Tox Tuesday: Methadone

AspirinTabletsPouring_blogA drug used to treat narcotic addiction has seen an uptick in abuse in recent years.

Methadone, a synthetic narcotic, is used to treat people with severe narcotic addictions (such as those to heroin) as it helps soften the effects of withdrawal by suppressing symptoms for 24 to 36 hours. While  methadone doesn’t have the same effects as heroin, such as euphoria, it can be abused, often in dangerously higher doses in an effort to achieve the same high as other drugs, according to the U.S. Drug Enforcement Administration (DEA). Methadone also is used to treat pain.

Methadone is an opiate, meaning it affects the brain’s dopamine receptors (dopamine is a neurotransmitter associated with reward). When used to treat addiction, methadone replaces heroin or other similar drugs in attaching to those receptors, which helps decrease withdrawal symptoms. Methadone treatment was first created in the 1960s. Its use as an addiction-treatment therapy is closely monitored and regulated, according to the U.S. Centers for Disease Control and Prevention (CDC).

Although methadone can help those fighting addiction, like other drugs it can be dangerous when abused. Last year, the CDC reported that although methadone is only linked to 2 percent of painkiller prescriptions in the U.S., it is associated with almost 40 percent of overdose deaths from a single opiod pain reliever. About three-quarters of these overdoses were not people who were part of opiod addiction treatment programs, and were people who were using it without a prescription.  Methadone should not be used for mild pain or as a first choice painkiller, CDC notes.

The number of deaths in the U.S. associated with methadone overdose peaked in 2007 with 1.8 deaths per 100,000 persons. Since the peak, methadone overdoses as well as methadone’s use as a painkiller have decreased slightly.

“The primary advantages of using methadone over other opioids for pain treatment are its long duration of action, relatively low cost, and availability in liquid formulation for oral use,” the CDC reported in a July 6, 2012 edition of the Morbidity and Mortality Weekly Report. “Its primary disadvantages are its long and unpredictable half-life and associated risk for accumulating toxic levels leading to severe respiratory depression; its multiple interactions with other drugs, including frequently abused drugs such as antianxiety agents; and its ability to cause major disturbances of cardiac rhythm.”

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