Methadone - How Is It Taken?

How Is It Taken?

In most clinics, methadone is dispensed in sugary liquids and swallowed by the patient. The drug can also be taken as a biscuit ("diskette") or in pill form. Very rarely, in a hospital or clinical setting, the drug is injected into a muscle. Methadone is not commonly used in post-surgical settings because other drugs such as morphine and fentanyl work faster to relieve pain. (Separate entries on morphine and fentanyl are available in this encyclopedia.) Rather, methadone is used for long-lasting pain, such as that resulting from cancer, back injuries, or severe arthritis.

In 2000 the federal government relaxed rules on prescribing methadone in pill form. Doctors who complete an eight-hour training seminar become certified to dispense methadone pills that vary in strength from 20 to 120 milligrams.

Methadone Chronology

1939     German scientists develop a synthetic opioid painkiller in response to wartime shortages of morphine. They call the new drug Amidon.

1947     American pharmaceutical company Eli Lilly begins trials of the painkiller. Lilly calls the drug methadone.

1950     Researchers begin using methadone to treat withdrawal symptoms in heroin addicts.

1964     Researchers in Lexington, Kentucky, conclude that a daily dose of methadone allows heroin users to avoid withdrawal symptoms while also being unable to experience a heroin high. The first methadone clinic opens in Lexington.

1970     The U.S. Controlled Substances Act places methadone on its list of Schedule II substances, recognizing that the drug has medical uses but also the potential for misuse and abuse.

2000     Prescriptions for the pill form of methadone rise sharply in response to abuse and illegal use of other opiate/opioid painkillers such as Vicodin and OxyContin.

2003     U.S. trials begin on the drug buprenorphine for use as an alternative to methadone.

The first week of methadone use for chronic pain can be difficult and dangerous. Doctors need to monitor patients carefully because the drug acts slowly on the pain and accumulates in the body. Patients must be watched for tolerance levels so that they are not given deadly doses. They must also be cautioned that methadone is not a "quick fix" for pain, and that taking an extra dose will not make the drug work any faster. Typically, patients will see little or no pain relief from methadone for the first twenty-four to forty-eight hours. After that, methadone works well for chronic pain, provided the user follows the directions and does not mix the medication with other drugs, except on the advice of a doctor.

Illegal Use

People also use methadone illegally as a recreational drug, which is a drug used solely to get high, not to treat a medical condition. People have been known to grind up methadone tablets and snort the powder or inject the drug. This can be extremely dangerous, even in the absence of other drugs or alcohol. Because methadone works so slowly, it does not provide the rushA feeling of euphoria or extreme happiness and well-being. of euphoria that the user craves. This may entice the user to take more methadone, eventually leading to a deadly build-up of the drug in the body. It is often hours and sometimes even days before the poisonous effects of methadone become apparent, as the user first slips into a deep sleep, then into a coma, and then stops breathing.