Is Methadone a Viable Alternative or Substitute?

Ask a coffee junkie about the best way to skip the first cup of joe. Chances are, you’ll hear a long ode to the benefits of tea.

Same goes for sugar freaks. Ask them how they kick the habit, and they’ll tell you Splenda is a wonderful friend.

But what if opioids are your addiction of choice?

The prescription drug methadone works on receptors triggered by opioids. Take it, and you’ll skip the sick feeling that comes with opioid withdrawal. In a way, it makes an excellent opioid replacement.

But methadone comes with a few dangers you’ll need to guard against. And some of them could keep you from using this medication in the first place.

What Is Methadone?

Methadone has been used to help people overcome addictions to opioids like heroin since the 1960s. But throughout its long history, the drug has been mired in controversy, researchers say. People can’t quite decide if it’s a remarkable solution to a difficult problem, or if it’s a dangerous drug that should be eliminated altogether.

Part of the problem comes in methadone’s classification. Technically, it’s in the opioid class. That means it’s structurally similar to some of the scary drugs you’ve heard about, including:

  • Fentanyl
  • OxyContin
  • Vicodin
  • Heroin

All of these drugs latch to receptors in the brain, intestines, and spinal cord to deliver relaxation and euphoria. But methadone is a little different, says the National Alliance on Mental Illness. It stays in the body for longer.

Drugs that persist in the body aren’t typically as “rewarding” as those that don’t. When a drug comes on slowly, you don’t feel a big rush or a huge high. And you don’t feel that sudden longing when it stops working either. You might feel a change, but it’s subtle.

Since methadone works on the same receptors, and since it’s not rewarding, it seems like an ideal treatment for people recovering from an addiction to something like heroin.

But some people do abuse methadone. Some of them haven’t tried other opioids before, so they don’t expect a big rush with the first hit. They enjoy the experience as it is, and they can grow addicted to the substance.

methadone chemical compound

How Does Methadone Treatment Work?

Methadone treatment is made for people with an addiction to another opioid. Methadone is designed to ease cravings and soothe physical distress, and that can allow people to feel well enough to participate in addiction therapy.

When you’re addicted to an opioid, your brain changes. When you try to quit, you feel:

  • Physical symptoms. They’re often described as “flu-like” and can include nausea, vomiting, and aching muscles.
  • Mental distress. You can feel depressed, anxious, or both.
  • Severe cravings. You know a hit could take all the pain away, and you’d do anything to get it.

When you make a commitment to quit opioids, doctors want you to stick to it. Methadone seems to help. You’ll get a dose titrated to your addiction, and you’ll take it regularly to keep withdrawal away.

The Substance Abuse and Mental Health Services Administration says most people take methadone for about a year, but some people need help for even longer.

It’s not easy to stay on methadone treatment. Often, you need to go to a clinic to get your drugs, as most pharmacies and health care centers aren’t licensed to hand out the stuff. If you live in a rural area, you might have a long drive to the clinic, reporters say.

But if your head is clear and your body feels healthy, it might be well worth the trip.

What Makes Methadone Different?

You’ll need to take your methadone regularly to avoid feeling sick. Sometimes, you’ll need to set your schedule around getting your medication. Remind you of anything? Staying on methadone can seem similar to taking heroin. But researchers say the two habits are very different.

The World Health Organization says methadone is different than dope because it can:

  • Reduce the risk of infectious disease. When you take methadone in a clinic, you’re not sharing needles on the street with heroin addicts. That means your risk of infections, like HIV and hepatitis, drops.
  • Reduce your risk of overdose. You’ll only have the amount your doctor gives you. That means you can’t go on a spree or take more because you want to. You won’t have it available.
  • Keep you away from crime. Opioids are expensive, and that can lead you to steal to support your habit. Methadone is often covered by insurance.

The Drug Policy Alliance also says people taking methadone don’t feel high. You might have a moment they describe as a “mild glow” after you take your dose. But it’s transient, and you won’t feel full-blown euphoria. Instead of feeling wrapped up in a blanket of happiness, you’ll just feel normal.

man sleeping next to alarm clock

Methadone Withdrawal Is Real

As we mentioned, most people who take methadone do so because they want to stop taking things like heroin or OxyContin. Methadone clears their minds so they can focus on therapy. But some people do abuse the drug. And even those who take it therapeutically will experience some discomfort when they try to quit.

Methadone’s placement in the opioid class means you’ll feel flu-like symptoms, mental health distress, and cravings if you quit cold turkey. If you absolutely must get sober in a hurry, researchers say, the prescription medication buprenorphine may help. It also works on opioid receptors, but it’s a mild medication that you can take at home.

If you do go cold turkey, expect your discomfort to peak after about two days, researchers say. But if you don’t have a rehab program to help you, expect to deal with significant cravings for methadone you’ll struggle to keep under control. You’ll need all of your strength to avoid a relapse when your sobriety is new and your distress is strong.

Your doctor may also choose to offer you a taper. You’ll take a little less methadone every day, and your withdrawal symptoms will be mild. In time, you’ll be sober. But you won’t be uncomfortable as you move through it.

If you don’t have a written prescription for methadone, don’t take it. You’ll need a doctor’s help to find the right dose, and you’ll need a prescription to take the drug legally. Without that, you’re abusing an illicit drug. That’s never smart.

If you’re searching for ways to get out from under an addiction to heroin, OxyContin, or something similar, methadone might be a good solution. But you’ll need to work with a doctor to find out. And methadone isn’t a cure for addiction. You’ll also need therapy to build habits that support sobriety.

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