Methadone Maintenance Treatment

What is Methadone Maintenance?

According to Harvard Medical School, “Since the 1970s, professionals who care for opiate addicts have reluctantly recognized that many of them will not or cannot stop taking the drug.” This does not need to be a begrudgingly-accepted fact and, because of methadone maintenance and other similar programs, many people are able to end their abuse of illicit opioids and stop abusing injection drugs.

Methadone maintenance is the “dispensing [of] opiates under medical supervision.” Patients are given the drug methadone in order to reduce withdrawal symptoms and cravings and to help them stop abusing heroin and other dangerous opioids drugs. Methadone maintenance is very beneficial, and many patients are able to change their lives based on using this program.

What Does Methadone Maintenance Entail?

Patients are given methadone once daily in order to reduce their withdrawal symptoms and cravings for opioids, to block the opioid receptors in the brain, and to maintain their lives without turning to dangerous opioid drugs. The NIJ states that these programs also “involve… providing patients with comprehensive rehabilitation services” such as:

• Therapy
• Medical services
• Education
• Housing
• Employment

Methadone maintenance is not about giving patients free drugs. It’s about helping them maintain their lives and reduce their dependence on opioids. In addition, these clinics often provide therapy and other behavioral treatments in order to give patients even more chances to change their lives and to eventually end their dependence on opioids.

Pros of Methadone Maintenance

Methadone is taken on a daily basis at licensed clinics.

Methadone maintenance is incredibly beneficial to many individuals. According to Harvard Medical School, “More than 100,000 American addicts are now using methadone as a maintenance treatment.” Some of the benefits of the program are:

• It can be taken once a day.
• It “does not cause euphoria or intoxication itself (with stable dosing), thus allowing a person to work and participate normally in society” (CDC).
• It improves the outcome of pregnancies in opioid-addicted pregnant women.
• It reduces criminal activity in opioid-addicted individuals.
• It reduces relapse and overdose in opioid-addicted individuals.
• It reduces depression in opioid-addicted individuals (Harvard Medical School).
• It reduces the transmission of HIV, hepatitis, and other diseases like “bacterial infections, endocarditis, soft tissue infections, thrombophlebitis, [and] tuberculosis” (CDC).
• It cost-benefit ratio is actually 4:1, meaning that “for every $1 spent on MMT, $4 is accrued in economic benefit” (NIJ).

Overall, methadone maintenance has been found to greatly improve the lives of many opioid addicts. With this program, they have much better chances at success, health, and life satisfaction. And methadone maintenance benefits the economy as well.

Cons of Methadone Maintenance

Methadone maintenance, however, does have some downsides. Harvard Medical School states that the program is “still politically controversial,” as many individuals believe that the only solution to drug dependence is abstinence. While this is sometimes an obtainable possibility, many people are not able to become completely abstinent from opioids ever and must attend methadone maintenance for years or even indefinitely.

Political controversy aside, there are still other cons of methadone maintenance treatment which should be addressed, including:

• The possibility of the diversion of the drugs to the illicit market
• “The possibility of patients abusing and overdosing on methadone” (NIJ)
• It isn’t a beneficial program for those who wish to finish treatment more quickly

In response to the final issue, there are many programs which provide assistance to those who want to detox from opioids and attend addiction treatment. This is a much faster alternative, and methadone maintenance is for those who need long-term care.

Why Choose Methadone Maintenance?

Many opioid-addicted individuals must decide which type of detox or maintenance program to attend along with addiction treatment. For methadone maintenance as an beneficial program, the individual can be:

• Someone who has struggled with opioid addiction for a number of years
• Someone who has attended treatment of some kind before (perhaps even multiple times) and been unable to stay abstinent from opioids
• Someone who is addicted to strong opioid drugs (like heroin or fentanyl)
• Someone who would experience withdrawal symptoms if taken off of opioids, including:
  • Fever
  • Anxiety
  • Muscle and bone pain
  • Vomiting
  • Nausea
  • Diarrhea
  • Runny nose
  • Goose bumps
• Someone who needs to live their daily life but can do so with the help of methadone

Commonly, methadone maintenance programs are available in outpatient clinics. This is because many of the individuals who receive methadone maintenance do so for years and need to attend treatment as part of their daily life. If all or many of these describe you in your life, you could be a great candidate for methadone maintenance treatment.

Is Methadone Maintenance Successful?

Yes. Depending on your definition of the word, methadone maintenance is actually successful in many ways. As described above, it actually helps to reduce many of the problems associated with illicit opioid abuse including overdose, crime, relapse, and the transmission of diseases. And for many patients who are on methadone maintenance for years, this is the definition of an incredibly successful life.

According to the NIDA, methadone maintenance can also dramatically reduce illicit opioid use altogether. “Patients’ illicit opioid use declines, often dramatically, during methadone maintenance treatment.” While therapy is also essential for this kind of effectiveness, it is provided to most patients in methadone maintenance treatment clinics, and the two treatments together do reduce the use of illicit opioids, which is the goal.

Dosing and Other Factors that Affect Methadone Maintenance Success

According to the CDC, “Most patients require a dose of 60-120 mg/day to achieve optimum therapeutic effects of methadone.” There are lower doses that some patients are placed on, but they are not usually as successful. Patients on these higher doses actually stay in treatment longer and use illicit opioids less. “Some patients need even higher doses for fully effective treatment.”

In addition, there are other factors that affect methadone maintenance success. The NIDA states, “A younger age at the onset of heroin use is associated with poorer treatment outcomes.” Other factors that may affect treatment are:

• Psychiatric health
• Severity and duration of drug use
• Emotional health
• Criminal history
• Age

Depending on these factors, a person may have a chance of being more or less successful in treatment. However, methadone maintenance is still an incredibly beneficial and successful treatment for many opioid-addicted individuals.