The Methadone Clinic [Advantages and Drawbacks]

A methadone clinic is a specialized facility which offers a form of medication assisted treatment for addiction and dependence to opiate drugs. Methadone treatment, also referred to as methadone maintenance, involves a patient going to a facility every day to receive a dose of the medication. A form of replacement therapy, methadone clinics are designed to treat those who have had multiple unsuccessful attempts at quitting the use of opioid drugs like heroin and prescription painkillers. The drug methadone, while they are a narcotic, has the impact of blocking the effects of these other opioid drugs making a methadone less likely to use them while on methadone.

The regular administration of methadone at a methadone clinic, under the care and supervision of a doctor and medical staff, has helped people regain control of their lives by allowing them to restore a sense of normalcy and stability while still preventing them from experiencing the often debilitating withdrawal symptoms and cravings associated with opioid addiction.

However, it is important to remember that methadone alone is not a magic bullet. Treatment at a methadone clinic is usually more successful when it is used in conjunction with other forms of treatment such as individual or group therapy sessions and other therapies such as cognitive behavioral therapy or dialectical behavioral therapy. This is because the drug methadone is really only successful at addressing the physical aspects of addiction such as chronic pain, withdrawal symptoms and physical cravings. It does not in itself address the emotional and psychological factors of addiction, which are also extremely important to confront.

Methadone clinics are not without their drawbacks as well. While they can offer successful treatment for some cases, they are not appropriate for everyone for a few reasons. First of all, it is typically suggested that an individual who is struggling with an opiate addiction attempt abstinence based treatment prior to attending a methadone clinic. This is because attending a methadone clinic is a commitment which shouldn’t be taken lightly and discontinuing methadone after a long period of time can be extremely difficult.

Before deciding if treatment at a methadone clinic is right for you, it is important to consider the specific benefits and disadvantages to make sure that you are making the right decision for your specific needs and expectations for recovery. Deciding to attend a methadone clinic is not one which should be taken lightly and considerable thought should go into it before making a final decision.

What is methadone?

Methadone was developed in the mid-20^th century as a synthetic substitute for other opiate pain kil

lers like morphine and codeine. Although it was not initially developed as a form of treatment for opiate dependence, its specific characteristics eventually made it the most common choice for this type of treatment.

Methadone is a full agonist opioid and has a very strong affinity for the opioid receptors in the brain and peripheral nervous system, creating a significant analgesic effect on most individuals who take the drug. The two characteristics that make it so useful for the treatment of opioid addiction are its half-life and its strong affinity to opiate receptors in the nervous system.  Methadone has a half-life of anywhere from 8 to 59 hours, meaning that the drug stays active in an individual for a relatively long amount of time. This compared to drugs like heroin or oxycodone which have a much shorter half-life, meaning that a person will begin to feel the effects of things like withdrawal symptoms much sooner after the last administration on these drugs compared to methadone. This allows patients at a methadone clinic to take the medication only once a day, as opposed to multiple times a day which is often the case for those who are dependent on other opiates.

The other significant advantage for methadone as a form of replacement therapy for other opioid drugs is its strong affinity for opiate receptors. This creates a situation where methadone clinic patients who take the drug as prescribed will not feel the high from taking drugs like heroin or prescription pain killers because the methadone in their system has a stronger affinity for their opioid receptors, essentially blocking the other opioids from having any euphoric impact. This is primarily helpful for the reduction in cravings that many methadone clinic patients report after beginning methadone maintenance treatment.

Is a methadone clinic right for me?

While methadone clinics and methadone maintenance treatment can help people overcome their dependence to other opioids, it is important to remember that methadone itself is still a powerful opioid narcotic. This is why it is typically recommended that someone have multiple attempts at abstinence based treatment and recovery before beginning treatment at a methadone clinic. Attending an inpatient or outpatient abstinence based rehab program is often useful for many people who are dependent on opioids and allows them to recover from their addiction without needing to begin taking another very powerful medication for a long period of time.

However, there are some individuals who have multiple attempts at sobriety and multiple relapses. These individuals, also referred to as chronic relapsers, can find significant benefits from treatment at a methadone clinic. This is due to the fact that while a patient at a methadone clinic is still dependent on a strong opioid medication, the characteristics of methadone make it much easier for the individual to live a mostly normal and productive life, as long as they are following the treatment protocol closely.

