Monday September 26th 2016

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Is methadone safe?

Yes, methadone is generally a safe medication.

When taken as prescribed, methadone is safe and effective. In fact, methadone allows people to recover from addiction and to reclaim active and meaningful lives. Still, there are risks of opiate/opioid overdose that come with using methadone. And some serious side effects can occur.

This article provides you with some basic information about the safe dosage of methadone as well as common side effects people have reported on methadone. Plus, we’ll look into the issue of methadone as safe for long-term treatment. Then, we invite your questions about the safe use of methadone at the end. In fact, we try to answer ALL legitimate questions personally and promptly.

Methadone safety

Methadone is used to prevent withdrawal symptoms and minimize cravings in people addicted to opiate or opioid drugs. Methadone is in a class of medications called opiate (narcotic) analgesics. As a maintenance medication, Methadone works to treat opiate addicted individuals by producing similar effects and preventing withdrawal symptoms in people who have stopped using these drugs.

Combined with behavioral therapies or counseling and other supportive services, methadone enables patients to stop using heroin (and other opiates) and return to more stable and productive lives. Methadone has also been shown to reduce addiction-related death, criminal recidivism, and the spread of HIV.

For optimal results, when you take methadone, you should also participate in a comprehensive medication-assisted treatment (MAT) program that includes counseling and social support. Appropriate methadone maintenance treatment (MMT) provides several benefits:

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  1. Blocks the effects of other opioids.
  2. Prevents the onset of withdrawal for 24 hours or more.
  3. Promotes increased physical and emotional health.
  4. Raises the overall quality of life of the patient.
  5. Reduces or eliminates craving for opioid drugs.

Can taking methadone cause serious side effects?

Methadone may cause side effects and you should consult your doctor if any of the following symptoms appear and do not go away:

  • decreased sexual desire or ability
  • difficulty falling asleep or staying asleep
  • difficulty urinating
  • dry mouth
  • flushing
  • headache
  • loss of appetite
  • missed menstrual periods
  • mood changes
  • nausea
  • sore tongue
  • stomach pain
  • sweating
  • vision problems
  • vomiting
  • weakness
  • weight gain

These are some of the serious methadone side effects:

  • difficulty breathing or swallowing
  • extreme drowsiness
  • hallucinating (seeing things or hearing voices that do not exist)
  • hives
  • hoarseness
  • itching
    rash
  • seizures
  • swelling of the eyes, face, mouth, tongue, or throat

Methadone may cause serious or life-threatening breathing problems, especially during the first 72 hours of your treatment and any time your dose is increased. You should carefully follow doctors orders during your treatment.

How much methadone is safe to take?

Methadone comes as a tablet, a dispersible (can be dissolved in liquid) tablet, a solution (liquid), and a concentrated solution to take by mouth.

When initiating pain management therapy, using oral methadone in non-tolerant people, the usual oral dose starts at 2.5 mg to 10 mg every 8 to 12 hours, slowly tolerated to effect. If you take methadone as part of a treatment program, your doctor will prescribe the dosing schedule that is best for you.

For safety, your first dose of methadone should be low or moderate. New patients usually start at a dose not higher than 30 to 40 mg. A larger dose of 60 to 120 mg a day may be required during long-term maintenance. In order for the therapy to be effective you should take methadone exactly as your doctor directs.

If you are using the dispersible tablets, do not chew or swallow before mixing the tablet in a liquid. If your doctor has told you to take only part of a tablet, break the tablet carefully along the lines that have been scored into it. Place the tablet or piece of the tablet in at least 120 mL (4 ounces) of water, orange juice, citrus flavors of Kool-Aid, or a citrus fruit drink to dissolve. Drink the entire mixture right away. If some tablet residue remains in the cup after you drink the mixture, add a small amount of liquid to the cup and drink it all.

Your doctor may change your dose of methadone during your treatment. If needed, you may be instructed to decrease your dose or take methadone less often as your treatment continues. On the other hand, if you experience pain during your treatment, your doctor may increase your dose or may prescribe an additional medication to control your pain. Talk to your doctor about how you are feeling during your methadone treatment. Do not take extra doses of methadone or take doses of methadone earlier than they are scheduled even if you experience pain.

Safety recommendations when using methadone

1.  Drinking alcohol while taking methadone should be avoided at all means.
2.  Do not drive a car or operate machinery until you know how this medication affects you. You should know that this medication may make you drowsy.
3.  If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methadone.
4.  Inform your doctor and pharmacist about any allergies to methadone, any other medications, or any of the ingredients in the methadone product you plan to take. Ask your doctor or pharmacist or check the Medication Guide for a list of the ingredients.
5.  Methadone can cause life-threatening changes in breathing (it may slow or stop).
6.  Methadone can cause life-threatening changes to the heart beat that may not be felt.
7.  Methadone stays in your body longer than it’s pain relieving effects last. Therefore, do not to take more methadone than prescribed because methadone could build up in your body and cause death.
8.  Pain relief from methadone should last longer after you have taken it for awhile and as treatment continues.
9.  Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
10.  Tell your doctor if you are breastfeeding hence methadone is secreted into human milk. Babies can experience the same serious side effects from methadone as the mother.
11.  Tell your doctor if you start or stop taking other medicines. They may interact with methadone and possibly cause death, life threatening side effects, or result in less pain relief from methadone.
12.  Women who are pregnant or breastfeeding while on methadone can safely take the medication, but only with a clearance from their doctor.

Is methadone safe for long term use?

Methadone can produce physiological and psychological drug dependence and has the potential for being abused. Thus, it is very important to be used exactly as prescribed.

Methadone withdrawal symptoms are similar to those of other opioids but are less severe, slower in onset, and last longer. Symptoms of methadone dependence include:

  • anxiety
  • chills
  • cramps
  • diarrhea
  • dysphoria
  • increased sensitivity to pain
  • insomnia
  • irritability
  • loss of appetite
  • muscle aches
  • nausea
  • piloerection
  • pupillary dilation
  • restlessness
  • runny nose
  • sweating
  • tachycardia
  • tremors
  • watery eyes

The longer you’ve been dependent on opiates or opioids, the more likely you are to benefit from being on methadone. Those who withdraw from methadone after short-term treatment are more likely to return to drug use than those who stay in treatment until they have obtained the optimal treatment and recovery time. But, there is no strict time limit. In fact, you should stay in treatment as long as you are benefiting from it.

How to come off methadone safely

The length of time you stay in methadone maintenance treatment (MMT) is an issue that should be decided solely by you and your doctor. Some people are in methadone maintenance treatment (MMT) only for a few weeks, while others choose to stay in it indefinitely.

It may take from 6 months up to a year before you can completely come off of methadone. You should never set time limitations on yourself – taper off at your own pace in cooperation with your treatment provider.

Throughout treatment and after treatment ends, be sure to maintain and extend your support network. You can request to come back to the program every few weeks for the first year and expect to have the same privileges that you did before tapering off. Should you feel that you may relapse, return to your program immediately for re-dosing. You can always return to treatment. And, keep in mind that returning to treatment is not a failure – it’s a choice about what is best for you.

Methadone safety questions

If you still have questions about methadone safety and its use, please leave them here. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular question, we will refer you to someone who does.

Reference Sources: SAMHSA: Methadone
NIH National Institute on drug abuse: Methadone – Appropriate Use Provides Valuable Treatment for Pain and Addiction
Medline Plus: Methadone
OASAS Office of alcholism and substance abuse services: Methadone Dosing
NHTSA: Methadone
Introduction to Methadone

Photo credit: Daily Med

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