimum requirements to hide this habit from my family, graduate college, and hold a steady job as an academic counselor for 2 years. This pattern of illegal drug use has effected my life in every single aspect you can think of (criminally, financially, emotionally, mentally, physically, ect.). During the last year of using Oxycontin, I found myself running from the law, putting myself in serious financial and legal situations, and struggled to cope with the everyday problem with the disease of addiction. I will never forget how every second of every day during this time period I continually thought where was I going to obtain more pills to prevent withdrawal, as well as how I would financially pay for this drug by obtaining it from an illegal source. I used every financial resource I had available to me at the time until I exhausted each one. For example, I took out a pay day loan for $500 each from every service in person and online that was available to me, I continually took out cash advances on all my credit cards, and applied for credit cards already knowing what they would be used for, I took advantage of my parents; by continually calling them in CT making up various reasons why I would need my mother to put money in my account asap. Besides the negative impact this drug addiction had on my financial resources, it had an impact on my legal status with the state, after running from the law after being charged and arrested with trying to obtain a fraudulent prescription of narcotics, being terminated from TASC, a drug divergent program, shoplifting multiple times even after being caught (I would do this to allow me to have more cash instead of buying necessities such a food, ect.) During the last months of my addiction I tried multiple times to quit cold turkey, whether it was voluntary or involuntary, for 2-3 weeks at a time. I attended NA meetings regularly, even though I was not being truthful with myself or my sponsor. One of my close drug friends continually encouraged me to go to the methadone clinic with him. I was strongly against this idea because of the negative information I had been given. I once was given 30 sub oxen and had no withdrawal symptoms, but mentally could not fight the mental craving of snorting Oxycontin (while knowing the sub oxen was blocking it from my system). I finally gave in to my friends offer about the clinic, on a day where I had no money and no way of obtaining any type of narcotic. I even had gone to the extreme of repeatedly admitted myself to the hospital in hope of receiving some type of opiate to relieve my withdrawal symptoms without informing the doctor this was the only reason I was their. After going to one clinic for methadone, I soon switched to one that was closer and seemed to be a better fit for me. I went up to 85mg and took this dose for 1 1/2 to 2 years. For the remaining 1 1/2 years I had the nurse reduce my dose from 85mg to 50mg, by reducing my dose 3mg every week. I felt withdrawal symptoms once I reached 50mg, and the nurse increase my dose to 60mg for 2 weeks and then reduced my dose by 2mg every week. As I got lower they began to reduce my dose by 1 mg per week. I truly believe the saying, “everything happens for a reason”, because once I hit 30mg I truly began to feel the side effects of my dose being lower. The day my dose was reduced to 20mg, was the day the law had finally caught up with me. I was arrested and incarcerated for 8 days for a prior shoplifting and theft charge from 2009 that I failed to appear which resulted in a warrant for my arrest. I was truly miserable and uncomfortable during the time I was in Maricopa county jail in Phoenix, AZ, I look back on this experience as knowing this is what got me off methadone. Of course the jail tells you and your family they are medically attending to your withdrawal needs and being administered by medical staff, this is far from the truth, they do not give you anything in regards to your symptoms unless you state your an alcoholic and I believe they checked my vitals for the first 3 days and forgot about me after that. During the hours of being without my freedom, I believed I would go back onto 20mg of methadone immediately following my release. However, due to my charges and knowing that I was not being bailed out, I was unsure of my time in custody would be. I assumed the worst and told myself to not be surprised if I was their for 6 months or minimum 40 days. After going to court twice I luckily had the help of a public defender by pleading guilty to one misdemeanor 1 charge of shoplifting, while all other 4 charges were dropped, as my 8 days counted as 10 days served in jail as well as 10 days time served, plus a fine and restitution. Thankfully after jail I did not return to the methadone clinic, other than to provide them with the information I was no longer on methadone. I did feel slight withdrawal symptoms for about 30 days after, which included my appetite, stomach aches, cramping, resltlesness, increased anxiety, inability to sleep throughout entire night, ect. However, each day I felt more “clear headed” and more myself. My father even stated to me over the phone the day I was released from jail, that I sounded like his “old Lindsay” prior to my use of Oxycontin and methadone. I never realized that these drugs were impacting my with physical and mental state, but ability to think with a clear head. I now know why I never realized such an obvious fact because I did not feel “high” or under the influence during the last 2 years of abusing Oxycontin and the 3 years of being on methadone, therefore I felt “sober” even though I technically was on a high level of methadone. Overall, I find many myths and false statements about methadone, but I do believe that their are many addicts that abuse the ability to willingly receive help from any methadone clinic by still using when they are able too, or just remain on methadone for the rest of their lives’ with the hopelessness of never being able to be without this drug ever again. I hope this gives hope to any struggling addict that can relate to my past 7 years of my life. I truly believed that I had lost the fight to my addiction to Oxycontin multiple times during my time of use. I am here today without any opiate or op-aide in my system for over 37 days and have absolutely NO craving or desire to ever use or try an opiate *narcotic for the rest of my entire life. I do not regret the bad decisions I have made in my past, but I do know that I have grown stronger as a person and have learned the hardest way possible for every mistake/decision I have ever made. At time I have thought of past decisions that I regretted but learned that I can not look back on what I did not wrong.

in the shadows of death
12:39 am August 14th, 2013

Four years ago on memorial day my husband overdosed and died fron simply 20mg of methadone. He had a severe back injury and was on oxycontin for 3 years until the doctor found marijuana in his blood work. Cold turkey cut him off which took 3 long months of horrible withdrawls in which I was frightened for his life. He did it and made it through alive but I understand enabling and co-dependence but I don’t believe I was either as he was doing pills behind my back and my response when he seemed inebbriated and would not tell me what he took as his dinner is sliding down the front of his shirt, I would call an ambulance and ALWAYS they would say “he’s an adult we can’t take him anywhere”. I’d like to have a word with those EMTs to see how they felt he did not need to be hospitalized…maybe I’m still in denial but I strongly believe I did everything in my power to get him help in an un codependent way and I will not accept responsibility or an enabler in his death…..I never dreamed I’d be a 38 year old widow, again over 20mg of methadone…

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About Dr. Jana Burson, MD

Jana Burson M.D. is board-certified in Internal medicine, and certified by the American Board of Addiction Medicine. After practicing primary care for many years, she became interested in the treatment of addiction. For the last six years, her practice has focused exclusively on Addiction Medicine. She has written a book about prescription pain pill addiction: "Pain Pill Addiction: Prescription for Hope." Also see Dr. Burson's blog here.