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February 12, 2019

Does Methadone Make You High?

If you are in treatment for an opioid use disorder (OUD), you may have been prescribed methadone as part of your treatment program. You’ve probably heard a lot about methadone, although much of what you think you know may be unreliable or wrong. On the other hand, you might be quite savvy about methadone and are not in professional treatment (or are in treatment and decide you’re going to abuse it anyway). Some people take methadone in a deliberate attempt to get high, or to circumvent treatment and use it in combination with other drugs to get high. Does this work? Does methadone make you high? What if you don’t want to get high on methadone, but are taking it as prescribed as part of treatment? Will methadone still get you high or are you safe taking it as your doctor prescribes?

WHAT IS METHADONE?

Initially launched as a pain reliever in 1939, and in 1964 introduced to treat dependence on opiates, methadone is a synthetic opiate – and a very powerful narcotic. It was approved by the Food and Drug Administration (FDA) in 1973 as a long-term pharmacological treatment for dependence on opiates. Drug rehab facilities currently use methadone (as one of the three FDA-approved medications for the treatment of opiate addiction) to reduce opiate withdrawal symptoms and as an alternative to other opiates, painkiller drugs, and heroin, in some cases. In fact, methadone is sometimes prescribed to transition clients from opiate drugs like heroin.  

IS IT POSSIBLE TO GET HIGH ON METHADONE?

Under normal circumstances, when someone is on a maintenance treatment program for opiate dependence or for OUD, the methadone they’re prescribed doesn’t produce the same type of a high that’s associated with heroin and other opiate substances. The National Institute on drug Abuse (NIDA) says this is because methadone produces stable levels of the medication and has a gradual onset. It blocks euphoria while also helping to significantly reduce drug cravings. The same is true for other medications used in medication-assisted treatment, or MAT, to treat opiate addiction, such as buprenorphine.

However, it is possible that methadone can make you high – although it necessitates taking abnormally high doses. This includes taking it much more frequently, or injecting or snorting the drug. The latter two are extraordinarily dangerous because those methods release the drug into the body over time, where it builds and is stored in the tissues.

Other ways people get high on methadone include taking it in combination with benzodiazepines (such as Xanax, Ativan, or Klonopin), combining it with alcohol, street drugs or other opiate drugs to enhance methadone’s effects, and when the individual taking methadone has no tolerance to opiates.

All of these abuses of methadone are dangerous.

Methadone and Alcohol

A central nervous system (CNS) depressant, alcohol mixed with methadone (consuming alcohol while taking methadone) can result in death. The reason people do both is to supposedly enhance the effects of both alcohol and methadone. The unfortunate byproduct of combining the drugs in this way is that they both affect the same parts of the body and may result in a shutdown of those critical mechanisms. The most slowed of the bodily functions is usually respiratory, resulting in slowed or stopped breathing – a life-threatening event.

Methadone and Benzodiazepines

Using benzodiazepines and methadone makes it much more likely for the abuser to get high. Valium, for example, is a benzodiazepine that may be prescribed to treat anxiety or insomnia, but it is also – like methadone – a CNS depressant. Mixing methadone and benzodiazepines causes a synergistic effect: they both significantly depress (slow down) breathing and can result in complete breathing cessation.

Methadone and Other Opiates

First of all, combining methadone and opiates is a risky approach, one that can lead to unintended consequences following a methadone high – overdose and death. The tricky part about taking methadone while also taking other opiates is that the methadone is used to block the euphoric effects of other opiates. Theoretically, you shouldn’t be able to get high on this combination. If you do get high, it’s not likely it will be much of a high. Yet, it’s also important to note that each person is different. While some people on methadone may be able to get high when adding opiates, most won’t – or it’s less likely. If someone is on a lower methadone dose, it may be possible to get high with opiates, but those taking more methadone and combining it with opiates probably can’t.

What is a Methadone High Like?

Knowing what a methadone high is like can help the person abusing it as well as family, friends and concerned others who may need to intervene to get medical help in the case of overdose. Naloxone (Narcan) is a potentially life-saving medication that counteracts the effects of a methadone high that results in overdose.

Common effects of a methadone high include:

  • Drowsiness
  • Euphoria
  • Lack of energy
  • Nodding off
  • Pain relief
  • Relaxation
  • Sweating
  • Slowed breathing
  • Trouble urinating

Why do People Abuse Methadone?

While carefully monitored prescribed methadone use is unlikely to result in abuse of the opiate during MAT, it is possible to deliberately take more of the drug that they obtain elsewhere in an effort to achieve euphoric effects. Why would someone take methadone to get high? Regardless of the risks, if someone wants to get high, they’ll do almost anything to recapture that feeling. Add to that the fact that methadone is less expensive and more readily available than other opiates, prescription and street drugs, and the scenario where someone who wants another way to get high starts to take shape.

It’s not necessarily all that easy for abusers to obtain the methadone they will likely inject, probably also consuming alcohol, other opiates or benzodiazepines. After all, methadone dispensing occurs at clinics and treatment centers under tight regulating restrictions, and only by those staff having received training and certification allowing them to prescribe it. Methadone abusers side-step this by doctor-shopping, or by using a fake name/identification to get the dose of methadone to suit their purposes – achieving a high from increased dosage or staving off withdrawal.

