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No, the lack of understanding on this topic furthers the stigma around MAT and creates barriers for those struggling with opioid addiction. Methadone and buprenorphine are FDA approved medications that do not cause “euphoria” or impairment when taken at the correct dosage. Instead, they relieve an individual’s craving for opioids and the physical symptoms of withdrawal. In addition, MAT programs provide counseling and supportive services to address the causes of addiction so that patients may experience long-term recovery. Individuals in a medication-assisted treatment program are often able to regain employment, rejoin their family and become productive members of their communities. Like many other prescription medications, there are withdrawal symptoms if stopped abruptly, but those are managed through a carefully monitored, individualized medically-supervised taper to come off medication.
When taken as prescribed, methadone and buprenorphine are safe and effective in the treatment of opioid addiction. Extensive research indicates that medication-assisted treatment (MAT) does not cause physical harm to patients, even if patients are in a MAT program on a long-term basis. MAT program medical providers carefully monitor the dosage for each patient to ensure it is safe and appropriate for their needs. There are many myths about the effects of methadone on the body, but extensive research over the last 50 years has proven no lasting side effects from the use of methadone to treat opioid addiction.
The length of a medication-assisted treatment program varies for each person based on a number of factors including their drug use history, drug of choice, recovery support system and individual brain chemistry. While the time in treatment can vary, research indicates that the longer individuals participate in a medication-assisted treatment program, the more likely they are to experience long-term recovery.
Methadone is a full agonist opioid meaning that it acts similarly to other opioids by activating the mu receptors in the brain fully. However, there are two key differences:
1) when administering at the proper dose, there is no “high” like with illicit opioids.
2) it is very long acting so it does not cause cycles of high and withdrawal like short acting opioids do. The long-acting nature of methadone allows a single dose to provide relief for 24-36 hours when administered. Methadone helps to normalize the chemical and hormonal imbalances an individual experiences when in active opioid addiction. This effect reduces the physical symptoms of withdrawal and eliminates the craving for illicit opioids.
The correct dosage of methadone varies for each patient. The goal of methadone maintenance treatment is to reach a therapeutic dose where the patient no longer experiences physical withdrawal symptoms or cravings to use illicit opioids. Methadone is a longer lasting opioid than heroin and most prescription pain relievers, allowing a single daily dose to be effective for addiction treatment.
Methadone is available in pills, tablets, wafers and liquid varieties. Health Care Resource Centers ONLY dispenses liquid methadone. It is taken at the medication window with a nurse as a witness to prevent diversion of the medication. Take homes are also given in liquid form once earned by patients meeting all legal and clinical requirements.
Most side effects are reported as mild, and if experienced, should be discussed with your treatment provider and physician as a dosage adjustment may help. Possible side effects can include:
A proper dose of buprenorphine, or buprenorphine compound, varies for each person. Buprenorphine, and buprenorphine compounds such as Suboxone®, have been shown to be more effective at lower doses overall. At a certain point, increasing the dose may not provide additional benefits due to the ceiling effect. It is important to note that before beginning a buprenorphine treatment program, a patient must be completely opioid-free or experiencing moderate withdrawal to ensure that a complication called precipitated withdrawal does not occur.
Buprenorphine, and buprenorphine compounds such as Suboxone®, are known to have a ceiling effect. This means that the effects of the medication do not increase beyond a certain dose. In this instance, it means that any feeling of euphoria provided by Suboxone® is limited, and at a certain dose, will not increase any further regardless of how much medication is taken.
Most side effects are reported as mild, and if experienced, should be discussed with your treatment provider and physician as a dosage adjustment may help. Possible side effects can include:
This is opioid withdrawal symptoms caused by taking buprenorphine too soon after the last opioid use. This can be very uncomfortable and unpleasant, but it is usually preventable by following the induction dosing instructions for starting buprenorphine.
Methadone and buprenorphine are both FDA approved medications for the treatment of opioid use disorder, or opioid addiction. Both medications are classified as opioids, have similar side effects and are long acting medications. However, very key differences distinguish them from one another.
Methadone is a full opioid agonist. This means that as the dose increases, there will be increased therapeutic effects as well as possible side effects. In a medically supervised program, once the right dosage is achieved, methadone can provide relief from opioid withdrawal symptoms and cravings. Additionally, a therapeutic methadone dose can reduce the likelihood of feeling high if illicit opioids are used. Some people refer to a therapeutic dose as a “blocking dose” for this reason.
Buprenorphine is a partial opioid agonist, which means it does not fully activate the mu opioid receptors in the brain. This is commonly referred to as a “ceiling effect.” This means that as the dose increases, there will not be increased therapeutic effects or side effects. Partial opioid agonists are considered safer due to quality. Additionally, buprenorphine with naloxone, commonly known by the brand name Suboxone®, can actually cause an individual to go into immediate withdrawal if injected, deterring misuse.
