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Drug Information

sunshine coast health care center

QUICK FACTS – Methadone

Commercial and Street Names

Dolophine® , dollies, fizzies, amidone, chocolate chip cookies (ecstasy combined with heroin or methadone).

Description of Methadone

Can be legally prescribed in Canada only by specially authorized doctors. Primarily for the treatment of narcotic addiction but also for chronic pain management. Orally: orange-flavoured solution, tablets.

Effects of Methadone

Can last up to 24 hours, thereby permitting once-a-day oral administration in heroin detoxification and maintenance programs.

Prolonged use results in tolerance and dependence. Withdrawal develops more slowly and less severe but more prolonged than heroin withdrawal. Methadone is abused and can lead to overdose death when combined with other drugs.

For more information visit the Pain Killer Addiction section.

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The Challenge of Treating Clients who Prefer to Taper Off Methadone

Clients that are on methadone present a challenge to residential drug and alcohol treatment programs for a number of reasons:

(1) Clients wishing to come off of methadone should first realize that going “cold turkey” is extremely difficult. Typically, the recommended taper for methadone is 5 mg per week. Most inquiries we receive report clients that are on daily dosages over 40 mg so doing the math will tell you that the client will take 8 weeks to taper off completely. Withdrawal symptoms experienced during a methadone taper vary on the individual, but often prevents active participation in group and individual therapy.

(2) Clients that are wanting to go on methadone need to realize that stabilizing on methadone requires enhanced medical monitoring that most treatment centers are not willing to provide due to the amount of time a physician needs to dedicate to the task.

(3) Methadone is an opiate and this poses a philosophical challenge for abstinence-based programs that have a zero-tolerance policy for other opiates such as Oxycontin and heroin. Treatment centers that do not take the time to explain the unique properties of methadone in comparison to other opiates may experience peer group resentment that methadone users are allowed to continue with their drug of choice while they are expected to be abstinent from drugs such as alcohol, heroin or cocaine.

(4) most residential treatment centers do not have a medical detox staffed with medical professionals with a secure area for storing narcotics. Transporting clients to the local pharmacy for their daily dose of methadone poses a logistical challenge.

(5) The final difficulty that methadone presents to residential treatment centers is the requirement that physicians have a special license for prescribing methadone.

At Sunshine Coast Health Center, our current position on methadone is that it does serve some individuals who are unable to maintain abstinence from heroin or other opiates. Our reason for not providing methadone maintenance therapy is due to the demands it places on our medical program (items 1 and 2 above).

If you or a loved one is on methadone and want treatment at Sunshine Coast Health Center, it is necessary to taper down to the last dose of methadone of 5 mg on the morning prior to arrival. Clients wishing to begin methadone maintenance therapy will be referred to other programs.

If you have any questions please contact our Nursing Supervisor toll-free at 1-866-487-9050.

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RESOURCES

I. PRINT RESOURCES – METHADONE

Methadone – A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References (2003) Icon Health Publications

Methadone Maintenance Guidelines (2005) Centre for Addiction and Mental Health

Methadone Maintenance Treatment and Other Opioid Replacement Therapies (1998) is a guide to the use of drug substitution in the treatment of opiate dependence. Provides an up-to-date account of treatment research and practice. Jeff Ward, Richard P. Mattick, Wayne Hall.

Methadone Maintenance Treatment in the U.S.: A Practical Question and Answer Guide (2007) Nancy D. Berkman (Contributor), Wendee J. Wechsberg (Editor), Jennifer J. Kasten (Editor)

Methadone matters: evolving community methadone treatment of opiate addiction (2003) is a multi-authored book, comprising chapters from the best of clinicians, researchers and policymakers. A guide with a goal of increasing the relevance and effectiveness of methadone treatment. Gillian Tober, John Strang.

Methadone Treatment for Opioid Dependence (1999) Eric C. Strain and Maxine L. Stitzer

State Methadone Treatment Guidelines: A Treatment Improvement Protocol
(1994) serve as guidelines for State policy officials and methadone maintenance treatment providers. Presents state-of-the-art in effective therapeutic techniques for methadone maintenance treatment. Mark W. Parrino, Treatment Improvement Protocol (TIP) Series 1, Substance Abuse and Mental Health Services Administration (SAMHSA).

