Methadone

What is methadone?

Methadone is a prescription drug, and is part of a group of drugs known as opioids. Opioids are depressant drugs, which means they slow down the messages travelling between the brain and the rest of the body.¹

Methadone is taken as a replacement for heroin and other opioids as part of treatment for dependence on these drugs. Replacing a drug of dependence with a prescribed drug in this way is known as pharmacotherapy. As well as improving wellbeing by preventing physical withdrawal, pharmacotherapy helps to stabilise the lives of people who are dependent on heroin and other opioids, and to reduce the harms related to drug use.²

Methadone is also used to relieve pain following heart attacks, trauma and surgery.

Slang names

Done or ‘the done’.

How is it used?

The Victorian pharmacotherapy program uses the syrup form of methadone. There are 2 brands of this liquid: Methadone Syrup^® and Biodone Forte^®.³ Generally, there are 2 types of methadone programs:

• Maintenance (long-term programs): May last for months or years, and aim to reduce the harms associated with drug use and improve quality of life.
• Withdrawal (short-term detoxification programs): Run for approximately 5-14 days and aim to ease the discomfort of stopping the use of heroin.⁴
  

For pain relief methadone is administered through an injection or tablets.

How effective is it?

Methadone treatment is more likely to be successful if it is part of a comprehensive treatment program, which addresses the body, mind and environment in which heroin has been used.

For example, treatment may include a combination of methadone, counselling, alternative therapies and the development of a positive support network of peers, friends and a support group.⁵

Methadone maintenance may not work for everyone, so it is important to work with a doctor or drug counsellor to find the best approach.⁵

Advantages of methadone maintenance over heroin use

• Using methadone on its own is unlikely to result in an overdose.
• Methadone maintenance keeps the person stable while they make positive changes in their life.
• Health problems are reduced or avoided, especially those related to injecting, such as HIV, hepatitis B and hepatitis C viruses, skin infections and vein problems.
• Doses are required only once a day, sometimes even less often, because methadone’s effects are long lasting.
• Methadone is much cheaper than heroin.⁵

Effects of methadone

There is no safe level of drug use. Use of any drug always carries some risk – even medications can produce unwanted side effects. It’s important to be careful when taking any type of drug.

Methadone affects everyone differently, based on:

• Size, weight and health
• Whether the person is used to taking it
• Whether other drugs are taken around the same time
• The amount taken

The effects of methadone last much longer than the effects of heroin. A single dose lasts for about 24 hours, whereas a dose of heroin may only last for a couple of hours.⁶

People with pre-existing impaired liver function (due to conditions such as hepatitis B, hepatitis C or prolonged alcohol use) may require careful monitoring while receiving methadone treatment.⁷

Side effects

The most common side effects of methadone are:

• Sweating (drink at least 2 litres of water each day to prevent dehydration)
• Difficulty passing urine
• Loss of appetite, nausea and vomiting
• Abdominal cramps
• Constipation
• Aching muscles and joints
• Irregular periods
• Low sex drive
• Rashes and itching
• Sedation¹

Dose-related effects

Some people on methadone programs will experience unwanted symptoms during their treatment due to their dosage not being right for them. This occurs particularly at the beginning of treatment.⁷

If the dose is too low, the following symptoms may be experienced:

• Runny nose and sneezing
• Yawning, feeling weak and difficulty sleeping
• High temperature but feeling cold and sweating with goosebumps
• Tears, irritability and aggression
• Loss of appetite, nausea and vomiting
• Abdominal cramps and diarrhoea
• Tremors, muscle spasms and jerking
• Back and joint aches
• Cravings for the drug they were dependant on¹

Overdose

If the dose is too high, the following symptoms may be experienced. If you experience any of the following effects, call an ambulance straight away by dialling triple zero (000). Ambulance officers don’t need to involve the police.

• Pinpoint pupils
• Slow pulse and shallow breathing
• Low body temperature
• Low blood pressure, poor circulation and dizziness
• Cold clammy skin with bluish tinge
• Mental numbness
• Occasional seizures
• Coma¹

Long-term effects

Methadone in its pure form will not cause damage to the major organs of the body.

Prolonged use of methadone will not cause any physical damage.⁸

Withdrawal

Methadone withdrawal develops more slowly and is less intense than withdrawal from heroin. Withdrawal symptoms are similar to those listed under ‘Dose-related effects’ under ‘too low’ dose. Most of these effects will begin within 1 to 3 days after the last dose and will peak around the 6th day, but can last longer.¹