Yet the concept of bulking up on methadone dose to get high is setting the stage for failure. More is not better, nor will it produce the kind of high abusers think they’ll get. In addition, taking too much methadone – a highly addictive drug – can be life-threatening. Using it in combination with other central nervous system depressants, such as alcohol and other opiates, or benzodiazepines magnifies the risk of overdose and death.

The Risk of Methadone Addiction

Yes, you can become addicted to methadone. According to Medline Plus, methadone can be habit-forming. Although when you take it exactly as prescribed by a doctor, the risk of dependence and addiction is reduced, if you take methadone long enough and abuse it, you can develop an addiction. The problem is that methadone is one of those drugs that, because it is less expensive than other opiates and is easier to come by, is frequently diverted. Indiscriminate dosing of methadone, taking doses too often or in increasing quantities, especially when initiating use of the drug, raises the risk of accidental death due to respiratory depression. There are, of course, other dangers such deliberate abuse of methadone poses, including arrhythmia, sedation, methadone overdose (including coma) and other possible life-threatening effects.

TREATMENT FOR METHADONE ADDICTION

Treatment for methadone addiction involves undergoing medically-supervised drug detox and methadone rehab. During the process of methadone withdrawal, which can be 3-6 months (and longer for chronic, long-term methadone use), a treatment program will be crafted to meet the client’s specific needs. This will likely include taking other alternative medications to wean off the methadone and participating in counseling and certain behavioral therapies prescribed to speed a return to normal functioning and learning to live a drug-free life. Developing a personal relapse prevention plan is a big part of the comprehensive treatment plan, and one that paves the way for completion of the official treatment program. Ongoing aftercare and alumni programs also help solidify the foundation for recovery established during formal treatment.

Methadone Withdrawal Symptoms

Experts say that methadone withdrawal symptoms are neither as harsh nor as common as those of a heroin withdrawal experience. Still, serious side effects – including extreme dehydration – have occurred in some individuals who abruptly, and without medical supervision, discontinued methadone. Common withdrawal symptoms with methadone discontinuation include:

  • Agitation
  • Anxiety
  • Appetite loss
  • Body aches
  • Chills
  • Cramps
  • Diarrhea
  • Increased rate of breathing
  • Increased heart rate
  • Nausea
  • Restlessness
  • Runny nose
  • Shaking
  • Sleep problems
  • Sweating
  • Vomiting
  • Watery eyes

However, it should also be noted that a 2014 study published in Substance Use and Misuse found that those study participants who were in long-term opiate maintenance therapy using methadone reported more difficulties detoxing from methadone than heroin. Still, professional drug rehab treatment can help in overcoming methadone withdrawal symptoms and coping with cravings, whether the client is getting off methadone due to methadone addiction or weaning off methadone used in long-term maintenance therapy.

Whether you are in MAT for opiate dependence or OUD using methadone, or in treatment for OUD to methadone, you need to trust that your doctors and treatment team will use the latest evidenced-based medications and therapies to help you get through the withdrawal and treatment process. Their sole intent is to help you do so safely and effectively, providing you with a solid foundation for ongoing recovery. Therefore, if you have questions about the efficacy of the medications used in your treatment, and how long such medications may be used or if there are alternatives that may be better for your situation, speak up and get the reassurances that only your treatment team can provide.

For more about methadone, addiction and recovery, check out these articles:

Alternative Methods for Managing Pain Without Opiates

Do I Need Methadone Rehab?

How Does Methadone Make You Feel?

Methadone Detox – Withdrawal Symptoms and Timeline

How to Get Off Methadone

Probuphine: The New Implant for Opiate Addiction

Sources:

Centennial-Rockefeller University Hospital. “The First Pharmacological Treatment for Addiction: Methadone Maintenance.” Retrieved from http://centennial.rucares.org/index.php?page=Methadone_Maintenance

Center for Substance Abuse Research. “Methadone.” Retrieved from http://cesar.umd.edu/cesar/drugs/methadone.asp

Drugabuse.gov. “Methadone Research Web Guide.” Retrieved from https://www.drugabuse.gov/sites/default/files/pdf/partb.pdf

Drugs.com. “Methadone.” Retrieved from https://www.drugs.com/pro/methadone.html

JAMA Network. JAMA Psychiatry. “Buprenorphine vs Methadone Maintenance Treatment for Concurrent Opioid Dependence and Cocaine Abuse.” Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article-abstract/497875

Medline Plus. “Methadone.” Retrieved from https://medlineplus.gov/druginfo/meds/a682134.html

National Institute on Drug Abuse. “Principles of Drug Abuse Treatment: A Research-Based Guide (Third Edition.” “Opioid Addiction: Methadone.” Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies

National Institute on Drug Abuse. “Principles of Drug Abuse Treatment: A Research-Based Guide (Third Edition.” “Is the use of medications like methadone and buprenorphine simply replacing one addiction with another?” Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/use-medications-methadone-buprenorphine

Psychiatrische Praxis. “[Methadone and levomethadone – dosage and side effects.]” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27246839

Substance Abuse and Mental Health Services Administration. “Methadone.” Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone

Substance Use and Misuse. “Why do patients stay in opioid maintenance treatment?” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24328842

WebMD. “What is Methadone?” Retrieved from https://www.webmd.com/mental-health/addiction/what-is-methadone#1

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