Introduction
Methadone
Interactions and Side
Effects of Methadone
Your Methadone Dose
Withdrawal From Methadone
Pregnancy and Methadone
Introduction
The initial goal of methadone treatment is to free an opiate dependent
person or heroin dependent person from the periodic withdrawal that prompts
the regular use of illicit opiates or heroin. Methadone treatment is not
appropriate for those people who are not currently physiologically addicted
to heroin or other illicit opiates. A person may be physiologically addicted
to opiates if they have been taking heroin or other opiates on a daily basis
for extended periods of time and exhibit symptoms of withdrawal when they
stop using these drugs. Along with irritability and cravings to use opiates
within eight hours of discontinued use, the most common signs of opiate
withdrawal are runny nose, large pupils, eyes tearing, sweating, chills,
diarrhea, yawning, nausea, cramps, insomnia, joint pain, and gooseflesh.
Prior to admitting any new patient for treatment, our physician will conduct
a complete physical examination to determine whether methadone treatment is
appropriate for that patient.
Methadone is a therapeutic tool of recovery for the opiate dependent person
that may or may not be discontinued. For some people, the desired change in
lifestyle may occur through a successful detoxification from heroin using
decreasing doses of methadone. For other individuals, the use of a methadone
maintenance program provides longer-term stability and the opportunity to
slowly change many aspects of one's life. We believe that you can have a
happy and purposeful life while on a methadone maintenance program.
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Methadone
Methadone is a long acting synthetic opiate that is taken in a liquid oral
form once per day. The proper dose of methadone remains effective for 24-36
hours and does not result in an altering of perceptions or euphoria. A
person taking methadone is alert, energetic, able to function well, and
feels no withdrawal symptoms between doses of the drug. It is important to
note that a person with a pre-existing opiate or heroin dependency does not
gain an additional addiction when he/she takes methadone. Methadone
satisfies that person's pre-existing opiate dependency in a safe, legal, and
responsible manner under the supervision of medical professionals. Here,
patients must participate in treatment as planned and prescribed. Missing a
methadone dose may result in discomfort and the start of withdrawal. Once
stable on the proper methadone dose, a patient will most likely feel less of
a need to inject heroin, thus minimizing the health risks of HIV and
hepatitis B and C. Patients who stop using heroin and other drugs can
altogether avoid the possibility of overdosing. Methadone treatment is
provided in an environment where medical and counseling services are readily
available. Here, many methadone patients make changes in their lives and
build support systems that allow them to improve their health and stay
sober.
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Interactions and Side Effects of Methadone
Methadone may be interactive with other drugs and alcohol. Please tell our
physician if you are taking any prescriptions or have a dependency or
addiction for another drug. The use of other opiates, benzodiazepines, and
alcohol may be dangerous in combination with methadone. You may experience
some side effects during treatment but these are usually minimal and
short-lived. Please read the list below and notify the medical staff if you
experience any of the following symptoms: light headedness, dizziness,
extreme tiredness, nausea and vomiting, sweating, ankle swelling, skin rash,
restlessness, malaise, weakness, headache, insomnia, agitation,
disorientation, visual disturbance, constipation, dry mouth, flushing of the
face, low heart rate, faintness and fainting, problems urinating, changes in
sexual drive, irregular menstruation, joint pain, joint swelling, and
numbness.
Warning: (PENTAZOCINE) TALWIN and RIFAMPTIN cannot be used by patients on
methadone.
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Your Methadone Dose
It is the intention of Stateline Medical, Inc., to have every client
on the correct dosage of methadone. We recognize that a dose too low
produces unnecessary withdrawal discomfort and invites the risk of heroin
use. We also know that a dose too high produces undesirable side effects and
provides no additional benefit to the client. Achieving and maintaining the
correct dosage requires cooperation between the client and the staff. All
clients will be informed of their dosage upon request. Minor dosage
adjustments may be made by the nurse in accordance with the standing orders
of the physician.
Where a requested dosage change does not fall within the parameters of the
physician's standing orders, a medicating nurse must receive a new verbal or
written order from the program physician to change a client's dose. If a
client is experiencing physical discomfort and believes he/she needs a
higher dose, the client may request an appointment with the program
physician. If, after reviewing the physical symptoms with the client, the
physician supports the need for a dose change, a new medication order
reflecting the changed dose would be written and presented to the nursing
staff.
In limited circumstances, the program physician may also change a medication
order by issuing a verbal order to a nurse. Where a physician is providing a
verbal order to change a dose without seeing a client, the client shall be
required to meet with other involved staff (Clinic Supervisor or Primary
Counselor and Nurse) so that additional information may be provided to the
physician prior to his/her decision regarding a change in dosage.
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Withdrawal From Methadone
Because methadone has a longer half-life than heroin, withdrawal from
methadone takes longer than withdrawal from heroin. With heroin withdrawal,
the most substantial symptoms are over within the first three to five days.
With methadone, the initial symptoms are frequently less severe, but they
can last from ten days to two weeks. The longer duration of methadone
withdrawal is not always well tolerated. However, if the patient follows a
medically supervised tapering schedule that accounts for and is readjusted
to received signs from the patient's body, withdrawal from methadone may be
achieved without extreme discomfort.
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Pregnancy and Methadone
Federal Treatment Improvement Protocols state the following:
Pregnant women users who are in treatment with methadone deliver healthy
babies. It is true that babies born to women on methadone sometimes
experience some withdrawal symptoms during the first several days after
birth. The symptoms are routinely treated by the baby's pediatrician and do
not result in any long-term damage. In addition, babies born to women on
methadone tend to have a slightly lower birth weight than babies of
non-addicted control mothers. The most important comparison, however, is not
how these babies compare with non-addicted controls, but rather how they
compare with babies of mothers addicted to heroin. Studies that have
compared babies born to mothers in methadone treatment with babies born to
mothers who use heroin have demonstrated tremendous benefits from methadone.
Methadone treatment allows the mother to be followed in prenatal care, to
receive nutritional supplements, information and to participate in
parenting classes. The vast weight of evidence supports the use of methadone
with heroin-addicted women to reduce the risk of miscarriage, increase birth
weight, reduce infection and HIV risk to fetus, and generally produce a much
greater chance for a healthy baby.
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