The United States has added yet another menacing
substance to the ever-growing problem of drug abuse. Methadone,
a medication typically used as replacement or maintenance for
opiate-dependent patients, has become the substitute drug of choice
for heroin and the popular painkiller turned street drug, OxyContin.
The Drug Abuse Warning Network reported that across
the nation, Methadone-related incidents requiring emergency room
treatment has increased 37 percent between 2000 and 2001. Florida
saw an 80 percent increase in Methadone related deaths in the
same period, and North Carolina's fatalities increased eight times
from 1997 to 2001. Virginia is witnessing similar trends, and
data predicts that we will soon be seeing significantly more Methadone-related
abuse than OxyContin.
Like Vicodin and Lortab, the frequency in which
Methadone is being prescribed for pain is also increasing. Patients
who were prescribed Methadone by their physicians to treat the
pain of common ailments such as chronic back pain, sports-related
injuries, or migraine headaches, are now seeking treatment for
a dependency on a drug that was originally intended to help them.
For many years, Methadone was not considered an
addictive threat because of the length of time (several hours)
between taking it and experiencing the narcotic effect. Additionally,
it has a sedative, rather than stimulant, effect. As an opiate-based
painkiller, Methadone can serve as an adequate stand-in for heroin
or OxyContin. This can be extremely dangerous due to the delayed
and subtle effect of the "high". People can overdose
because they don't anticipate or feel the actual damage being
done until it is too late.
Methadone has become more widely available in
recent years, due in part to the increased number of clinics using
Methadone to treat heroin and OxyContin addictions. This makes
it difficult to determine whether the drug is friend or foe. Ryan
Curry, a 21 year-old Maine resident, began taking OxyContin to
get high with his friends several years ago. Like many people
who use OxyContin recreationally and for medical purposes, his
body became dependent. Ryan decided he wanted to break his dependency
so he sought treatment at a local Methadone clinic. Ryan was put
on a low dose of Methadone to replace the OxyContin he had been
abusing. As he became tolerant of the effects of the Methadone,
doctors gradually increased his dose.
Ryan continued to take the Methadone supplied to him by the clinic
for two years with his prescribed dose having more than quadrupled
during that time.
"I couldn't understand why they kept increasing
my dose when I was supposed to be getting the drugs out of my
system," said Ryan. "My body would grow accustomed to
the dose and I would need it increased just to make it through
the day. It was not helping me."
Methadone treatment facilities traditionally service
the patient on an outpatient basis, administering medication with
a drive-thru mentality. A patient's vulnerability, compounded
by a lack of sufficient medical supervision and psychological
support, can sometimes result in the emergence of the new dependency.
More so, a doctor may have difficulty judging the proper Methadone
dose for a first-time user. Additionally, patients are escalated
to Methadone doses much higher than the original opiate in order
to allow for 24-hour dosing. The consequence of this is that Methadone
patients are much more difficult to detox.
Experts argue that people who are prescribed Methadone
for dependency on heroin or another opiate can lead normal lives
and should be praised for giving up their addictions. However,
these people may need to take Methadone forever, unable to function
without it. Like any other dependency, quitting Methadone can
cause withdrawal symptoms because the user is still dependent
on opiates. Fundamentally, Methadone treatment neither addresses
nor reverses the core issue of dependency, and studies of former
heroin dependents have shown that withdrawal from heroin was far
less excruciating and lengthy than withdrawal from Methadone.
Is substituting one form of dependency for another
really the way to approach this life-threatening problem?