Was methadone maintenance sort of lied about in the past?

It seems like twenty years ago the general public believed methadone for opiate addicts was something like antabuse, I remember hearing it said it was a drug that kept addicts from getting high, which it is only in the sense that it raises the addicts tolerance to opiates.

I’m wondering if this er obfuscation really existed and where it came from.

Yes.

Methadone clinics are a major industry. I’ve been told by people in the field that there is a better alternative but isn’t catching on because there’s “no” money in it. This suggests that methadone clinics profit from their patients dependency–like drug dealers.

I’ll have to make a phone call to get the name of the drug. I just did a search but there are two alternatives. Let me see if I can find this out before my 5 minutes to edit is up.

no answer. be back later.

The general public isn’t that knowledgeable about a lot of things especially the nuances of psychopharmacological treatments. Methadone treatment certainly has its problems but it is legal and it doesn’t make heroin addicts high or in as much danger as their original drug of choice. It is hard for me to judge this question because studied this general area in school but I think what Methadone actually was and is was downplayed but for good reasons.

  1. It is a legal medical treatment for opiate addicts
  2. Employees that need it have some small degree of privacy and protection
  3. Used as directed, people on regular Methadone therapy can still function in the regular world.

As mentioned above, there is money in the clinics as well. However, given the choice between being a dead heroin addict and taking Methadone as a functional replacement, I would choose the latter (I have never abused opiates myself BTW but I know many that have).

Well if you mean my own opinon I fully support methadone treatment(I’m actually one of those legalize everything nuts but I did not want this to turn into a political debate).

What Shagnasty said. Methadone maintenance may not be perfect, but for the addict who cannot or will not stay clean through other forms of rehab, it’s better than the alternative.

I don’t think I’ve ever heard methadone compared to Antabuse. I suppose it is similar in a roundabout way, but it doesn’t make the user sick if he shoots heroin-- it just greatly reduces the “kick,” making junk not worth doing.

Maybe I misunderstood the point of your question? If so please straighten me out.

(I believe drugs should be legalized too.))

I’ve been aware of methadone maintenance since about 1981, when I rotated through a clinic as a medical student.

Methadone maintenance started as a ‘harm reduction’ strategy, when it was noted that heroin addicts who used methadone instead generally were able to engage in goal-oriented activity (above and beyond obtaining their next fix), weren’t on the nod constantly, and when they did take heroin on top of the methadone, didn’t get as much euphoria from it.

The goal was to get the heroin addict habituated to a high enough methadone dose that would keep them from seeking out more heroin. The euphoria of methadone is much much less than that of heroin, oxycodone, morphine, and other shorter-acting opioids. These folks could get go out and hold down some sort of job, stop burglarizing homes to get money for their next fix, etc.

In the medical community it was never considered the equivalent of antabuse.

It’s been somewhat successful in reducing harm for some folks. Personally I think it’s a better plan to eventually get folks off opioids completely. But for chronic relapsers whose lives are really going to hell, it’s something.

Suboxone maintenance is all the rage now, and that’s probably safer than methadone. But problems exist there too. I’m a licensed suboxone prescriber, but use it only to detox patients, not to maintain an opioid addiction.

So I feel the approach is legit, if not ideal. Of course, a number of unscrupulous practitioners did open methadone clinics, and made lots of money off it, or tried to, and didn’t always practice up to best principles. But this happens in any venture, sadly.

I just wanted to know if there was some misinformation deployed in getting methadone treatment out there really because it seemed the public’s idea of what it was was strange. That seems to have changed as I remember a joke on a sitcom within the last few years of a character somehow mistakingly taking methadone and getting high.

I’m not particularly plugged into either the medical field or drug users, and I don’t really remember ever hearing methadone was anything other then what it is. Certainly I’ve never heard it compared to antabuse.

I’ve similarly never heard the idea that it would make you sick, but I am only 27 year old. I actually think it’s a better choice than antabuse, because I think making you sick also is likely to make you instinctively hate the antabuse and not just the alcohol. I’d be interested in recidivism rates between the two anti-abuse drugs to see which is more effective.

There’s a treatment where they give someone a drug- naloxone?- that causes immediate withdrawl. They sedate the person while they’re going through it and when it’s done they’re at least physically no longer addicted.

My understanding had been that methadone was a weaker opiate drug that was used to taper users off, similarly to how a quitting smoker might use nicotine gum (with the ultimate goal being no drug at all). I guess that’s not quite accurate?

Methadone is an opioid. Opioids are molecules that act on the opioid receptor in the body, whether they’re derived from opium (like morphine and heroin and codeine) or they’re synthetic, like methadone or fentanyl, to name only a few. Opiates are derived from opium.

Methadone is very powerful, and has a very, very long half-life. As such, the euphoria it induces tends to be not nearly as extreme as the short-acting opioids.

It’s the long half-life that makes it useful for treating withdrawal from short-acting opioids. They’ll ease the jonesing from coming off heroin, oxycodone, etc.

Now if you’ve been doing major methadone dosages for a long time, the withdrawal from that is a real bitch.

Hang outside any methadone clinic if you want to buy someone’s dose and get high off of it. For real.

How about “heroin”?

This should go without saying, but doing so would be incredibly dangerous and illegal, and would be very likely to get you in trouble with the law even if you didn’t succeed.

This is just my empirical observation, and neither here nor there really; but from observing people with whom I am acquainted over time, I can’t help thinking that to all appearances, methadone in the long term seems to make people both hard of hearing, and a lot less sharp.

–Then again, maybe it’s just really effective? Ha ha, but seriously, I have observed in this three separate people over a period of years.

Anyway, I think I get what the OP is talking about. The way methadone is generally represented, when mentioned at all, is as Qadgop said, something that keeps the sick off and enables an addict to have a life again and quit doing crime. I too remember having a vague impression of methadone as being “like heroin, but without the high” – BEFORE I knew anyone actually taking it. It can be a bit of a surprise to see people take their dose, and then be all nodding off, singing little songs to themself, in other words looking pretty convincingly like they’re hella loaded.

The fact that the strategy is to try and get the dose high enough to prevent “chipping” results, as you might expect, in some individuals who have got a really high dose.

Ibogaine?

Does methadone have any other legitimate medical applications besides heroin addiction?

I suspect he’s talking about suboxone, aka buprenorphine.