Understanding WhyMethadone Doesn’t Cure Heroin or Opiate Addiction

My Dear
Friends and Readers,
In my naivety, I thought that
Methadone was a cure for heroin addiction. What I found out was that methadone
addiction is often worse than heroin or opiate addiction.
 Understanding any form of addiction means
understanding the payoff and the hook of the drug as well as the cost of the
addiction.  There are three large categories
of drugs stimulants, opiates and hallucinogens. Heroin is an opiate. Opiates
are addictive and deadly because they create a psychological as well as physiological
craving for the drug.  The lure of
opiates and heroin is that they reduce physical and psychological pain. Once
heroin enters the brain, it is converted to morphine and binds rapidly to opioid
receptors in the limbic section of the brain which controls emotions.  Abusers typically report feeling a surge of
pleasurable sensation—a “rush.” The intensity of the rush is a function of the
amount of heroin in jested and how rapidly the drug enters the brain and binds
to the opioid receptors. The fastest way any drug gets into the brain is my
injection or by smoking it which also increase the risk of addiction.  The side effects of this rush are a warm flushing
of the skin, dry mouth, a heavy feeling in the extremities, which may be
accompanied by nausea, vomiting, and severe itching. After the initial effects,
users usually will be drowsy for several hours; mental function is clouded;
heart function slows; and breathing is also severely slowed, sometimes enough
to be life-threatening. Slowed breathing can also lead to coma and permanent
brain damage.
But the short term side
effects of heroin are mild compared to repeated abuse which can change the
physical structure and physiology of the brain, creating long-term imbalances
in neuronal and hormonal systems that are not easily reversed. Studies have
shown some deterioration of the brain’s white matter due to heroin use, which
may affect decision-making abilities, the ability to regulate behavior, and
responses to stressful situations Tolerance occurs when more and more of the
drug is required to achieve the same effects. With physical dependence, the
body adapts to the presence of the drug and withdrawal symptoms occur if use is
reduced abruptly. Withdrawal may occur within a few hours after the last time
the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone
pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold
turkey”), and leg movements. Major withdrawal symptoms peak between 24–48 hours
after the last dose of heroin and subside after about a week. However, some
people have shown persistent withdrawal signs for many months. Finally,
repeated heroin use often results in addiction—a chronic relapsing disease that
goes beyond physical dependence and is characterized by uncontrollable
drug-seeking no matter the consequences.
The characteristics of
heroin and methadone vary greatly.  One of the main differences is that Heroin
withdrawal usually lasts for 7-10 days and Methadone addicts can experience
withdrawal symptoms for 4-6 weeks. It is reported that up to 40 percent of
heroin addicts suffer mainly from psychological addiction. On the other hand,
almost 90 percent of methadone addicts are both physically and psychologically
dependent on the drug.  According to the Centers for Disease Control and
Prevention, (CDC), heroin addictions are easy to manage in comparison to the
extremely hard to treat methadone addiction.
 Almost everyone has
heard about methadone.  Methadone belongs to a class of drugs known as narcotic
(opiate) analgesics. It works in the brain to change how your body feels and responds to pain.
Methadone is not intended to relieve mild pain or pain that will go away within
a few days. Methadone is a long term substitute for heroin addiction.  Developed
in 1939 in Germany, it was brought to the United States by Eli Lilly in 1947 as
Dolophine. Dolophine was derived from the Latin word dolor (pain) and finis
(end). Later Dolophine came to be known as methadone.
Originally marketed as a pain reliever, Methadone was
considered dangerous and not as effective as drugs like morphine, hydrocodone
and oxycodone and was not successful. In the 1960’s, a new market was found for
methadone- as a substitute for heroin. Methadone creates an addiction so strong
that if the addict does not take a dose of the drug each day, the addict will
experience very painful withdrawals. Once someone becomes addicted to methadone
it is very likely that the user will be on methadone the rest of their lives—or
at least for many years. The former heroin user is now “chained” to a methadone
Methadone mimics many of
the effects of heroin and other opiates; however there are many differences
between the two drugs. One example of this is that heroin produces an immediate
“rush” and euphoria that lasts for a very brief period of time, resulting
in a craving to use more heroin, as compared to the gradual onset of methadone
when it is administered orally.  The effects of methadone can last up to
36 hours, which allows the individual to take the drug once a day, usually
without experiencing many withdrawal symptoms. Research has demonstrated that,
when methadone is taken in regular doses as is the case when an individual is
receiving treatment in a Methadone Maintenance Program, that if they consume
heroin, they will not experience the euphoric high that generally accompanies
the use of the drug.
When an individual is
taking methadone as prescribed, these individuals are often able to tackle some
of the components of their heroin addiction. The person may at least be able to
confront the psychological aspects of their addiction, where as they could not
do this if they were taking heroin, because of the often intense cravings.
Because methadone helps to alleviate heroin withdrawal symptoms, the individual
is often able to use this period of not chasing the drug to somewhat stabilize
their lifestyle. In a perfect world, it is as this point that the methadone
dose can be slowly reduced until the individuals is eventually off of the drug
completely. Unfortunately, it is more common for an individual to use methadone
for several years, and many of these people may be using the drug for the rest
of their lives. When Methadone is used specifically to alleviate heroin
withdrawal symptoms, it has been successful in that the ‘cold turkey’ symptoms
that are usually associated in withdrawing from heroin are must less severe.
Even though there are distinct
differences in the effects of these two drugs, they are both opiates. The main
premise of Methadone Maintenance Treatment is that when it is introduced into
the system, the individual will not want heroin that drastically, which can be
beneficial in the heroin detoxification process. Opponents of Methadone
Maintenance Treatment strictly see this process as a legal drug swap, a
position taken by many former heroin and methadone users. These individuals
have stated that if they knew what they know now, they would have made the
choice to go through heroin detox in the beginning instead of trading one
addiction for another.  
After reading the circular
addiction process of heroin and opiates and methadone even if I were wracked with
physical or emotional pain, I would consider any other option besides an opiate
pain killer. Users beware: the tolerance and addiction are difficult to bear.  
Brianna S. Clark
The Addict Writes.

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