Do you get high on methadone?
ARTICLE OVERVIEW: No, most people do not get high on methadone. In fact, methadone does not cause euphoria or intoxication when used as prescribed. But you are getting high on methadone, you are at risk of overdose and death…plus, you are breaking the law. More on the differences between use and abuse below.
TABLE OF CONTENTS
- Why Doctors Prescribe It
- Mechanism Of Action
- Main Effects
- Euphoric Effect
- Signs of Overdose
- Recommended Dosage
- Addictive Potential
- Signs of Addiction
- Where to Go for Help
- Your Questions
Why Doctors Prescribe Methadone
Methadone is a long-acting synthetic opioid agonist medication that is prescribed by doctors for two reasons: the principal therapeutic uses for methadone are for analgesia and for detoxification or maintenance in opioid addiction. Mainly, methadone is prescribed:
1. For the treatment of opiate and opioids addiction. Methadone suppresses withdrawal symptoms, reduces cravings for opioid drugs, and blocks the euphoric effects of opioids for 24 to 36 hours. The principle behind long-term methadone maintenance treatment is to substitute methadone for harder drugs like heroin, morphine, codeine, oxycodone, hydrocodone, or fentanyl. People who take opiates or opioids for a year or longer can modify their brain chemistry in a permanent or semi-permanent way. Methadone helps occupy the opioid receptors in the brain so can function normally without feeling high.
2. To treat chronic pain. However, it is not generally used as a first treatment option. It is only used in applicable cases. For example, the U.S. Veteran’s Administration states that methadone is indicated for persistent, moderate to severe chronic non-cancer and cancer pain in patients requiring continuous, around-the-clock opioid administration over an extended time.
Mechanism of Action
So, how does methadone work in the brain?
According to NIDA, the National Institute on Drug Abuse, methadone is a mu-agonist; a synthetic opioid analgesic with multiple actions qualitatively similar to those of morphine, the most prominent of which involves the central nervous system and organs composed of smooth muscle. Some data also indicate that methadone acts as an antagonist at the N-methyl-D-aspartate (NMDA) receptor. The contribution of NMDA receptor antagonism to methadone’s efficacy is unknown.
In other words, methadone changes the way your brain and nervous system respond to pain so that you feel relief. You also feel less cravings for stronger drugs. Its effects are slower than those of other strong painkillers like morphine and it takes some time for methadone to build up in your system, according to this article published in the Western Journal of Medicine in 2000. For other part, it blocks the high you get from drugs like codeine, heroin, hydrocodone, morphine, and oxycodone.
As listed on the FDA-approved label for dolophine, the brand name for tablets containing methadone, short-term effects of methadone include:
- Feelings of relaxation.
- Pain relief.
Long-term effects of methadone:
- Cardiovascular issues, often because of injecting methadone and potentially leading to collapsed veins, arteriosclerosis, etc.
- Respiratory issues because of chronically reduced respiration rates.
- Menstrual cycle changes in women or sexual dysfunction in men.
- Issues with judgment, a tendency to engage in risky behaviors, and a lack of attention to personal hygiene.
- Changes in the brain that are associated with learning and memory, particularly learning by reinforcement in the area of the brain often referred to as the pleasure or reward center.
- The development of physical dependence.
- The development of an opioids addiction.
You can get high on methadone, by taking without a prescription or other than prescribed, although its euphoric effects are limited. However, if you take methadone in higher doses, more frequently than prescribed, or take it in ways that are not prescribed (unstable dosing, injection, snorting, etc.) you are in danger of overdosing. This is because methadone does not produce the euphoric rush associated other opiate or opiate drugs. Instead, methadone is released into the body over time (it is a long-acting drug). So large quantities of methadone are a vain attempt to attain the desired euphoric effect and methadone can build up in your tissues, leading to overdose.
In scientific terms, methadone’s elimination half-life is longer than the duration of its action. If you take more doses of methadone faster than your body can metabolize, serious toxicity or poisoning can result. Additionally, deaths can occur when people who have no or low opioid tolerance take too large a dose or mix methadone with other respiratory or depressants.
Signs of Overdose
Below are some of the symptoms of a methadone overdose:
- Blue fingernails and lips.
- Breathing problems, including slow, labored, or shallow breathing.
- Cold, clammy skin.
- Coma (decreased level of consciousness and lack of responsiveness).
- Low blood pressure.
- Muscle twitches.
- Nausea and vomiting.
- Spasms of the stomach or intestines.
- Tiny pupils.
- Weak pulse.
