Is Methadone Safe?
Methadone is a long-acting opioid that is safe for most individuals to use when it is administered in appropriate doses and under the qualified supervision of a physician or opioid treatment program OTP provider. It works much the same way as other short-acting opioids to relieve pain and unpleasant symptoms of opioid withdrawals and cravings, although it has a much slower onset of action.
Methadone has a long history of safety in use during medically supervised withdrawals, detox, and maintenance treatments for opioid addictions. Methadone causes no adverse effects to the lungs, heart, kidneys, or liver, or brain and can stabilize physiological processes to improve overall health in the long run whereas shorter acting opioids have higher levels of addiction and abuse consequences such as IV use and the spread of communicable diseases.
Some patients may experience minor symptoms of constipation, skin rash, water retention, drowsiness, excessive sweating, or even euphoria which usually diminishes once a stable daily dosing is achieved. This steady state of dosing adds to methadone’s safety by reducing interferences with ordinary activities such as operating machinery or driving a car that could be dangerous if using other opioid medications.
Methadone is a preferred agonist therapy for pregnant mothers who are dependent on opioids versus the risk of prenatal opioid dependence and miscarriage or premature labor during opioid withdrawals.
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Observation in Dosing
Observation is the key to safety when using methadone and treatment regimens should always begin with the least amounts. In an OTP, methadone dosages of 20mgs – 30mgs are usually sufficient to maintain a comfortable state for those who are detoxing from shorter-acting opioids, with first day dosages limited to no more than 40 mgs.
Patients are monitored for their responses to the medication and subsequent dosage increases to measure the safety and comfort levels. According to the Substance Abuse and Mental Health Services, it is important to adjust methadone dosage carefully until stabilization and tolerance are established
Patients receiving methadone for pain management purposes are observed less frequently than required by federal regulations for the treatment of opioid addictions and those who are naïve to methadone; those using other CNS depressant medications; and the severely ill, frail, or elderly may be a higher risk of overdose.
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It takes about 5-7 days for methadone to build up the person’s system where a steady state of relief can be obtained for 24 hours or more. Because methadone remains stored in bodily tissues until it is slowly released into the blood stream, taking too much methadone, taking it more often than every 24 hours, or taking it with alcohol or other substances, especially CNS depressants without physician approval, can cause adverse and dangerous effects including the high risk of respiratory depression and overdose.