As a synthetic opioid, methadone was initially developed for the treatment of pain during World War II. Being part of the opioid family of drugs, it is currently considered as the most commonly used treatment for addiction. Aside from this, it is also used for the treatment of chronic pain as well as pain that is closely associated with terminal sickness. The use of methadone to address drug dependency was only developed during the 1960s. Methadone Maintenance Treatment or MMT is considered as a form of treatment for drug addiction rather than a cure.

How does it work?

The Methadone Maintenance Treatment is used to provide both social and medical support to recovering addicts to allow them to improve and stabilize their lives so that they can be integrated into society as productive members. In recent years, the number of patients that have undergone MMT have risen. In Ontario alone, the number rose from 3,000 in 1996 to more than 50,000, which is about four times the per-capita rate of the United States.

MMT works by individuals contacting a treatment provider either directly or by referral. The referral is normally made by a social service provider or a community health worker. The patients will initially receive a comprehensive assessment to verify if methadone is the right treatment for them. When the patient is admitted into the treatment program, regular contact is maintained with the physician including the treatment staff. The staff is normally composed of case managers and counsellors.

Aside from providing urine samples, the patients need to go to the pharmacy every day to receive medication that will be supervised by a pharmacist. Some may receive medication from the clinic with a nurse supervising the entire process. For patients that have reaches a certain level of stability, the number of visits to the pharmacy for their required dose may be reduced. Remaining doses for the week may be taken home in carries and stored inside a locked box.

How long will a patient be under MMT? That would depend and vary largely based on the person needing treatment. What is sure though is that the longer the patient remains in treatment, the better results are achieved with the possibility of relapsed greatly reduced. This is the reason why this program is referred to as the Methadone Maintenance Treatment.

To ensure that the treatment is not abused, the College of Physicians and Surgeons of Ontario along with Health Canada developed best practice guidelines for the implementation of the treatment. The guidelines are in addition to the Program Standards and Clinical Guidelines for the delivery of methadone services.

Is it effective?

Hands down, MMT is considered as the most effective treatment to date to address opioid dependency. The significant benefits that a patient receives while under treatment translates to benefits for the community as well. In essence, MMT has been known to reduce deaths caused by overdose, transmission of certain diseases (hepatitis B and C, and HIV), and similar public health risks that are related to drug use.

Those who undergo the program also display improved mental and physical health. After a while, the patient regains social functions and the ability to retain employment. The treatment has also been associated with the reduction in usage of other illegal substances and activities that may result in crime.

Along with these social benefits are the cost benefits. The MMT treatment is widely acknowledged as being cost-effective with each dollar spent on the program resulting in a savings for the community anywhere from $4 to $13. If you take into account the social cost for one untreated drug dependent, factoring in crime victimization, productivity loss, law enforcement, and cost of healthcare, the annual amount would reach $45,000. When the person enters MMT, the amount drastically drops to $6,000 per year.

A key to achieving these benefits is finding the right treatment center to administer MMT. Contact Towards Recovery Clinics today to find out how they can help curb addiction.

Despite the varying points of view, it is difficult to dismiss the effectiveness of the methadone maintenance treatment in the reduction of heroin use of addicts. In fact, there have been studies that revealed that the methadone treatment program is more effective than the 180-day detoxification programs, which is founded on a series of counseling services. Just how effective is the methadone treatment program?

Comparison with the Alternative

Methadone maintenance treatment is a popularly used, but often controversial method of stopping heroin addiction. Compared to its alternative, the 180-day methadone assisted detoxification, the methadone maintenance treatment resulted in lower usage rated with less drug-related HIV risk behaviors like needle sharing for example.

Based on a study published in the Journal of American Medical Association, 179 participants were enrolled in the study and were assessed every month for a period of one year. Collected urine specimen was used as the basis for testing. Addicts in the methadone maintenance treatment were given stable doses. An hour-long group therapy per week was part of the program, which participants attended during the first six months.

Participants in the 180-day detoxification treatment were given 120 days of methadone treatment that was followed by 60 days of methadone dose reduction. This continued to the point where they no longer took methadone. For the first six months the participants attended a two-hour group therapy for substance abuse and an hour of cocaine group therapy if they used the drug. Individual group therapy was also part of the treatment program.

Not only did the methadone maintenance treatment retain more patients, but it was also more effective in reducing heroin use. Cocaine addicts were more likely to drop the 180-day program compared to the methadone treatment program.

Reduced Usage

Aside from treatment retention, another possible gauge of effectiveness is the reduction of opioid use. This has been the subject of research ever since the methadone maintenance treatment was introduced to cope with opioid dependence.

In 1998, the Marsch meta-analysis found that there was a consistent statistical relationship between the reduction of opioid use and methadone maintenance treatment. In 2007 a more recent meta-analysis was introduced and it supported the findings of Marsch. Randomized controlled trials showed reduced abuse of opioid.

Despite establishing the reduction in opioid use with the methadone maintenance treatment, it should be noted that the reductions are dependent on whether the addict receives adequate dosage levels or not. The reductions were also maintained for as long as addicts received methadone treatment. The conclusion was that addicts were less likely to be involved in heroin usage as long as the proper dosage of methadone was received.

Cost Benefits and Effectiveness

When we take into account the cost of untreated dependence on opioid, the cost of delivering methadone maintenance treatment is dwarfed by its benefits. Are you aware that the cost per annum of the treatment is significantly lower compared to the cost of drug-free treatment programs, untreated heroin usage, or incarceration? In fact, social costs of the criminal activities that are associated with heroin use are four times higher than the methadone treatment.

In the United States, every dollar spent on the delivery of the methadone maintenance treatment program translates to a savings of anywhere from $4 to $13 for the community. The same cost benefits are now being observed in Canada, particularly in Toronto where it is estimated that the average social cost of having untreated opioid dependents can reach roughly $44,600 a year. The Centre for Addiction and Mental Health in Toronto further estimates that the annual cost of providing methadone maintenance treatment would be about $6,000 every year.

The higher retention rates combined with lower delivery costs of the methadone maintenance treatment program compared to other treatment programs for opioid dependence makes it a considerably cost-effective solution. The cost effectiveness of the methadone treatment program compared to other programs produced a benefit to cost ratio of 4.4 is to 1 based on one study.

Towards Recovery Clinics can help you find an appropriate treatment program for addiction that will yield an effective result based on their holistic approach. Call them.

In case you weren’t aware of it, the use of legal opiate as a way to reduce the intake of illicit drugs has long been plagued with controversies. This is despite scientific evidence has supported the treatment as a cost-effective and practical strategy that will prevent illnesses and deaths associated with street drug usage. It also allows people with addiction to get back their lives. If this is so, why is there a methadone treatment controversy?

Replacing the Addiction

Methadone as a legal substitute for morphine, heroin, and other painkillers is a type of long-acting narcotic. The treatment makes use of methadone to replace the opiate that is the source of the addiction in order to prevent physical withdrawal, reduce cravings, and create a euphoric high. It is in this context that one of the controversies is anchored on. Many opponents of the treatment believe that the addiction is only replaced and not resolved.

The Ontario medical watchdog, College of Physicians and Surgeons, regulated methadone way back in 1996 after the responsibility was devolved to the provinces by the federal government. It is quite noteworthy to understand that the program was initially introduced when there were a lot of controversies surrounding the treatment of addicts and the increased access to the treatment.

Is there really any difference between methadone and the other opiates being prescribed by doctors? Doctors would prescribe Demerol, Percocet, Tylenol 3 and 4, and codeine for example, without any controversy. The ironic thing is that these often cause the addiction requiring the patient to turn to the methadone treatment.

When we come to think about it, shouldn’t the concern be directed to those who are using drugs and not seeking the proper treatment, rather than those who are on the methadone treatment? There is no doubt that many have benefited from the treatment. Unfortunately, such controversies are only stigmatizing methadone as well as those taking advantage of the treatment.

Addicts Keep on Using

Although some say that it is a better way of treating heroin addiction, some contend that how could it be better if addicts are still using? Their point being that what is the use of an addiction treatment where addicts do not really quit?

Methadone treatment may not be for everyone, but when it comes to harm reduction that policy makers are trying to get to, it has helped reduce instances of certain illnesses like HIV for example. The treatment would not be as controversial if it is understood that the part of the idea of the treatment is to help people live healthier and more productive lives while reducing health risks that are associated with heroin and other opiates.

