Methadone For Heroin Addiction

Methadone is the gold standard for heroin (and opioid) addiction.

Forget what well meaning people tell you, who have never actually used it.

It does not get into your bones, does not rot your teeth and was not invented by Adolf Hitler.

For many decades, Methadone has been used, the world over, to help people recover from heroin and opioid addiction.

Few people are allergic to it and it is straightforward to use. You can either use it to detox or if you don’t feel ready: Maintain.

Methadone For Heroin Addiction: How Does it Work?

Methadone is a fully synthetic opioid. This means it is manufactured in a laboratory and is not a derivative of the Opium poppy.

It is what is known as a full agonist. This means that when it reaches the opioid receptors in the brain it will open them up: Fully. This leads to the release of naturally occurring chemicals. These provide a feeling of euphoria and stop pain signals.

Opioids take over the brains reward system. These receptors are also involved in pain relief because when opioids bind to these receptors the nerve signals that convey pain are inhibited. This means that a very pleasurable sensation is felt.

The problem is that this leads to a cycle of reward because of overwhelming cravings. Who wouldn’t want to recreate a pleasurable experience?

What role do Endorphins play?

Endorphins are naturally occurring neurotransmitters. They play a very significant role in both pain regulation and producing feel good sensations.

When you use opioids/Heroin the body’s production of endorphins is significantly altered. Continued use means endorphin levels drop. This is because the brain will rewire itself due to the constant presence of opioids on receptors.

A state of tolerance occurs. This means you will need more and more to have the same effect as the amount you started with.

How does opioid addiction progress?

Addiction doesn’t take long to take hold.

When you first start taking opioids/Heroin you will feel an amazing sense of euphoria. Due to the phenomena of tolerance, you will need to take more and more to have the same effect as the amount you started with.

If you can not feed your habit and opioids become dislodged from receptors you will experience withdrawal.

Within the brain is a region known as the locus coeruleus, which is crucial when managing opioid withdrawal. This area of the brain has many opioid receptors and controls noradrenergic activity. In other words, it controls a naturally occurring chemical known as norepinephrine. When this chemical is not properly regulated, physical withdrawal symptoms occur.

The body enters a state of autonomic dysregulation. The medical term is Dysautonomia. This is what causes the shivers, gooseflesh skin, etc. The body is in a state of chemical imbalance. Until this is restored, the symptoms will continue.

Overcoming withdrawal has absolutely nothing to do with willpower, going to the gym or drinking water. You can no more “flush toxins out of your system” than E.T could phone home. Managing withdrawal is all about science.

What Are the Symptoms of Heroin/Opioid Withdrawal?

Opioid withdrawal affects both the body and the mind.

Physically, someone withdrawing will experience troubling withdrawal symptoms within a few hours after their last hit. These can include:

• Muscle aches
• Sweating
• Nausea
• Vomiting
• Diarrhea
• Agitation
• Tremors
• Insomnia
• Dilated pupils
• Hypersensitivity to noise, light and touch
• Cravings
• Goose flesh skin
• Raised blood pressure and pulse
• Abdominal cramping
• Loss of appetite
• Runny nose
• Sneezing
• Yawning
• Altered body temperature

Psychological effects

Opioid withdrawal affects natural feelgood chemicals so it is logical that there will be significant psychological effects from withdrawal. These can include:

• Mood swings
• Irritability
• Anxiety
• Depression
• Memory issues
• Extreme fatigue

Methadone For Heroin Addiction: The Dangers of Going Cold Turkey

Forget what you see on TV and in the movies.

Going “cold turkey” is extremely dangerous. Indeed, it can be fatal.

Managing heroin and opioid withdrawal is much more than just locking yourself in a room with some bottled water, a bucket and some toilet roll. Even if you were able to overcome the physical symptoms, the cravings would be so extreme that you will succumb.

As soon as you stop taking opioids your tolerance drops. This means you will need more than you were using to have the same effect. It is very common for people to overdose, accidentally, because they take an amount they think they need to settle themselves. The loss of tolerance leads to overdose.

Timeline of Heroin Withdrawal

When you start to withdraw depends on a multitude of factors, including the type of opioid you have been taking, how long you have been taking it for and your general state of health.

Usually, you will start to experience symptoms within six to twelve hours after your last use. For some it can start earlier and for others, a little later.

The symptoms should peak within a day to three days. Most people will see a significant reduction in symptoms within five to seven days.

Some symptoms can persist for weeks: If not months. It can take the brain six months to a year to fully recovery.

How Methadone Can Help

Methadone is a fully synthetic opioid.

