METHADONE

Methadone is an opioid agonist that, similar to morphine, triggers its effects primarily through µ receptors in the central nervous system. Its characteristics are analgesia, respiratory depression, suppression of cough, vomiting, and constipation. Methadone causes a pronounced miosis (contraction of the pupil of the eye) and leads to a typical opioid dependence when used for a long period of time.

Nowadays, methadone is important mainly in the assistance of opioid (usually heroin) dependent subjects.  So-called methadone programs help reduce the dangers for heroin dependent individuals around the world.  These programs yield manifold benefits; the treated subject's general state of health improves, their risk of contracting the human immunodeficiency virus is reduced, they engage in fewer criminal activities, and they acquire a better socioeconomic status.  Methadone is not devoid of problems; according to the available studies, however, it does not jeopardize the chances of complete withdrawal.  The drug is probably most successful in the context of a comprehensive counseling program.  Several specialists recommend establishing plasma levels when relatively high doses are administered.

Like other opioids, methadone is suitable for the treatment of strong pain, e.g. in cancer patients.  In comparison with morphine it has the advantages of a longer lasting effect and a better availability after oral administration.  However, it is difficult to find the correct methadone dose.  According to several studies, it is also suited for perioperative analgesia if long-lasting pain is expected.

Long Term Effects

Deaths occur more frequently at the beginning of treatment in methadone programs; they are usually a cause of excessive doses (i.e. erroneously estimated tolerance) and they are affected by concomitant diseases (hepatitis, pneumonia).

Methadone generally entails the entire spectrum of opioid side effects, including the development of tolerance and physical and psychological dependence.

Respiratory depressions are dangerous.  The released histamines can cause hypotension or bronchospasms.  Other symptoms are:  Constipation, nausea or vomiting, sedation, vertigo, edema.  Euphoria is considered a positive effect in the context of methadone programs (reduced craving for illegal substances).

 

 

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