WHAT & WHY? Methadone 6 meth : physeptone : juice No. 6 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION
What? Methadone is one of a large number of drugs that have been manufactured to mimic one or more of the effects of natural opium. It is a much longer-acting drug than heroin, so people who are dependent on opiates can usually take it once a day and be free of withdrawal symptoms.
Methadone is manufactured as a white crystalline powder that is mixed into a medicine or, less commonly, dissolved in an ampoule ready for injection or pressed into tablet form. There is an often repeated myth that methadone is much more addictive than heroin. Although the physical withdrawals from methadone may last longer than those from heroin, there are two parts to drug dependence: the physical and psychological. Overall there isn t much difference between methadone and heroin because, psychologically, people tend not to crave methadone (because it doesn t give the same high) as much as they crave heroin.
However, this is not always the case. Some buy it as a cheap intoxicant and mix it with other drugs such as alcohol and diazepam (Valium). Most of the overdose deaths in which methadone is implicated are due to using it in this way. Attempts are being made in many places to reduce the illicit sale of methadone by arranging for those people who are in treatment, but whose drug use is not yet stable, to take their methadone either at the drug service in front of a member of staff or at the chemist in front of the pharmacist. To achieve maximum effectiveness in terms of reduced risk, health improvements and crime reduction, the methadone prescription should be part of a treatment programme that includes effective psychological and social support.
Why? Although it doesn t give a high like that of heroin, methadone gives most users the sense of having taken an opiate some feeling of warmth and the absence of withdrawals and so reduces or removes cravings for heroin.
People usually seek methadone treatment when they reach a point where heroin is more of a problem than a solution, and they are prepared to give up the heroin high for less euphoria and more stability. It is prescribed because a large number of scientific studies have shown that methadone can help people who are dependent on opiates to stop using heroin or greatly reduce the amount they use. It can also assist people to stop injecting (or to inject less often and with less risk of HIV and hepatitis infection), improve their physical health and stop committing crimes to get money to buy drugs. So, although people remain opiate dependent, they are much safer. There is no simple answer to the question of why people get into a situation where they need to be prescribed methadone. Although there are theories which say that those who take drugs or become dependent are victims of peer pressure, or different because they have an addictive personality, there is very little, if any, scientific evidence to support them. It is probably more helpful to try and understand opiate use on an individual basis, weighing up the relative importance of factors to do with the person their psychological make-up, history, coping skills, self-esteem, mood, emotional state etc; society the ease with which drugs can be bought, the number of people using them, the attitudes of the person s peer group as well as social circumstances, employment status etc; and the drug the physical and psychological effects of the drug on the individual. The balance between these factors may be fairly straightforward or very complex; it may also change over time.
For some, the physical dependence may include their body having temporarily given up production of its own endorphins (a natural feel good chemical in the brain) in the face of such powerful competition. Little is known about the exact science of this, but after detox ex-users often report feeling low for many months. It is thought that, for some, this may in part be due to a delay in endorphin production returning to normal levels. The need to have enough endorphin-like chemicals natural or not in the brain may be a biological factor in triggering relapse, and, for some, may be a contributing factor in methadone treatment lasting for many years. However, although such problems may be due to endorphin suppression by opiates, they can also have psychological or social causes. Methadone can be prescribed safely for many years, provided it is reducing harm from heroin use. For many, reducing the methadone dose simply precipitates a return to heroin use with all its attendant risks. Methadone treatment which may last years means that more people can make it to the point where they are ready and, more importantly, able to come off opiates alive, free of HIV and hepatitis, and with their lives in some semblance of order. The success of methadone treatment should, therefore, be measured by the number of people prevented from catching HIV and reductions in crime and overdose, rather than in the numbers who become drug free.
01 Some patients have their methadone dispensed daily to take home Photo: David Hoffman Photo Library 02 Photomicrograph of recrystallised methadone Photo: Dr Michael Davidson, Natural High Magnetic Field Laboratory, Florida State University 03 A week s supply of methadone may be dispensed to more stable patients who have been in treatment for some time Photo: fluke 04 Supervised consumption of methadone in a community pharmacy Photo: David Hoffman Photo Library 05 Measuring the dose Photo: David Hoffman Photo Library 06 Drinking methadone out of the bottle may look alarming but if the patient only has one day s supply, and if they are dividing the doses, they don t really need to measure it out Photo: David Hoffman Photo Library 07 Methadone tablets should not normally be prescribed for the treatment of drug dependence (because they can be crushed up and injected) Photo: fluke
WHAT & WHY? weed : dope : bud : skunk : hash : oil No. 1 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? speed : whizz : base : amphet : sulphate No. 2 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? mdma : E : pills No. 3 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? c : coke : charlie : rocks : freebase No. 4 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? smack : brown : skag : diamorphine : H what drugs are and why people take them SECOND EDITION WHAT & WHY? meth : physeptone : juice No. 6 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION No. 7 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION Written by Andrew Preston What & Why? 6: Methadone. Second edition. Published by Exchange Supplies. ISBN 1-903346-05-3 Exchange Supplies 2000 2004. Designed by fluke. Printed in the UK on recycled paper made from 100% chlorine-free post-consumer waste. Responsibility for all errors, omissions and opinions lies with the author. Exchange Supplies is an independent social enterprise producing information and resources to reduce drug-related harm. For more information go to: www.exchangesupplies.org The What & Why? series covers cannabis, amphetamine, ecstasy, cocaine, heroin, methadone and harm reduction. All titles in the series are available direct from: Exchange Supplies, tel: 01305 262244. Additional information on LSD, mushrooms, addiction and motivation are available on our website: www.exchangesupplies.org Exchange Supplies, 1 Great Western Industrial Centre, Dorchester, Dorset DT1 1RD. Tel: 01305 262244 Fax: 01305 262255 Email: info@exchangesupplies.org www.exchangesupplies.org Cannabis 1 Amphetamine 2 Ecstasy 3 Cocaine Crack & 4 Heroin No. 5 in a series of guides to help people understand Heroin Methadone 6
What & Why? is a series of booklets for anyone who wants to understand illicit drug use. Illustrated with stunning photography, What & Why? explains what drugs are (how they are made, sold and used), their effects and why people choose to take them. Essential reading for anyone confronted with illicit drug use at home or at work. What & Why? is written mainly for professionals, parents and the relatives and friends of drug users. The booklets may also provide a useful contribution to secondary school discussion about drugs. www.exchangesupplies.org