According to statistics, opioid dependence affects approximately five million individuals in the United States each year and is responsible for 17,000 deaths each year in the U.S. The abuse potential for opioids begins at a young age, usually during adolescence or early adulthood and continues into middle and late adulthood. Americans makeup approximately five percent of the world’s population but are responsible for 80% of the consumption of the world’s opioid supply and therefore have one of the largest opioid crises in the world. Prescription opioids are majorly responsible for this crisis resulting in 46 deaths per day in 2012. Opioid treatment in itself is a multi-million dollar industry with methadone-based treatment, a type of medication-assisted treatment, having positive effects. Methadone, for example, is a common medication used for treating opioid withdrawals however methadone itself, is considered a low strength long-acting opioid.
What is methadone?
In a methadone-based treatment center, healthcare professionals with administering small doses of methadone to heroin-addicted clients with the idea that the withdrawal side effects will be minimized over time and simultaneously the dose of methadone will decrease. Methadone is favored in heroin treatment centers because unlike heroin, methadone is a long-acting opioid and therefore does not produce the instantaneous euphoric high that heroin produces. As an opioid, methadone still has many properties that are shared across the spectrum of opioids including analgesia, respiratory depression, sedation, low blood pressure and decreased gut activity. The analgesia element associated with methadone is very important when it comes time to treating individuals who suffer from chronic pain but the other side effects of methadone can be beneficial when treating individuals who have a heroin addiction. Individuals who are undergoing heroin withdrawals will usually experience stomach pains, diarrhea, depression and anxiety and methadone is known to help counter all of these side effects by slowing down the gut to counteract diarrhea and eliciting drowsiness to counteract the anxiety. Since methadone is an opioid, it does come with an addiction profile and therefore it is used as a short term treatment for individuals who are withdrawing from heroin while paying extreme caution to not create an unhealthy need for methadone itself, potentially causing another addiction.
How is methadone used to treat heroin addiction?
In methadone-based treatment programs, addiction treatment professionals will administer small doses of methadone to clients who are currently withdrawing or who are in jeopardy of withdrawing from heroin. Methadone treatment usually begins around 10-20mg and will increase by increments of 10mg until the heroin withdrawal symptoms are under control. Since methadone is not as strong or fast acting as heroine, some clients may experience mild withdrawal symptoms while on methadone. Once the client is on the correct dose to ease their heroin withdrawals, they will stay on this methadone dose for a few days and then will be slowly weaned off the methadone in a step-down fashion to ensure addiction to methadone does not occur.
Naltrexone aka Vivitrol
The long-acting injectable form of naltrexone under the brand name Vivitrol is administered once a month for individuals who are undergoing opioid treatment. Vivitrol is an opiate and opioid antagonist, meaning it blocks the effects of opioids. An opioid antagonist attaches to the same receptors as the actual opioid drugs would, but it does not trigger a release of the feel-good brain chemical dopamine. When an individual uses Vivitrol and then tries to misuse opioids, the effects of the opioid are blocked. It is considered a long-term medication and therefore is given to the client only if he/she has abstained from heroin for 7-10 days, and therefore is usually administered after the client has undergone medication-assisted treatment with methadone. Since Vivitrol does require detoxification before it can be administered, it is imperative that individuals seek professional help for their heroin/opioid addiction as soon as possible.