What is Methadone Used For?
Legal methadone uses are limited to relieving severe pain and as a way to manage withdrawal symptoms associated with heroin (or other narcotic) addiction. Due to its addictive nature, illicit use of methadone is common.
Opioids manage pain symptoms by binding to opioid receptors located in the central nervous system, thereby blocking pain signaling in the brain. Prescriptions of methadone for pain management have become somewhat controversial in recent years, mainly due to the addictive nature and the risk of selling or giving away prescribed pills.
- Chronic Pain: Chronic pain affects more than 40% of older Americans. Prescriptions of methadone for chronic pain management were common until recently, but mounting evidence suggests that long term opioid use for chronic pain management may cause more problems than solutions. Many people who use methadone to manage chronic pain report that they develop tolerance to the medication, resulting in the requirement for ever-increasing doses in order to continue to manage their pain. Consequently, long-term methadone use for pain management leads to addiction, withdrawal symptoms, and unmanaged pain.
- Cancer Pain: Many people undergoing treatment for various cancers suffer from moderate to severe pain, and methadone has been shown to be a reliable first-line therapy in the management of cancer pain. Interestingly, many lines of tumor cells have been shown to have opioid receptors. In these patients, methadone could have “tumor thermalgesic” properties; that is, methadone could control pain as well as enhance the efficacy of anti-tumor agents.
- Back Pain: Chronic lower back pain is one of the most prevalent pain syndromes among adults in the United States, affecting 13.1% of adults ages 20 to 69. Methadone can be an effective short-term management strategy for acute back pain, but it should not be used to manage chronic back pain.
Addiction Treatment: How Does Methadone Work for Addiction?
Opioids are among the most powerfully addictive drugs known to man. Common opioids of abuse include heroin, fentanyl, oxycodone, and morphine. Although methadone is an opioid, it has a more gradual onset of action than other opioids and the overall effect is mild enough that users do not experience the euphoric high that is associated with other opioids of abuse.
Related Topic: Methadone Treatment
Underlying all opioid addictions are significant changes in brain chemistry, primarily associated with mu-opioid receptors and the dopamine-mediated reward system. Opioid use rapidly induces a state of tolerance, meaning that a person must take ever-increasing doses of the drug to feel the desired effect.
Physical dependence and addiction quickly develop with regular opioid use, and withdrawal symptoms can be profoundly debilitating. When people discontinue opioid use, physical symptoms generally subside within days or weeks, but the chemical changes in the brain may persist for years. Because methadone acts on the same brain regions as other opioids without delivering the euphoric high, methadone can stave off physical and psychological withdrawal symptoms associated with heroin and other opioids. For individuals who struggle with chronic opioid addiction, methadone treatment may be a lifelong strategy that allows them to avoid relapse. However, methadone itself is associated with dependence and addiction. Long-term methadone treatment strategies should be reserved for extreme cases of opioid addiction.