Treatment of Opiate Addiction Using Methadone: A Counselor’s Manual
(1995) was written to facilitate training of new counselors and improve the quality of the counseling component of methadone treatment. Michael J. McCann, Richard A. Rawson, Jeanne L. Obert.

For more information on methadone treatment see the Biological Modalities section .

Printed Resources – Drug Policy and Methadone

Federal Regulation of Methadone Treatment (1995) is a study of government standards for narcotic addiction treatment and the regulation of methadone treatment programs pursuant to those standards. Richard A. Rettig, Institute of Medicine (IOM).

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II. ONLINE RESOURCES – METHADONE

Online Resources – Methadone Advocacy Websites

Methadone Group BCAPOM
Methadone Support
National Alliance of Methadone Advocates

Online Resources – Assessment and Treatment Planning for Methadone Maintenance Therapy

Assessment and Treatment Planning for Cocaine-Abusing Methadone-Maintained Patients (1994) Treatment Improvement Protocol (TIP) 10. Substance Abuse and Mental Health Services Administration (SAMHSA). DHHS Publication No. 94-3003.

Online Resources – Best Practices and Methadone Maintenance Therapy

Best Practices: Methadone Maintenance Treatment (2002) is intended to help improve the effectiveness of current programs and encourage the establishment of new programs. Health Canada. Cat. H49-164/2002E.

Online Resources – HIV/AIDS Prevention and Methadone Maintenance Therapy

WHO/UNODC/UNAIDS position paper: Substitution Maintenance Therapy in the Management of Opioid Dependence and HIV/AIDS Prevention: Position Paper (2004) World Health Organization, United Nations Office on Drugs and Crime, Joint United Nations Programme on HIV/AIDS. ISBN 92-4-159115-3.

Online Resources – Impaired Driving and Methadone Maintenance Therapy

Methadone – Drugs and Human Performance Fact Sheets (April 2004) is a detailed fact sheet on effects of methadone use, particularly on performance and driving. National Highway Traffic Safety Administration (NHTSA).

Online Resources – Mortality and Methadone

Methadone (April 2007) was the findings of a multidisciplinary group for a national assessment of methadone-associated deaths. Methadone Mortality Working Group, Drug Enforcement Administration Office of Diversion Control.

Online Resources – Research and Methadone Maintenance Therapy

Evaluation of the AFM’s Methadone Intervention & Needle Exchange Program (m.i.n.e.) (July 2005) is a detailed evaluation of the program. Addiction Foundation of Manitoba (AFM).

Literature Review: Methadone Maintenance Treatment (2002) provides an overview of the evidence of the effectiveness of methadone maintenance treatment. Health Canada. Cat. H49-162/2002E.

Online Resources – Treatment with Methadone

Methadone Maintenance Treatment: Client Handbook (2003) Centre for Addiction and Mental Health (CAMH)

Methadone Maintenance Treatment: A Community Planning Guide

Methadone Maintenance Treatment: Information for Clients (2002) Centre for Addiction and Mental Health (CAMH)

Methadone Maintenance: A Counsellor’s Guide to Treatment (2003) Garth Martin, Bruna Brands, and David C. Marsh

Methadone Maintenance: A Pharmacist’s Guide to Treatment (2004) Centre for Addiction and Mental Health

Methadone Maintenance: A Physician’s Guide to Treatment, 2nd Edition

Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction (2003) Gillian Tober, John Strang

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III. VIDEO RESOURCES

Warning: some of the images in the videos that follow are considered graphic. Viewer discretion is advised.

The Dangers of Methadone reports that methadone is being overprescribed and that it can be abused. Effects also vary depending on the individual. Art Fennell Report.

HARMD Inc. is Helping American Reduce Methadone Deaths, a methadone awareness advocacy group.

Methadone Addiction explains why methadone is dangerous and why overdose is becoming more common. Methadone stays in your system much longer. CBS News.

Methadone saves lives … don’t believe the lies! is the testimonial of one opiate addict that claims it saved his life.

Suspicious Activities Outside of a Methadone Clinic is a news story about the illegal trade of drugs around clinics. When combined with other drugs, methadone can be lethal. NBC10.

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Follow Daniel Jordan, our director, for more information.