Methadone maintenance program( therapy): the essence of the method, indications, effectiveness

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Getting rid of drug addiction is a long, complex and, sometimes, inconclusive process. More than 30% of drug addicts do not want to stop at the desire to live in eternal pleasure. Approximately the same number of patients are very thirsty to get rid of the craving for heroin, but they do not work. For this group of people, substitution treatment with methadone was introduced.

Methadone replacement therapy

The use of methadone in drug therapy is not a panacea for drug addiction in society, it is rather the replacement of one potent drug by another, cheaper, and, most importantly, legal.

Methadone popularity as a substitute for heroin and morphine swept the world in the 70s of the XX century. It was then in the US that methadone was first tested on a small circle of drug addicts. The results obtained were so overwhelming that after only a couple of years this method was introduced in many countries - Australia, Holland, Estonia.

Western statistics state that the illegality of acts in the ranks of drug addicts who are on methadone substitution from six to five years, falls from 100% to 8%, and among those who take legal drugs for more than five years - only 6%.

To date, the methadone program has been officially endorsed by WHO, strongly recommended by the United Nations Office on Drugs and Crime and is considered the most promising for addressing the problems associated with universal drug abuse worldwide.

Despite the support of the world's leading organizations, the Russian Federation, along with Germany, Switzerland and France, strongly opposes the introduction of this methodology. From the methadone treatment, eight US states and a number of Australian cities also declined.

The essence of the program

Practically methadone treatment is carried out as follows. A drug addict with a diagnosed addiction to opiates is offered a specially selected dose of officially approved methadone for him. Dosage of the drug is determined strictly individually in order to remove the symptoms of heroin withdrawal from the patient, but not to allow drug intoxication. Being under the influence of methadone, the addict remains in sound mind and sober consciousness, can carry out complex kinds of work, be in the family, raise children.

Actually methadone is the same drug as heroin and morphine, but there are significant differences between them:

• Methadone is many times cheaper than heroin.
• The action of one injection of heroin lasts about four hours, and drug addicts have to stab the drug 3-4 times a day. The dose of methadone calms the addict from 12 to 24 hours.
• Heroin is injected, but there is a high risk of damage to the veins and infection of the addict with hepatitis C, HIV infection and other dangerous diseases. The use of methadone excludes the possibility of infection, since the forms of the drug are tablets and syrup.
• Methadone, in contrast to heroin, does not provide an opportunity to get a thrill, after which the lion's share of drug addicts is chased. That's why many drug addicts are not ready to start rehabilitation.
• According to many drug addicts, the effect of methadone on the psyche is many times stronger than heroin, and it is impossible to refuse the use of this drug without medical assistance. In addition, not all drug treatment centers are able to cure dependence on methadone, often drug addicts with strong dependence on methadone are not accepted for treatment at all.

Substitution therapy is not suitable for all drug addicts without exception, otherwise there would not be a stop from those wishing to get a legal drug free of charge.

Only the following types of patients fall into the methadone program:

1. Patients with diagnosed dependence on opiates. Dependent on other drugs, such as amphetamines or drugstores, can not be taken for rehabilitation.
2. The patient must be of legal age.
3. The diagnosis should take at least two years.
4. There must be a record in the addict's card that he was previously subjected to various types of therapy and rehabilitation, but nothing has produced results.

Treatment Scheme

As mentioned above, the dosage of the drug is calculated for each patient separately. However, there are general recommendations based on long-term observations of the effectiveness of the technique. Studies show that the best results are achieved when using for maintenance therapy a dosage of 80-100 mg per day. The dose is gradually increased, at the beginning of treatment it can be as low as 20-30 mg per day, and then 10 mg per addition is added more often than twice a week.

Methadone therapy can last a fairly long period of time, until the drug produces the desired result and does not lead to side effects.

When taking methadone, patients are obliged to stop using opioids, which is confirmed by regular urine tests. In the event that the tests confirm the use of heroin, the patient is excluded from the methadone program.

The effectiveness of

Despite the fact that the World Health Organization strongly recommends the use of methadone rehabilitation in the socialization of drug addicts, the effectiveness of this method raises many questions.

Adherents of the use of a new drug consider that the benefits in the program are incomparably greater, namely:

1. Drug use on a legal basis and control of its turnover by government bodies allows to reduce the criminal traffic of drugs on the black market.
2. Non-injection method of methadone intake reduces the risk of HIV infection and other life-threatening infections.
3. The drug is issued free of charge, so there is no need to obtain money for a dose by criminal means.
4. The lack of an intoxicating effect of the drug is the first step to a sober life. Subsequently, patients learn to live without drugs at all.
5. Getting used to living without heroin injections, drug addicts soon agree on other methods of getting rid of addiction.

Opponents of substitution of one drug for another believe that methadone is a terrible evil and only aggravates the sad statistics.

As convincing arguments they lead the following:

1. Almost a quarter of drug addicts are immune to methadone.
2. Methadone is not a way to get rid of anesthesia, the dependence does not disappear anywhere, most drug addicts return to heroin to get their portion of buzz. However, they require a dose of heroin twice as much as before. Or, taking methadone orally, drug addicts "catch up" with the help of alcohol or synthetic drugs, which is incomparably worse than returning to heroin.
3. Methadone causes a severe compulsive addiction, which is much heavier than heroin, and its treatment involves a lot of money and is always spent in the hospital, while heroin addicts who are determined to embark on the path of a sober life are able to tolerate symptoms of withdrawal without the help of medics.
4. Methadone is a very toxic drug. Cases of methadone overdose are not so rare, the drug often leads to a halt in breathing and cardiac activity. Given the fact that the half-life of methadone is very high, drug addicts who decide to inject heroin after a while are in great danger of getting the strongest overdose.
5. The use of methadone is, first of all, the legal permission to take drugs. It is impossible to treat drug dependence, using other powerful drugs.

Apparently, this technique has a lot of supporters, but also a lot of opponents. It is clear that substitution therapy will never become a full-fledged alternative to treatment for severe drug addiction, but will only allow to socialize a drug addict in society. But this is already an achievement. And yet, the substitution of one drug for another is unlikely to at least somehow solve the problem of drug addiction. Having firmly resolved to break with addiction, the addict must take the path of a sober life, and not seek salvation in a new drug.
On video, the advantages and disadvantages of methadone replacement therapy: