Since 1964, methadone has been used to treat opioid use disorders. With the rise of the opioid epidemic, it remains an effective maintenance medication for people saddled with this kind of addiction. Patients requiring methadone have grown from 227,000 to 350,000 between 2003 and 2016, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
However, there is controversy over the use of methadone as a maintenance medication for opioid addiction. Why? Because, as an opioid, it is an addictive substance all its own. Also, more physicians and treatment centers are prescribing alternative opioid treatment medications like buprenorphine because they do not possess methadone’s addictive properties.
Still, methadone is a medical marvel because of its lasting utility. The World Health Organization (WHO) includes methadone on its List of Essential Medicines, which details the safest, most effective medicines needed in a health system.
Because methadone is available only in outpatient treatment clinics that have been certified by SAMHSA and registered by the U.S. Drug Enforcement Administration (DEA), choosing the right clinic is essential.
Read on to find out how to locate a methadone clinic that best fits your needs and opioid treatment alternatives offered in professional recovery.
How Methadone Works
Three times stronger than morphine, methadone works by stimulating the opioid receptors in the brain. It possesses distinct features that make it suitable as a maintenance therapy medication. For one, it has an exceptionally long half-life, which is estimated to last between 15 to 55 hours. Secondly, it acts much more slowly in the body and lasts longer, but it does not produce the intense euphoria of other opioids. Methadone has also been proven to eliminate opioid withdrawal symptoms and alleviate drug cravings.
It can also provide pain relief for up to eight hours and prevents opioid withdrawal symptoms for up to two days.
What to Look for in a Methadone Clinic
You may be in the throes of overdose, or you have been arrested on a drug charge. Whatever the case, you are at the point where you have to get treatment at a methadone clinic. Without it, your addiction could consume you entirely.
There are roughly 350,000 patients who receive methadone doses daily, along with counseling and other services, states Pew Charitable Trust. They get that treatment from 1,460 opioid treatment centers nationwide.
However, not all treatment centers are created equal. To find the best clinic that fits your needs, the four questions you need to ask are:
- Is it located near you? Because you will require your methadone dose daily, it is critical that you consider a clinic that is closest to where you live. Otherwise, getting the treatment you need at a far off location will interfere with your life and become a job in and of itself.
- Can this provider help you right away? An unfortunate reality of methadone treatment is having to wait in line for hours to get your dose. If you have multiple options at your disposal, it is perhaps best to choose a clinic that will provide the most expedient service. That way you can get your dose and the additional treatment you need without it taking up too much of your time.
- Is it affordable? If you have insurance, you will want to make sure the provider accepts it. Short of that, you have to determine how you will cover the cost. Does the clinic you choose offer grants or sliding-scale payment options?
- Does this clinic offer other treatment in addition to methadone? Proper treatment that offers medication in combination with counseling and other services can maximize your recovery. If you are just receiving methadone, it may not allow you to recover quickly.
What the Best Methadone Clinics Offer
In addition to your methadone dose, reputable clinics can offer the following:
- Counseling: You can receive this service on your own or with family. Counseling can allow you to uncover the underlying causes of your addiction.
- Job training: Addiction and unemployment are often intertwined. A treatment center can offer resources and information that can help you find employment.
- Housing assistance: Some clinics can help people find programs that provide low-income housing. Having a safe place to live can provide stability and make you less likely to relapse.
- Legal outreach: If you have been arrested for drug use, you may be under orders to provide proof of treatment. A treatment center can provide help in this area, which clears any potential legal hurdles you may face.
The Cons of a Methadone Clinic
Methadone continues to be a controversial medication because critics still view it as replacing one drug with another.
There are also significant disadvantages to receiving treatment from a methadone clinic, according to The Fix. Those main drawbacks are as follows:
- Most methadone clinics do not offer any formal therapy or counseling as part of a treatment program. Thus, clients do not get the opportunity to examine the underlying cause behind their addictions.
- Methadone is as addictive as other opiates, and addicted persons must visit a clinic daily to receive treatment.
- Many patients have to wait in line for hours to receive their dose.
- Being on a methadone maintenance schedule makes it impossible to take vacations or weekend trips — activities that are a part of a normal life.
- Because methadone’s effects diminish over time, clinics raise dosage amounts to accommodate a patient’s tolerance. This often leads to them taking high doses of the drug, potentially leading to dependency and addiction.
The Effects of Methadone
Yes, methadone has primacy as an opioid treatment medication. Yes, methadone can be a drug of abuse and comes with its own set of concerning effects. Those effects may include:
- Mood changes
- Vision problems
- Weight gain
- Dry mouth
- Sore tongue
- Stomach pain
- Difficulty falling asleep or staying asleep
- Difficulty urinating
There Are Also Serious Side Effects Associated With Methadone. Those Can Include:
- Agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- Nausea, vomiting, loss of appetite, weakness, or dizziness
- Swelling of the eyes, face, mouth, tongue, or throat
- Difficulty breathing or swallowing
- Extreme drowsiness
- Inability to get or keep an erection
- Irregular menstruation
- Decreased sexual desire
Alternatives to Methadone
Opioid treatment medications like buprenorphine and naltrexone carry a lower risk of addiction than methadone. These substances are often prescribed in combination with therapy and counseling. This approach is referred to as medication-assisted treatment or MAT. MAT is a feature of many professional addiction recovery programs.
For opioid addictions, treatment programs can offer Suboxone, a combination of buprenorphine and the anti-overdose medication naloxone. Suboxone works to alleviate withdrawal symptoms. Naltrexone blocks the sedative and euphoric effects of opioids, which diminishes the psychological reward often associated with opioid use.
The other advantage these medications have over methadone is availability. Unlike methadone, Suboxone and naltrexone can be administered in physician offices and drug treatment settings rather than at sanctioned and registered clinics.
How Professional Treatment Can Help
MAT is a key feature of professional addiction treatment. The offerings in a reputable program are comprehensive, multifaceted, and tailored to address the whole person.
Opioid treatment starts with medical detoxification where you are weaned from a substance using an MAT drug like buprenorphine, which treats those withdrawal symptoms. Medical staff will also provide around-the-clock care and supervision.
After detox, you can receive ongoing care at a treatment facility on a full-time basis through a partial hospitalization program (PHP) or an intensive outpatient program (IOP). Both programs offer intensive treatment and therapy. However, IOP will allow you to live at home (or some other housing arrangement) during treatment.
What’s more, both offer the kind of therapy designed to help you get to the root of your addiction.
After your stint in PHP or IOP, a caseworker will arrange aftercare through an alumni program, which allows you access to a recovery community that provides support and mentoring.
All the while you can receive MAT to further assist your recovery.