According to the Centers for Disease Control and Prevention, nearly one million people are addicted to opiates or opioid pain relievers. For many, Methadone Maintenance Treatment, or MMT, is the best path to ending addiction. When deciding whether or not to participate in a methadone maintenance program, it is important to weigh the pros and cons of methadone maintenance for opiate addiction recovery. To do this, one needs to know what methadone maintenance is, the pros of methadone treatment, the cons of methadone treatment, and what alternative treatment options are available for treating opiate or opioid addiction.
What is methadone maintenance?
The Substance Abuse and Mental Health Services Administration states that methadone is an opioid (synthetic opium like substance) that has been used for nearly 40 years to treat opiate and opioid addiction. It works by blocking the opiate receptors in the brain, thereby reducing cravings and eliminating withdrawal symptoms. This allows patients to participate in counseling and therapy, so that they can enact the positive lifestyle changes necessary for their long-term mental and physical well-being and sustained sobriety and drug abstinence.
Methadone maintenance is an addiction treatment program that is administered by healthcare professionals in a clinical environment. This is usually an outpatient program where the patient returns to the clinic daily for their dose of methadone. Methadone doses typically last 24 hours, so it is important that the patient return every day. Also, having to go to the clinic reduces the risk of overdose or abuse of methadone, by strictly controlling the amount of methadone the patient has at any one time. This makes methadone maintenance a very useful method of treating opiate addiction.
Pros of methadone treatment
As with all treatments for addiction, there are positive and negative aspects to methadone maintenance programs. The pros include:
- A record of more than 30 years of successful treatment of opiate addiction,
- Daily clinic visits to help addicts get their lives back on track by providing structure,
- Doses that last for a minimum of 24 hours,
- Group and individual counseling that is often provided along with the methadone,
- Reduced cost, because it is generally less expensive than other treatment options, and usually offers a sliding scale payment option,
- Reduced tolerance, because there is no maximum effective dosage, and the amount of methadone given to a patient can be raised to combat tolerance,
- Complete opiate addiction recovery, because it is possible to wean a patient back off of methadone, and back to a drug free existence,
- Convenience, because there are no arbitrary limits on the number of patients a clinic can treat, making methadone clinics relatively easy to locate and get to,
- Stopping withdrawal symptoms, because it is an opioid,
- Reducing cravings by blocking the opiate receptors in the brain,
- Stopping opiate use or abuse by making it difficult, or impossible, to get high from opiates, because of the receptor blockage mentioned above,
- Reducing the risk of abuse and overdose, because it is strictly monitored in a clinical environment, and
- The opportunity to develop a support network with other patients of the clinic.
This makes it obvious that there are many positive aspects to participating in a methadone maintenance program. However, it is important to remember that there are many negative aspects as well.
Cons of methadone treatment
Methadone treatment, even after nearly 40 years of success, is still controversial. This is because of the negative things associated with methadone treatment. The cons of methadone treatment include:
- It is still possible to use, and abuse, illicit opiates and opioids (to a much lesser effect, thanks to the methadone’s blocking abilities),
- A person who uses opiates while on methadone is far more likely to overdose, because they don’t feel the desired effects,
- Tolerance, resulting in having to take higher doses for the same effect,
- Dependence, because it is an opioid,
- Complications from interactions with other drugs,
- A long list of mental and physical side-effects,
- Interference with work schedules, because of the nature of daily visits to the clinic,
- An inability to travel, for the same reason as above,
- Failing drug screens, because methadone shows up as an opiate,
- Being stigmatized as a drug user,
- A strict treatment regimen, that may make the patient feel like they are not in control of their own treatment, and
- Self-esteem issues, related to the clinical environment and lack of control associated with methadone treatment.
There has also been ongoing research into whether or not methadone clinics attract drug-related crime such as the distribution or sale of illicit substances, violence, and vagrancy. However, at this time, that data is inconclusive. Methadone maintenance is not the only option.
Deciding on Methadone Maintenance Treatment
According to the National Institute on Drug Abuse, drug addiction is a complex disease, and no single treatment is right for everyone. There are many treatments available. Many of these treatments can be combined with methadone to provide a complete treatment plan. A few of the other treatments include holistic or natural medicine remedies, religious counseling, mental health counseling, or other medications, such as buprenorphine, that are not opioids. If someone is addicted to opiates or opioids, they should consult with their doctor and other trusted people in their lives to come up with a treatment plan that meets all of their needs. Doctors and therapists are most suited to helping a patient consider the pros and cons of methadone maintenance for opiate addiction recovery.