So even if addicts don’t get completely clean, the reduction in HIV and hepatitis C that can spread with the use of dirty needles is something worth considering. There is also the benefit of crime reduction in the areas of theft and prostitution that are used in funding the habits of drug addicts.

Cost of Treatment

There are some quarters that insinuate that the cost of providing methadone treatment is just too high. What makes up the cost of the treatment anyway? In a gist, the estimated cost for the delivery of methadone maintenance treatment comes from laboratory costs, pharmacy costs, physician costs, and methadone costs. The pharmacy costs also covers markups and dispensing fees.

A study involving 9,479 patients, it was discovered that the average age that sought treatment was 34.3. And 62.3% of these patients were male. A total of 6,425,937 patients were involved in treatments for the study with the cost coming out to a total of $99,491,000. Out of this amount, 46.7% went to laboratory screening, 39.8% for pharmacy costs, 9.8% went to physician billing, and 3.8% for methadone. If we were to take this study as a reference point, we would come up with an average cost per day of $15.48 for the treatment or $5,651 each year. This of course is based on the assumption of continuous treatment for patients.

When you put this amount into context, the cost of delivering methadone treatment in Ontario is virtually the same as the estimates for both Australia and the United States. There shouldn’t be too much controversy with that.

If you would want to know more about effective methadone treatment, get in touch of Towards Recovery Clinics.

As a drug, methadone has been known to treat chronic pain aside from opiate addiction. It was originally developed during World War II in Germany and introduced in the United States in 1947. After 1950 it was used for the treatment of withdrawal symptoms from heroin and morphine addiction. Although similar to opiates, it is not the same because instead of coming from opium poppies, it is synthesized in labs. It also has longer pain-killing effects compared to natural opiates.

Treatment Delivery

How is the methadone maintenance treatment delivered?  Usually, a national level regulatory framework is in place for the prescription of methadone. In Canada, the Office of Controlled Substances work with provincial governments as well as medical licensing bodies. This is to help in facilitating the access to the treatment program.

There are numerous guidelines developed in the use of opioids for the management of opioid dependence. These guidelines also cover the training for practitioners who are interested in delivering the methadone maintenance treatment. Even if provinces are increasingly involved in outlining the conditions who are allowed to prescribe methadone, Section 56 of the Controlled Drugs and Substances Act explicitly identify that only those with exemption can do so.

There are a variety of conditions where the methadone treatment program can be delivered. This can include the following:

• Substance use for inpatient and outpatient treatment;
• Community-based health centers;
• Private medical clinics;
• Community pharmacies and physician’s offices;
• HIV/AIDS services;
• Hospital-based clinics;
• Correctional facilities; and
• Mental health agencies.

The delivery of methadone treatment programs is not limited to those with medical disciplines and backgrounds. Many practitioners come from diverse fields like social work, mental health, and substance use treatment for example.

Factors like program setting, qualifications, geographic location, and available resources result in varying roles. In the same way that there will be differences that exists among the programs in the manner of services delivered, clients served, program philosophy, policies, settings, and level of client involvement.

Philosophy and Treatment Goals

What is program philosophy? It is the principles and goals where the treatment is based. This is why it is extremely important to have a clear declaration of the program philosophy, which will serve as a starting point for the development of an accessible and effective methadone treatment program.

The concerns on drug use and its related crimes have greatly influenced the various goals where the methadone treatment programs and its delivery approaches have been based. But the different goals for treatment can result in how its definition for success can be interpreted. You also need to take into consideration that goals will change depending on the progress of the treatment.

In the eyes of policy makers, such a treatment program should be able to deliver long-term positive results that will reduce threats to society brought about by opioid dependence.

For practitioners, more specific focus on specific clinical benefits can be expected like reduced opioid withdrawal symptoms for example.

From a patient’s point of view, success can be measured in different terms like the reduction of the risk of infection, improved family relations, better job performance, or better methods of treatment while imprisoned for example.

The methadone treatment programs must be able to examine and clarify its expectations in terms of substance use, opioid dependence, and the treatment goals that will be implemented. The program philosophy should be extremely clear to all patients as well as the members of the program team expected to oversee the implementation.

