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Methadone

Methadone is a synthetic narcotic analgesic that acts in a manner similar to morphine or heroin. It was developed as a pain killer, but now its primary use is the sedation, maintenance, and detoxification of narcotic addicts. It is given to addicts in sanctioned methadone programs to reduce their opiate use. Methadone is sometimes used for severe pain management, usually with cancer patients.

Methadone is produced in tablet, oral, and injectable forms. In the United States, methadone clinics prescribe and dose in liquid form only, per federal regulations. Methadone is classified as a Schedule II drug and is a federally controlled substance.

Methods of Use

Methadone is usually prescribed in oral doses as treatment for narcotic addictions. Methadone treatment for narcotic addiction works best when used in combination with a comprehensive counseling program.

In methadone treatment, doses of methadone are typically given to addicts once every 24 hours. Dosage depends on the patient's tolerance levels and must be carefully assessed to avoid negative and adverse side effects.

In methadone maintenance, regular doses of methadone are given to addicts to keep them from using other narcotics. Methadone can also be used to withdraw addicts from other narcotics, usually over a 21-day period.

Tablet and injectable forms of methadone are obtained and used illegally.

Effects on the Central Nervous System

Methadone works primarily with the body's opiate receptors in the central nervous system and in organs composed of smooth muscle tissue. Because methadone is a synthetic narcotic, it has the potential to produce drug addiction with psychological dependence, physical dependence, and tolerance. Major hazards include respiratory depression, circulatory depression, respiratory arrest, shock, and cardiac arrest. Methadone must be used carefully when combined with central nervous system depressants (such as general anesthetics), other narcotic analgesics, tranquilizers, sedative-hypnotics, and tricyclic antidepressants.

Intoxication

When appropriately prescribed, methadone does not produce intoxication. It is used as a medication to treat narcotic addictions and to aid patients with chronic severe pain.

Adverse reactions and side effects may include dry mouth, lightheadedness, dizziness, sedation, vomiting, nausea, sweating, euphoria, dysphoria, weakness, headache, insomnia, agitation, disorientation, anorexia, constipation, faintness, urinary retention, and reduced libido and potency.

Life Risks

The major hazards of methadone overdose are respiratory depression, and to a lesser degree, circulatory depression, respiratory arrest, shock, and cardiac arrest. Methadone can cause psychological dependence, physical dependence and tolerance. Overdose and death can also occur.

Withdrawal

Methadone abstinence syndrome (withdrawal) is similar to withdrawal from morphine and heroin, but the onset of withdrawal is slower, the course is prolonged, and fewer severe symptoms occur. Symptoms may include restlessness, irritability, weakness, anxiety, depression, goose flesh, fever, chilliness, excessive perspiration, tachycardia, abdominal cramps, body aches, involuntary twitching and kicking movements, anorexia, nausea, vomiting, diarrhea, and intestinal spasms.

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