Methadone is a long-acting, synthetic drug that was first
used for the treatment of drug addiction in
the United States in the 1960s. It has a 40-year history of demonstrated success in the treatment of opiate addiction.
When used in proper doses in maintenance treatment, methadone does not create euphoria, sedation, or an analgesic effect. Doses must be individually determined. The proper maintenance dose is the one at which the cravings stop, and the euphoric effects of other opiates is blocked.
Although methadone is not a single product from a single manufacturer, the active ingredient is always the same: methadone hydrochloride. All manufacturers add inactive ingredients, such as fillers, preservatives and flavorings. Methadone is dispensed orally in different forms, which include:
Tablets, also called diskettes. Each one contains 40 milligrams of methadone, is dissolved in water, and then is administered in an oral dose.
Powder is also dissolved in water.
Liquid methadone can be dispensed with an automated measuring pump. Dosages can be adjusted to as small as a single milligram.
Patients have different opinions about the various types of methadone. Each methadone provider usually offers a single type of the drug and obtains its supply from one source, which means that patients generally do not get to choose which form of methadone they get. For most people, a single dose of methadone lasts 24 to 36 hours.
How is methadone different from heroin and other opioids (for example, morphine or dilaudid)?
Methadone lasts longer. The body metabolizes methadone differently than it does heroin or morphine. When a person takes methadone regularly, it builds up and is stored in the body, so it lasts even longer when used for maintenance. Most people find that once they're stabilized on a dose of methadone that's right for them, a single oral dose will "hold" them for at least a full 24-hour day. For some, the effect lasts longer; for others it lasts a shorter time.
Stability is easier on oral methadone. Most people who are on a stable, appropriate dose of methadone for several weeks will not feel any significant sense of being "high" or "dopesick." Some patients may feel a transition"—or temporary, mild glow—for a short time several hours after being medicated, however. Others may feel slightly "dopesick" prior to taking the day's medication, but most will feel very little or no effect from the proper dose of methadone once they have stabilized.