Methadone
Methadone is a narcotic pain reliever, similar to morphine. It also reduces
withdrawal symptoms in people addicted to heroin or other narcotic drugs without
causing the '"high" associated with the drug addiction. Methadone
is used as a pain reliever and as part of drug addiction detoxification and
maintenance programs.
Methadone History
Methadone was first synthesized in 1937
by German scientists Max Bockmühl
and Gustav Ehrhart at IG Farben (Hoechst-Am-Main) during their search for an
analgesic that would be easier to use during surgery and also have low addiction
potential. Methadone is a Schedule II drug under the Single Convention on Narcotic
Drugs. Methadone was introduced into the United States in 1947 by Eli Lilly
and Company as an analgesic (They gave it the trade name Dolophine,® which
is now registered to Roxane Laboratories). Since then, it has been best known
for its use in treating narcotic addiction, though it is also used in managing
chronic pain due to its long duration of action and very low cost. In late
2004, the cost of a one month supply of methadone is $20, as compared to an
equivalent analgesic amount of Demerol at $120. The old name Dolophine comes
from the German Dolphium. The name derives from the Latin dolor (“pain”).
Methadone Abuse and Addiction
Although not common, Methadone is encountered on the illicit drug market and
has been associated with a number of overdose deaths. "Street Meth" demand
comes primarily from opioid addicts unable to get into a legal methadone program,
or addicts who have been removed from a Methadone program due to some infraction.
Methadone is not a common drug of choice because, generally speaking, addicts
seeking a high strongly prefer shorter-acting opioids. Studies have shown that
the vast majority of methadone diverted to the illicit market comes from pain
management prescriptions or theft from factories/shippers, and not from maintenance
patients.
In the late 1990s methadone abuse began to become a more serious problem,
and the number of methadone overdoses (an indicator of the prevalence of abuse)
jumped dramatically. The increase in methadone abuse was apparently caused
by heroin and oxycodone (OxyContin; a prescription painkiller) addicts using
methadone when they could not get other drugs, as well as by an increase in
the number of so-called recreational drug users who were abusing methadone.
In the brains of addicts, methadone prevents heroin or morphine from interacting
with receptors for natural painkillers called endorphins , blocking the effects
of the addictive drugs and reducing the physical cravings. In controlled doses
it creates its own effects of mild euphoria and drowsiness, but lasts much
longer (one to two days) and does not create the sometimes fatal respiratory
depression that opiates do. Its continued use as a heroin substitute eventually
restores sexual, immune, and adrenal function.
Supporters point out that methadone maintenance, being oral, breaks the dangerous
ritual of intravenous injection, that it is legal and eliminates the addict's
need to engage in crime to pay for drugs, and that it gives addicts a chance
to reevaluate their lives. Critics counter that methadone patients are still
drug addicts and that methadone therapy does not help drug addicts with their
personality problems. In many cases multiple drug use and a strong psychological
dependence undermine any gains made by taking methadone. Some addicts manage
to resell the methadone they receive in order to buy heroin; this and other
illegal diversion have resulted in methadone joining the group of addictive
drugs sold on the street.
Methadone Side Effects
Deaths occur more frequently at the beginning of treatment in methadone programs;
they are usually a cause of excessive doses (i.e. erroneously estimated tolerance)
and they are affected by concomitant diseases (hepatitis, pneumonia). Methadone
generally entails the entire spectrum of opioid side effects, including the
development of tolerance and physical and psychological dependence. Respiratory
depressions are dangerous. The released histamines can cause hypotension or
bronchospasms. Other symptoms are: constipation, nausea or vomiting, sedation,
vertigo, edema.