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March 1, 2018

Methadone: how it works and why it’s legal

Methadone dose, cup

There has been a lot of recent media attention on methadone, emphasising a range of factually incorrect messages. Various reports have made claims about how methadone is used, what it is used for, and how it can impact a person’s ability to go about daily activities like operating a vehicle. This sort of reporting is extremely stigmatising and has the potential to bring significant harm to an already marginalised group.

In response to these stories, we look at the facts.

What is methadone?

Methadone is a prescription drug, and is part of a group of drugs known as opioids. It has been used successfully to treat opioid dependence for more than 40 years1. Opioids are depressant drugs, which means they slow down the messages travelling between the brain and the rest of the body1.

Colloquially, methadone is not known as ‘meth’. Meth is a shortened name for methamphetamine, which belongs to an entirely different group of drugs known as stimulants.

Methadone is taken as a replacement for heroin and other opioids as part of treatment known as pharmacotherapy. Replacing a drug of dependence with a prescribed drug, helps to stabilise the lives of people who are dependent on heroin and other opioids and to reduce the harms related to drug use1. The aim of methadone treatment is to determine the correct dose for each person and prevent cravings. Which allows people to re-establish a quality of life once they have stopped using illicit opioids, not to provide a ‘high’1,4.

The Australian Institute of Health and Welfare produced a report in 2016 which showed that there were approximately 48,900 people receiving pharmacotherapy nationally 2.

Does methadone impair people’s judgement?

Methadone treatment is provided slightly differently in Australia’s states and territories, and health professionals are involved in the prescription, administration and ongoing use3. When a person decides to stop using illicit opioids, they work with their health provider to determine the correct dose for them. This period is called the ‘stabilisation period’ and it lasts for about two weeks. During this time, clients are advised not to operate heavy machinery or drive as their body will be adjusting to the medication.

When a person takes their dose of methadone, it takes approximately 30 minutes to start being absorbed and between 1-4 hours to reach peak blood level. If a person is on a stable  methadone dose and not using other drugs (or withdrawing), their thinking or reaction time should not be affected.5

Stigma & the impact of misinformation

When drugs are used to treat medical conditions that are common for many people, such as hay fever, as a society we accept this as a part of daily life. The medication that most people use, may have warnings that it can cause nausea and or/drowsiness, and so people will be given the choice as to how many of these tablets they take, and when they can operate a vehicle. However, in the case of methadone, there is misconception about who uses this medication, how often, and how it affects their daily activities. People who are on a methadone program must follow strict conditions, including when they take the medication. They must attend a specific pharmacy or clinic, present identification, and take an oral syrup in front of a health professional3. People on methadone programs are like people with other long term medical conditions that may require ongoing maintenance medications4.

When media reports present stories about a small group of people who are receiving medical treatment for a specific health condition, and deem it irresponsible without having the correct information, this compromises the safety, livelihood and control that these people have over their own lives.

Recent reports in the media regarding methadone were misleading, intrusive and sensationalised, and only served to contribute to a harmful stigma for a small group of Australians who are working to improve their lives.

The ADF is committed to working with communities to reduce the harm caused by alcohol and other drugs, and we strive to negate the harmful stigma surrounding people who use alcohol and other drugs.

Additional information

If you are interested in reading more on this topic, and some of the topics raised in media reports recently, please see the links below:

What are ‘cannabis goggles’ and do they work?

Fact Sheet: Methadone

References
  1. Brands B; Sproule B; & Marshman J. (Eds.) (1998) Drugs & Drug Abuse (3rd Ed.) Ontario: Addiction Research Foundation.
  2. Australian Institute of Health and Welfare. (2017, November 14). National opioid pharmacotherapy statistics (NOPSAD) 2016. Retrieved from Alcohol and other drug treatment services
  3. The Department of Health. (2011, April 18). Review of methadone treatment in Australia. Retrieved from Illicit Drugs
  4. Rankin, J. & Mattick, R. (1997). Review of the effectiveness of methadone maintenance treatment and analysis of St. Mary’s clinic, Sydney.
  5. Preston, A. (2012). The Methadone Handbook. Melbourne: Alcohol and Drug Foundation.