New Research Suggests ‘Safer’ Use, But Methadone Detox Still A Problem

Studies at the Washington University School of Medicine in St. Louis and the University of Washington in Seattle reveal that until now, no one has properly understood how the human body processes the powerfully addictive opioid painkiller methadone. The findings help explain why methadone is so deadly, and why addicts undergoing methadone detox have such a painfully difficult experience.

The researchers have learned that the body metabolizes methadone differently than previously believed, making it difficult for physicians to understand how and when the drug is cleared from the body. An unexpected buildup of methadone in the body is responsible for unintentional overdosing, leading to coma and death.

Doctors have prescribed methadone more frequently in recent years to treat acute, chronic and cancer pain, and the use is rising dramatically. Methadone prescriptions for pain rose 1,300 percent between 1997 and 2006. And as more methadone was prescribed, injuries increased by approximately 1,800 percent, and deaths soared 500 percent -- from 786 to 3,849 from 1999 to 2004.

“Unfortunately, increased methadone use for pain has coincided with a significant increase in adverse events and fatalities," said the principal investigator in the new methadone research, Evan D. Kharasch, M.D., Ph.D., an anesthesiologist and clinical pharmacologist. “The important message is that guidelines used by clinicians to direct methadone therapy may be incorrect.”

Dr. Kharasch and colleagues are learning more about the ways in which methadone is metabolized, which they hope will lead to safer prescribing methods. But it will not change the salient facts concerning the drug’s highly addictive nature, and its continued misuse as a ‘treatment’ for thousands of opioid addicts.

Methadone has been used for decades to combat addiction to heroin and other opioids. By targeting the same opioid receptors in the brain, it suppresses withdrawal and reduces cravings, without causing euphoria. And it requires only one dose a day, compared to the several doses needed by heroin addicts.

The problem with methadone ‘treatment’ is that rather than becoming drug free through a proper rehab program, an opioid addict remains an opioid addict -- now they’re addicted to methadone, which can continue for life. The only hope is a methadone detox program followed by lengthy rehab. But methadone is extremely difficult to withdraw from unless certain medical protocols are followed.

Steven Hayes, clinical director of Novus Medical Detox of Pasco County, FL, says methadone detox for people on the high doses associated with methadone maintenance programs for heroin addicts is not offered by most rehab centers. Methadone detox takes too long, causes terrible symptoms, and most facilities refuse to treat it.

“Methadone addicts often try to taper off their methadone use themselves, but routinely fail because of the extremely severe withdrawal symptoms,” Mr. Hayes said. “And since most drug detox facilities won’t accept them, addicts usually decide there is no way to become drug-free. They’re trapped for life.”

There are many people who become caught in the web of methadone addiction simply from treating chronic pain. Such people are faced with the same difficulties as anyone else when they look for a methadone detox program that can help them get off the drug.

Fortunately, there are a few medical drug detox programs available that have cracked the difficult methadone detox problem, Mr. Hayes said. New medical protocols allow methadone detox even for high-dose patients, minimizing withdrawal symptoms and greatly reducing the time traditionally expected for methadone detox.

This means anyone suffering from high-dose methadone maintenance can at last look forward to a life free from dependence on methadone. Mr. Hayes advises methadone addicts to persist in their search for clinics that can and will help free them from the trap of methadone addiction.