Methadone
Learn more about methadone, an opioid mainly used to treat opioid addiction.
Overview
Common Nicknames
Dollies, amidone, fizzies
Drug Class
Opioid
Drug Form
Liquid (typically green, with blue formulation more concentrated) and rarely tablet
Route of Administration
Oral
What is the science of Methadone?
Methadone was initially developed as a painkiller but now it is much more widely used to treat people who have got stuck on heroin or other opioid drugs. As an opioid, it mimics the body’s natural pain-killing chemicals, endorphins. Therefore, it can relieve pain, cause drowsiness, can cause mild euphoria, slow breathing, slow the bowels causing constipation, and cause other side effects of opioids.
Methadone should not be confused with mephedrone, as they are completely different drugs. Anyone taking methadone when they are looking for mephedrone risks extreme danger.
What are the risks?
If someone takes an overdose of an opioid drug, they can die quickly. This is usually by respiratory depression (slowing the drive and effectiveness of breathing). Anyone not used to opioid drugs would be much more at risk of this. Methadone is often reported as a contributory cause of death in opioid drug related overdoses. It is particular dangerous if mixed with other drugs such as heroin, alcohol, and benzodiazepines.
The risks of death by overdose increase when many substances are taken together, for example alcohol and benzodiazepines, which also have effects on breathing (respiration). Methadone decreases control and impairs judgment, making the risk of accidents much higher. This means that activities like driving under the influence of methadone are potentially very dangerous. If you are prescribed methadone by your doctor, you must inform the DVLA and they have to make a decision whether you are still safe to drive.
How might the drug make you feel?
Methadone can relieve pain and cause drowsiness, mild euphoria, slow breathing, slowed bowels (causing constipation), as well as other typical side effects of opioids. As it takes longer to build up in the body and takes longer to come out of the body, it causes much less euphoria than heroin. However, most people report being drowsy, mentally slowed, and often a bit sweaty taking methadone every day.
Is Methadone addictive, and what are the long-term effects?
One-off or occasional use of methadone is very unlikely to result in the development of depend-ence. However, taking methadone regularly over a sustained period can cause serious physical and psychological addiction. People who become dependent on methadone may become tolerant to the drug’s effects and experience withdrawal symptoms without it. Users may crave the drug and feel unable to cope without it. The risk of dependence increases the longer the drug is taken, the higher and more regular the dose, and the stronger the methadone.
The risks of depressed breathing caused by methadone may be increased in people with conditions such as muscle weakness (e.g. myasthenia gravis), sleep apnoea, or lung disease/breathing disorders.
Long-term risks of methadone are low if it is used as prescribed.
Harm Reduction and Drug-Drug Interactions
If taken according to prescription then methadone is very safe.
Mixing with benzodiazepines and alcohol is potentially very dangerous. Also if other opioid drugs are used, although initially methadone would usually block the effects, eventually you can over-whelm the methadone and accidentally overdose.
Medical Uses
It is mostly used as a substitute medication for people addicted to opioids such as heroin. It is occasionally prescribed as a pain-killer.
Myths and Misconceptions
Methadone just replaces one addiction with another
While methadone is an opioid and causes physical dependence, dependence and addiction are not the same thing. When taken as prescribed, methadone stabilises brain chemistry, reduces cravings, and allows people to function normally. Long-term prescribing of methadone is a clinically recognised approach, comparable to other medications taken daily to manage chronic conditions.
If you're on methadone, you're not really in recovery
Recovery means different things to different people, and methadone-assisted treatment is an evidence-based pathway recognised by major health bodies worldwide. Research consistently shows it reduces illicit opioid use, overdose deaths, and drug-related crime. Defining recovery solely as abstinence from all substances, including prescribed medication, is not supported by current evidence.
Withdrawal
A period of sustained dependence on any drug can be debilitating and prevent people from working and leading an active life. It may also cause mental and physical harm and opioid withdrawal can be very unpleasant.
Acute withdrawal effects from methadone can be intense, although for many they will be milder than those from heroin. Acute withdrawal effects include shivering, yawning, feeling cold and clammy, goose-bumps on the skin, diarrhoea and vomiting, flu-like symptoms, agitation, anxiety, insomnia and sensitivity to sound/light. Opioid withdrawal symptoms are unpleasant but do not endanger life.
Potential effects of long term methadone use include constipation, tiredness, sedation. People often have problems with their teeth as methadone reduces your natural saliva which protects the teeth against dental caries.