Methadone Maintenance Therapy: Information for Clients

What is methadone?

Methadone is a long-acting opioid, or narcotic, medication. It's an effective and legal substitute for heroin or other narcotics that you have been using.

Methadone helps to stabilize the lives of people who are dependent on heroin, and to reduce the harm related to drug use. Methadone has been used in treatment programs since the mid-1960s.

How is methadone taken?

Your doctor will provide the pharmacy with a prescription for your methadone. This prescription must be renewed periodically by your doctor. He or she will determine how often you come for appointments, depending on your needs and progress.

Methadone is a medication that is taken orally. It is diluted with juice such as orange juice. When you first start on methadone, you will be asked to go to your pharmacy each day to drink the medication. As you progress in your treatment, you may be eligible to take home some doses. These are called "carries."

Your carries must be stored safely to make sure the medication is not taken by anyone else, especially a child. Carries should be refrigerated.

How does methadone work?

Methadone is part of a long-term maintenance treatment for people who are dependent on heroin or other narcotics.

At first, the goal is to stabilize you by improving your general sense of well-being by preventing physical withdrawal. Methadone will significantly diminish your drug cravings, and help you reduce or eliminate heroin use.

The effects of methadone last for one to two days. So you can stop taking heroin or other narcotics that you may have been using many times a day. You can then devote your time to improving your life.

Methadone is a long-acting medication. So when your dose is adjusted, it may take four or five days for you to experience the full effect of the dose change. Be patient.

Treatment works best when combined with other services. Some services you may want to explore are relapse prevention, individual or group counselling and case management. Case management includes crisis intervention, as well as help for social problems concerning housing or food, and legal or financial concerns.

Remember, the goal of treatment is to stabilize your body physically so that you can make the best of your life.

How long do I have to stay on methadone?

This is the most common question we're asked. Even after about 30 years of experience with methadone, we still don't have an answer that applies to everyone. What we can say is that most people who are successful coming off methadone show three important characteristics:

• First, their lives have been stabilized after they've been on methadone maintenance treatment for more than a year.
• Secondly, the decision to stop taking methadone is made with their doctor, who gradually decreases the dose while providing support.
• Finally, they've made changes in their lives that show they're stable. For example, they may have a stable family life, support from the non-drug-using community, steady employment and fewer financial or legal difficulties.

It's important to understand that methadone, when taken as prescribed, is a safe and effective medication that individuals can take for years. We encourage you to use it as long as you feel it's working for you, and there are no medical concerns.

Does methadone have any side effects?

Once your dose is stabilized, methadone is usually a very well-tolerated medication. As with any effective medication, unwanted side-effects may develop during treatment with methadone. Most people experience few, if any, side-effects. While side-effects may be distressing, they are rarely dangerous and most diminish with time. Please let your physician or pharmacist know if any of these side-effects are bothering you:

Sweating. This can be due to a methadone dose that is too high or too low.

Constipation. You can try increasing fibre (such as bran) in your diet if you experience this problem. Regular exercise and drinking more fluids may also help.

Sexual difficulties. Some people experience reduced desire, while others show an increased desire associated with a better life.

Sleepiness or drowsiness. This is common, and may be caused by too much methadone. You should be assessed by your doctor to see if your dose needs to be adjusted. Don't drive a car or participate in activities that require you to be alert while this is a problem.

Weight change. People sometimes put on weight, but this may be because they're now eating properly and are healthier.

Can methadone interact with other drugs?

Remember, methadone is a medication that may interact with other medications you may be taking. Alcohol, as well as prescription, non-prescription, herbal and street drugs may interfere with the action of methadone. Discuss all medications you are taking with your pharmacist or doctor.

Is methadone dangerous?

When methadone is prescribed to a narcotic-dependent person at a proper dose, and is monitored by a doctor, it is a safe medication.

However, it can be extremely dangerous if used inappropriately. Methadone should never be taken by individuals for whom it is not prescribed. It can cause overdose and death when a person who is not dependent on narcotics takes it. Children are particularly at risk for overdose and death if they swallow methadone accidentally. If this happens, seek emergency treatment immediately.

What are my responsibilities?

It is your responsibility to drink your methadone dose every day. If you have carries, you must make sure that you store your methadone safely until you drink it. It's best to refrigerate your carries.

Also, you must not give or sell part or all of your dose to anyone. Diverting your methadone is a serious program violation and will result in loss of carries. If there are further incidents of diversion, you could be withdrawn from the methadone maintenance program.

Will methadone cure me?

There is still no "cure" for drug dependence or addiction. What your participation in a methadone treatment program can do is make your life more stable, allow you the opportunity to make positive lifestyle changes and provide you with an environment that supports you.

Remember, you are the one making the changes. We are here to support you in whatever way you feel will help improve the quality of your life.

Methadone is a long-acting opioid, or narcotic, medication.

It's an effective and legal substitute for heroin or other narcotics that you've been using.

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