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November 5, 2018

Do I Need Methadone Rehab?

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Methadone is a synthetic, pain-relieving narcotic medication that, in addition to treating severe pain, has been used to treat heroin and opiate cravings since the 1960’s and 1970’s. When used exactly as prescribed and as part of a comprehensive plan of treatment that includes therapies and other interventions, short-term methadone has helped many heroin users stay in treatment longer, according to a fact sheet from the Substance Abuse and Mental Health Services Administration.

However, methadone can also be highly addictive, and currently is not recommended as the first line of medication-assisted treatment (MAT), thanks to newer and potentially safer MATs. This article will help you understand how these addictive dangers may pertain to you, including whether rehab is your next best step.

Long-Term Methadone and Maintenance Clinics – The Addiction Dangers

Today, many rehab clinics and so-called methadone maintenance clinics continue to administer long-term methadone (an opiate) to people with heroin and opiate addiction— a form of “harm reduction” that for a long time has had its share of advocates and opponents. The controversy boils down to the question of whether long-term methadone as medication-assisted treatment (MAT) for heroin and opiates is really helping addicts find recovery, or merely teaching them to substitute one opiate addiction for another.

That’s because, while the addictive dangers of methadone may be less than heroin and other opiates, the drug can still be extremely physically addictive. (This is especially true when the therapeutic aim is not short-term administration of methadone but rather long-term, maintenance therapy.)

How Safe Is Methadone, and Can It Lead to Addiction?

The reality is that while methadone remains in some cases the only available MAT for an opiate addiction—depending on the person, their individual medical profile, and whether safer, less addictive MATs have already been tried without success—ongoing, long-term use of methadone can indeed lead to addiction, only further perpetuating an opiate use disorder.

In other words, there is such a thing as a “methadone addict”: a person whose primary drug of choice is this medication that acts much like the opiate morphine (only longer-acting and inducing a more gradual, milder onset of euphoria); and, a person whose thoughts, behaviors and daily life have come to revolve around getting and using methadone, leading to serious life consequences.

Just How Addictive Is Methadone?

Just how addictive is methadone then? Findings published by the Center for Substance Abuse Research at the University of Maryland reveal the following hallmarks of a highly addictive drug:

  • Physical tolerance to methadone can occur with frequent administration.
  • Psychological and physical dependence can develop with methadone use.
  • Methadone withdrawal symptoms can also occur.
  • And, while methadone may free someone from their compulsive, destructive impulses to use another stronger opiate, methadone use only perpetuates the same opiate dependency.

A 2014 article in Mental Health Daily summed up the addictiveness of methadone this way: “many people find [methadone] to be just as addicting (in some cases more addicting) than illicit opiates like heroin.”

Signs of a Methadone Addiction

If you have been using methadone—whether as a MAT for an existing opiate use disorder or legitimate form of pain management or illicitly without a diagnosis of an addiction or pain condition—the above signs could indicate a potential addiction. Let’s take a closer look at each of them:

  • Tolerance to methadone means that you are needing more and more of the drug (at higher dosages and greater frequency) in order to achieve the same effects.
  • Psychological and physical dependence to methadone can be marked by unpleasant mental, physical and emotional withdrawal symptoms in the absence of methadone (ranging from depression and anxiety to bad cramps, among other symptoms which are listed in the next section).

If you’ve progressed from taking oral doses of methadone to intravenous injection of the drug, this is a very big warning sign of addiction and a good indication you should go to rehab.

The best way to know for sure whether you have an addiction that requires rehab is to consult a medical professional who is qualified to give you an in-depth assessment and diagnosis of your condition. (Get more information and explore referrals.)

Methadone Withdrawal – Is It Worse Than Heroin Withdrawal?

Methadone withdrawal can be very painful and uncomfortable— so much so that some people have said methadone is even harder to withdraw from than heroin. Here is how one person described the experience of withdrawing from methadone, in a study of a heroin and methadone-addicted prison population:

…I went through the detox from the methadone and it was horrible. I was so sick. The only thing they gave me at jail was clonidine and something else— for my stomach because I kept vomiting so much. And I never want to go on that methadone again because … I literally wanted to die because of how much pain I was in. And I was only on what 80 milligrams, and I think I had been there for like five months.

Other Symptoms of Methadone Withdrawal

Because methadone is an opiate like heroin, withdrawal from the drug can involve many of the same symptoms that go along with heroin withdrawal. Common symptoms reported during methadone withdrawal:

  • Cravings
  • Depression
  • Insomnia
  • Chills and/or hot flashes
  • Cramps
  • Constipation
  • Anxiety
  • Body aches
  • Mental confusion
  • Concentration problems
  • Nausea and vomiting
  • Sweating
  • Vision disturbances
  • Restlessness

Methadone Overdose

A methadone overdose can pose another very real danger to those who are addicted. According to a report in 2009 by CBS News, methadone accounted for roughly one in three prescription painkiller overdose deaths.

Signs of a methadone overdose can include:

  • Shallow breathing (like other opiates, methadone produces respiratory depression)
  • Low blood pressure and a weak pulse
  • Constricted or pinpoint pupils
  • Body spasms
  • Cold, clammy skin
  • Blue lips and fingernails
  • Absence of breathing or consciousness

How Methadone Rehab Can Help

If you’re at risk of a methadone overdose or are exhibiting some or all of the above signs of potential addiction, you may benefit from methadone rehab. Treatment for methadone should begin with a medically supervised detox that ensures a safe and complete withdrawal that is as comfortable as possible. (Learn more about methadone detox.)

Your best chances of longer-term recovery will be a rehab program that couples detox with an extended period of residential, inpatient treatment, during which time, living in a highly structured, sober environment, you’ll receive group and individual therapies that will help you successfully manage cravings, stress triggers and any other psychological or emotional roots of a methadone problem.

A trusted rehab provider—learn how to find one—will also be able to help you discern whether a different short-term MAT, such as clonidine or Suboxone, could help you taper off methadone and ease more smoothly into eventual abstinence and a full recovery.

Understandably, it can be very disheartening to feel like you’ve kicked one addiction only to have developed another. The good news is that you don’t have to live dependent on methadone forever. With a comprehensive plan of care comprising detox and treatment, and in a rehab program you can trust, you can find another way to live that’s happier, healthier and doesn’t revolve around methadone.

For related information about methadone rehab and whether you need it, see these articles:

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