The overall program philosophy should be made up of specific procedures and policies that are consistent with it. On the other hand, the goals of the program must not only reflect the needs of individual patients, but also respect the goals.

When it comes to program philosophy, few are better than one that focuses on helping individuals take control of their addiction while helping them rebuild their lives and careers.

Get in touch with Towards Recovery Clinics today to get a better understanding of how the methadone treatment can work for you.

Strange as it may sound, but in order to treat opiate abuse, another opiate must be used as a support when the drug abuser stops the original drug used. The purpose is to try and limit the intense drive to seek and abuse opiates like heroin for example. In this instances, the usual choice would be methadone primarily because it is widely available and comparatively cheap. Unfortunately, it can be abused and comes with its own set of side effects. What are the potential methadone treatment side effects that may be experienced?

Major Side Effects

Are you aware that there are about 5,000 people that die from methadone abuse every year? This normally occurs when the drug integrates with substances like benzodiazepines and alcohol. The major side effects can be just as bad as those manifested by heroin. Even the injectable form of methadone can result in side effects especially when needle is shared or used in multiple doses. Here are some of the major side effects that may manifest:

• Bleeding gums;
• Black, tarry stool;
• Blurred vision;
• Blood in stool or urine;
• Soft and bulging spot on head of infant;
• Difficulty in distinguishing colors, especially yellow and blue;
• Skin color changes;
• Chest pains or difficulty in breathing;
• Convulsions;
• Feeling of confusion;
• Chronic coughing, sometimes with pink frothy sputum;
• Decreased amount of urine;
• Noisy or wheezing breathing;
• Dilated neck veins;
• Difficulty in swallowing;
• Feeling of dizziness, lightheadedness or faintness;
• Dry mouth;
• Extreme fatigue or weakness;
• Headaches;
• Slow, fast, or irregular heartbeat;
• Skin rashes, itching, or hives;
• Sweating;
• Frequent thirst;
• Loss of appetite;
• Muscle cramps or pain;
• Vomiting or nausea;
• Tingling sensation in the hands, feet, or lips;
• Pale colored skin, lips, or fingernails;
• Red spots on the skin;
• Swelling of around the eyes, lips, tongue, face, fingers, or legs;
• Seizures;
• Difficulty sleeping;
• Unexplained bruising or bleeding; and
• Weight gain.

Minor Side Effects

There will also be some side effects that do not necessarily need medical attention. These are usually symptoms of your body’s adjustment to the methadone treatment, which should go away after some period. Healthcare professionals may give advices how these minor side effects can be minimized or prevented. Here are some effects that you may experience during the treatment:

• Irregular menstrual periods;
• Blurry, double, or loss of vision;
• Feeling anxious or confused;
• Constipation
• Decreased sexual appetite or erection problems;
• Affects color perception;
• False sense of well-being;
• Seeing halos around lights;
• Irritable or feeling restless;
• Feeling weak;
• Night blindness;
• Swelling, redness, or soreness of the tongue;
• Tunnel vision;
• Welts; and
• Unexplained weight changes.

Short-Term Effects

Aside from the major and minor side effects, there are also some short-term effects with varying intensity. Normally, these can last up to 24 hours. However, if these effects last longer or become more intense, you must seek medical attention immediately. What are these short-term effects?

• Feeling of extreme happiness or relaxation;
• Drowsiness; and
• Sedation

Overdose Symptoms

Although similar to heroin, methadone does not create an effect that is the same as that of heroin. It is still open to abuse just like any type of opiate. Therefore, it can still have a potential to do harm, but, based on its track record, more good is done for the people that undergo methadone treatment.

Reduction of the dosage can be done safely even if it remains relatively safe even when used in high doses. Perhaps this is one of the reasons why it is highly recommended for maintenance therapy. Just to help you to be aware, here are some of the overdose symptoms that can be experienced when taking methadone:

• Difficult or shallow breathing;
• Low or high blood pressure;
• Twitching of the muscles;
• Sudden nausea or vomiting;
• Bluish appearance of the lips and fingernails (cyanosis); and
• Coma

To know more about methadone treatment side effects and other effective ways to get rehabilitated, get in touch with Towards Recovery Clinics Inc. now.