Is Methadone Safe?
The safety of methadone depends on how you use it.
Methadone is a very potent opiate medication, but the overwhelming majority of people who take this medication as directed can use it without fear of adverse consequences.
People with certain conditions should not take methadone, and care should be taken during the first couple of weeks of treatment. You should never take methadone with certain other drugs and you should never exceed your dosage of the medication.
You must take methadone responsibly and with respect for its power, but the careful and considered use of methadone has proven quite safe, even for long-term consumption. Methadone has been proven not to harm the lungs, heart, brain, liver, kidneys, or any other organ.
In 2005 methadone use was linked to more than 4,000 deaths. However, many of these deaths did not involve methadone treatment for opiate addiction — instead, they involved individuals who were using methadone without medical supervision for pain treatment, or who were otherwise abusing methadone.
Methadone use saves far more lives than it endangers. According to the National Alliance of Methadone Advocates (NAMA), opiate addicts who are not on methadone are more than three times more likely to die than are individuals who are using methadone as part of a supervised addiction recovery program.
Methadone, much like any strong opiate analgesic, has a respiratory depressive effect. If you take too much methadone, you can stop breathing and die.
The First Week
The risks of overdose are greatest during the first week or so of treatment with the medication. Methadone accumulates in tissues of the liver for the first week until a “steady state” of maximal accumulation is reached. The methadone that is stored in these tissues gets slowly released into the bloodstream, and contributes to the long lasting efficacy of the medication. For the first week or so, every progressive dose of methadone you take will have an increasing effect.
Since every first week dose has an increasing effect on the dosages that follow, an improperly large does of methadone can be dangerously amplified during the first week of treatment.
You will likely feel some mild symptoms of withdrawal during your first days of methadone maintenance treatment, as methadone levels accumulate in your tissues. Your doctor will err on the side of caution, will prescribe you methadone at a minimally acceptable dose for projected symptoms relief, and will raise the dosage as necessary after you achieve a steady state.
If someone were to take additional (illicitly procured) methadone during this first week in search of symptoms relief, they would place themselves in jeopardy of overdose.
Federal guidelines cap the use of methadone at 40mg during the first day of methadone maintenance treatment.
Drug Interaction Effects
Taking methadone with certain other medications, alcohol, or illicit drugs increases the risks of methadone overdose.
Methadone slows breathing, and combining this medication with any other central nervous system depressant or other medication that affects respiration increases the risks. Benzodiazepines (Xanax or valium, for example) seem especially dangerous in combination with methadone, and the combination of benzodiazepines and methadone has resulted in a significant number of fatal overdoses.
Do not take methadone with any other medication, even over-the-counter drugs, before checking with your doctor or health care provider. Avoid drinking alcohol with methadone, and also avoid taking other illicit drugs, particularly other opiates or sedatives.
Surprisingly, you should also avoid grapefruit and grapefruit juice while on methadone. Grapefruit influences the activity of an enzyme in the liver that can increase in the potency of the medication. Grapefruit increases the potency of anyopiate that is metabolized in the liver.
Who Shouldn’t Take Methadone?
Most people tolerate methadone well, but because of the medication’s effects on respiration, people with conditions that can influence respiration (such as sleep apnea, asthma, and extreme obesity) may not be appropriate candidates for methadone maintenance treatment.
Methadone can cause constipation as a side effect, and so people with intestinal blockages (paralytic ileus, for example) may not be suitable candidates for methadone maintenance treatment. Also, people with prior head injuries or problems with their heart, liver, lungs, kidneys, or prostate may also be unable to use the medication safely.
Be sure to tell your doctor about any preexisting conditions to ensure your suitability as a candidate for methadone maintenance treatment.
Is Methadone Safe During Pregnancy?
Methadone is the treatment of choice for opiate-addicted women during pregnancy, and seems safe for both the mother and the unborn child.
Other Risks of Methadone?
Because of methadone’s potency, especially for anyone without a developed opiate tolerance, methadone diversion and the accidental consumption of the medication pose serious concerns.
You must never share a take-home dose of methadone with anyone, and methadone must be stored securely and out of the reach of children. The amount of methadone in a single dose is enough to kill a small child
Is Methadone Safe for You?
Methadone is a strong but stable medication that is generally very safe for people who meet the following conditions:
- Have discussed any preexisting conditions with their doctor.
- Take the medication only as directed and under a doctor’s supervision.
- Don’t take any other medications, alcohol, or illicit drugs without asking a doctor first.
- Store the medication securely, ensuring that no other person has access to the methadone.
If you plan on following your doctor’s instructions and don’t plan on abusing the medication or playing around with other drugs while on methadone, then you have very little to worry about. Methadone has been around for a long time and has helped many people overcome addictions to heroin and other opiates.
To find out more about methadone and to arrange a confidential consultation with a doctor about your suitability for the medication, call the National Resource Center at 888-471-0430.