By replacing heroin/opioids with Methadone the withdrawals will stop. You then have a choice: Maintain (stay on Methadone) or taper down to zero.

As a liquid it is very easy to have a dose adjustment. In collaboration with your clinician you can go up or down with ease.

The first element of treatment with methadone is to eliminate withdrawals. This might take a day or two, depending on your state of withdrawal. As methadone treatment is a planned treatment, you do not need to arrive at rehab in withdrawal.

Adjunctive medication can be used to help with some of the symptoms of withdrawal.

Once you are comfortable on your dose of methadone, in that you are not experiencing any withdrawals, it is time to decide what you want to do.

Methadone For Heroin Addiction: Maintenance Vs Detox

All the research ever conducted on Methadone will tell you that the optimum treatment plan is to stay on Methadone for a year before tapering off very, very, slowly.

This is possible with community services. Of course, if you were able to pay for private residential treatment for a year it would get very expensive (and probably quite boring!)

The reason why you should stay on methadone for a year, before reducing, is because it can take your brain that amount of time to recover.

Community services (funded through council tax) are mainly aimed at crime reduction. Someone who commits crime to pay for drugs is less likely to do so if they are on a therapeutic dose of methadone.

When someone is on a therapeutic dose (60-120MG) they are far less likely to take other drugs as they won’t feel the need to do so.

One of the problems with methadone prescribing, especially in prisons, is that people are significantly under dosed and reduce far too quickly. This leads to cravings and relapse. You wouldn’t under prescribe for a diabetic or an asthmatic so the same applies to heroin and opioid addiction.

Addiction takes time to develop and recovery can not be rushed.

Treatment with methadone in rehab can be achieved within a 4-6 week period unless the use of heroin and opioids is excessive.

Never attempt a rapid detox. There really is no such thing.

All that happens is that you leave rehab still in withdrawal and with significant cravings. An accidental overdose is virtually guaranteed.

Methadone For Heroin Addiction: Rehab

Not every rehab provides treatment for opioid and heroin addiction. This is due to the logistics of prescribing controlled drugs in a private centre, storage, administration, etc. However, many do and it doesn’t need to be expensive.

Be wary of anyone who tells you that you can recover without an opioid substitute: You can’t.

There are four elements of recovery: Detox, therapy, relapse prevention, aftercare.

Detox

Until you feel well, your brain won’t respond to therapy.

No one can respond to help if they are feeling unwell.

Using methadone (and sometimes some adjunctive medication at the start of treatment) the withdrawals will be dampened down to such a degree that you can attend therapy groups and sessions.

In agreement with your clinician, a reduction plan for your methadone will be drawn up. This will enable you to leave rehab opioid free.

Timewise, It can take a day or two to establish how much methadone you will need to stop you feeling unwell.

It is quite normal to go up, down and up again at the start of treatment. It is the same as getting settled on other medication such as insulin.

Therapy

No one makes a conscious choice to be an addict.

People use drugs for many different reasons. Trauma, problems at home, PTSD. There could be a multitude of reasons. Sometimes, people become dependent on opioids after a legitimate prescription following a car crash or back injury.

Therapy is there to work through these issues. It will be hard work: No point otherwise.

All rehab centres, the world over, use a group therapy model. 12 STEP/SMART/eclectic: It matters not which model is used. Time spent worrying over this is time wasted.

Adjunctive therapies

Many centres provide additional therapies including art and music therapy, individual therapy and gentle exercise.

Relapse Prevention

Just as people with asthma and diabetes are taught how to manage their condition, so can people with opioid addiction learn the skills to stay abstinent.

Relapse happens: FACT. It doesn’t happen to everyone, but if it does it is best to know what to do.

Relapse prevention is about attaining skills for when challenges come around after rehab.

Your local chemist is not going to stop selling medications with opioids because you have been in treatment and neither is your dealer not going to answer the phone if you are craving at 2AM.

With the right skills you are in a much better place to deal with the challenges.

Aftercare

Recovery doesn’t stop when you leave rehab.

Every centre offers a weekly aftercare support group. This can be in person, if you live close by, or accessed through video conferencing.

There will also be regular telephone check in.

Should you be struggling, there will be a dedicated number to call for support.

Get Free Advice From an Experienced Addictions Clinician

You can get free, independent and impartial advice, in the strictest of confidence, from a clinician who has decades of experience prescribing methadone.

Should you choose to go into rehab, we provide free treatment referrals.

We only signpost to legally registered centres.

Our service is registered with the Information Commissioner’s Office.