What can you do if you experience serious side effects of this medication? First, seek emergency help, if necessary. Call 911 in cases of respiratory depression or slowed heartrate. Or call the Poison Control Center at 1-800-222-1222. Then, report serious side effects of methadone medications to the FDA at Medwatch Online or call 1-800-332-1088.
Methadone is safe when used appropriately. Normal methadone dosing is somewhere between 60-120 mg a day. Here are some of the guidelines outlined in these Clinical Guidelines for Drug Dependence.
1. The initial dose of methadone should not be more than 20 mg a day and should be determined for each patient based on the severity of dependence, the level of tolerance to opioids, use of other psychoactive substances such as benzodiazepines or alcohol, as well as on the other relevant clinical factors.
2. Once it has been established that the initial dose is well tolerated, the methadone dose should be gradually increased until the patient is comfortable and not using heroin or other illicit opioids.
3. The rate of increase should be individually assessed, and should generally not be faster that 10 mg every few days. On average, methadone maintenance doses range from 60 to 120 mg daily, sometimes higher dosage is required.
Is It Addictive?
If you are taking methadone to get high, you are breaking the law. However, the risks of addiction are even higher than the risks of being caught. Methadone is a Schedule II substance under the Controlled Substances Act. Schedule II drugs have a high potential for abuse, which may lead to severe mental or physical dependence.
Signs of Addiction
The Diagnostic and Statistical Manual of Mental Health Disorders, the DSM-V, is the current standard for addiction diagnosis used by most behavioral healthcare professionals. The DSM-V outlines a list of signs and symptoms of substance use disorder, which can warning about a methadone addiction. Diagnostic criteria for substance use disorders of the DMS-V are the following:
- Continuing to use, even when it causes problems in relationships.
- Continuing to use, even when it puts you in danger.
- Continuing to use, even when physical or psychological problems may be made worse by use.
- Giving up important activities because of use.
- Inability to manage commitments due to use.
- Increasing tolerance.
- Spending a lot of time to get, use, or recover from use.
- Using in larger amounts or for longer than intended.
- Wanting to cut down or stop using, but not managing to.
- Withdrawal symptoms.
People exhibiting fewer than two of the symptoms are not considered to have a substance use disorder, or addiction to methadone. However, those people exhibiting two or three symptoms are considered to have a “mild” addiction, four or five symptoms constitutes a “moderate” disorder, and six or more symptoms is considered a “severe” substance use disorder.
In any case, most people exhibiting two or more of these signs can benefit from professional help. You do not need to address addiction on your own!
Where to Go for Help
If you have a methadone problem and you are ready to get help, you can first seek an evaluation from your primary physician or family doctor. S/He should have screening tools in the office that can help. Otherwise, you can seek a referral to a medical doctor who’s been trained in addiction medicine. You can find these doctors on the ASAM, American Society of Addiction Medicine website. Finally, seek help from a substance abuse counselor (a licensed clinical psychologist, a licensed clinical social worker, or a certified rehab facility.
There are some many methadone abuse treatment centers around the United States, these are centers designed to specifically manage the effects of opioid withdrawal symptoms as an initial part of opioid abuse rehabilitation.
In the beginning phases of treatment, your specific situation will need to be assessed to understand the level, frequency and intensity of your methadone dependency and associated addictive behaviors. Depending on your responses, a detox period, followed by residential rehab or outpatient treatment will be recommended.
The main points of the addiction treatment are:
Detox. This process reduces the level of the substance in your body until it is completely out of your system. The supervision from medical professions will ensure comfort and safety.
Medications. Rehab programs might provide treatment by switching you to another medication that is used to treat opioid dependence.
Psychotherapy and behavioral therapy. Whether started after detox and rehab or at the beginning of recovery, no treatment plan will be complete without talk therapy. A therapist may use skills and interventions related to cognitive-behavioral therapy or motivational interviewing to address the underlying triggers of substance use and build your desire for abstinence.
Support groups and aftercare. The support and fellowship of 12-step programs can help foster the recovery process while building additional sober supports. Sometimes, living in a sober house or transitioning to a halfway house can help in the weeks or months after therapy.
Do You Have Any Questions?
If you think that you have a problem with methadone or have a question about methadone use or abuse, please leave us a message below. We are here to help, and will respond to all honest questions about methadone in a personal reply… or we may even write a new article just for you.
Reference Sources: CDC: Prescription painkillers overdoses
MEDLINE PLUS: Methadone overdose
NCBI: DSM-5 Criteria for substance use disorders
NCBI: Maintenance medication for opiate addiction
NCBI: Pharmacological treatments for opioid dependence
NCBI: Use of methadone
NIDA: Effective treatments for opioid addiction
Photo credit: ~mr-neight