Because methadone has a long half-life it can be taken just once a day in order to achieve its desired effects of preventing withdrawal symptoms and blocking cravings for other more illicit opiates like heroin. This allows methadone maintenance patients to return to a somewhat normal lifestyle which includes things like work, school and social activities which may have been severely impacted by chronic use of other opiates like heroin or oxycodone. Many methadone clinic patients report significant reductions in the amount of stress and anguish in their lives due to them no longer needing to spend so much time focusing on acquiring opiates such as heroin.

Methadone is also very useful for blocking the effects of these other opiates. This is the other large benefit of methadone maintenance treatment, as it removes the urge for an addict to use these other drugs.

If you are a loved one has struggled with opiate dependence or addiction and attempted abstinence based treatment in the past without success, then you may want to speak to an addiction treatment professional about the possibility of treatment at a methadone clinic. It is crucial to remember however, that methadone alone is not enough. Most reputable methadone clinics offer and require their patients to attend regular individual and group counseling sessions to treat the emotional, behavioral and psychological aspects of addiction which the medication alone cannot do.

The drawbacks to methadone clinics

Methadone maintenance treatment is not without its drawbacks however, which is why it is typically suggested only as a last resort form of treatment after more conventional forms of treatment have failed. While patients at a methadone clinic are able to regain some semblance of normalcy and stability to their lives, they are still dependent on a very powerful medication which can have side effects such as:

• Drowsiness
• Labored or shallow breathing
• Nausea/vomiting
• Constipation
• Abdominal cramps
• Rapid heartbeat
• Lightheadedness

While these symptoms can lessen over time, the longer the patient continues their treatment, they can still occur even in those who have been on methadone maintenance for a long period of time. The other significant drawback to treatment at a methadone clinic is the often long-term nature of treatment at one of these facilities. Methadone is notoriously difficult to discontinue, as lowering or stopping the medication altogether does have withdrawal symptoms associated with it. These withdrawal symptoms can be quite severe and long-lasting. Many people report post-acute withdrawal symptoms that can last a month or longer, making it quite uncomfortable to discontinue treatment at a methadone clinic.

These adverse effects can be mitigated by very slowly lowering the dose of methadone over a long period of time, but they typically cannot be avoided completely. Unfortunately, this means that once a person has committed to treatment at a methadone clinic, the process of eventually attempting to live a life completely free of all opioids is a relatively involved and long process. While some people take methadone for only a short time, many people end up on methadone for years due to this fact. Depending on the dosage, some patients may take months or even years to taper their dose down to zero which is often a cause of frustration. There is unfortunately no way to quickly discontinue methadone maintenance treatment without some uncomfortable detox symptoms.

Alternatives to methadone

Because of these significant disadvantages, there are some other options for the treatment of opioid dependence and addiction besides treatment at a methadone clinic. Again, while the most ideal option is always some sort of abstinence based treatment which involves the discontinuation of all forms of narcotic medications, there are also some other forms of medication assisted treatment which can be used.

The most common alternative to treatment at a methadone clinic currently is buprenorphine maintenance therapy, also referred to as Suboxone maintenance or Subutex Maintenance. Buprenorphine is a different type of medication which can be used for the treatment of opioid dependence, avoiding some of the disadvantages of methadone maintenance treatment.

Buprenorphine, unlike methadone, is only a partial agonist to opioid receptors meaning that for most people it does not have as strong of an euphoric impact, and the side effects like drowsiness can be mitigated somewhat. Like methadone however, it does have a long half-life meaning that it can be taken as infrequently as once a day. It also has a strong ability to block the euphoric effects of other opiates while still effectively combating strong cravings for opiates, meaning that it can be similarly appropriate for treating those who have had multiple failed attempts at traditional abstinence based treatment.

Unfortunately, just like methadone, buprenorphine can be difficult to discontinue after a prolonged maintenance program because it also creates a physical dependence which does have withdrawal symptoms associated with it. Again, just like with methadone, these withdrawal symptoms can be mitigated by slowly tapering the dosage but this requires a significant time commitment on the part of the patient.

When considering any treatment option it is important to be fully informed about the options, but most of all it is crucial to seek the advice of an addiction treatment professional before deciding on any one form of treatment. No one’s situation is the same, and a “cookie cutter” approach to substance abuse treatment rarely works. Instead, get help formulating a personalized and individualized treatment plan that works for you and your specific situation.