Q: How does methadone work?

Methadone, an opiate agonist, acts like morphine and other narcotic medications. Herion addicts are physically dependent on opiates and will experience withdrawal symptoms if the concentration of opiates in their bodies falls below a certain level. In methadone maintenance treatment, patients receive enough methadone to ward off opiate withdrawal symptoms, but not enough to induce a narcotic high.

Q: Does methadone make patients "high" or interfere with normal functioning?

No. In proper doses, methadone does not create euphoria, sedation or analgesia. It does not harm motor skills, mental capability or employability.

Q: What is the proper dose?

Dosage must be individually determined, depending on metabolism, body weight and opiate tolerance. The proper maintenance dose is one at which narcotic craving is averted - without creating euphoria, sedation or analgesia.

Q: Is methadone more addictive than heroin?

Physical dependence and tolerance to a drug are part of addiction, but they're not the whole story. The methadone maintenance treatment patient is no more an addict than the terminal cancer patient who is physically dependent on morphine, or the diabetic who depends on insulin. They do not seek out the drug in the absence of withdrawal symptoms or pain, and their lives do not revolve around drug use.

Q: Is methadone maintenance treatment for life?

Some patients remain in treatment for more than 10 years, and even for the rest of their lives, but they constitute a minority (5% - 20%) of patients.

Q: How long should treatment last?

Treatment should last as long as the physician and the patient agree that it's appropriate. Federal, and often state, regulations require annual evaluation of patients.

Q: Is methadone a street drug, with high potential for abuse?

Though methadone is sometimes sold on the illicit drug market, most buyers are active heroin users who won't or can't get into a methadone program. The extent of abuse associated with diverted methadone is small relative to heroin and cocaine, and primary addiction to methadone is rare.

Q: Are there "methadone" deaths from overdose?

Overdose deaths are few. The Drug Abuse Warning Network found, in its 1994 sample of emergency room incidents, 15 methadone deaths - as compared to 13 deaths from aspirin - and 251 heroin/morphine deaths.

Q: Does methadone interfere with good health?

Concerns about methadone's effects on the immune system and on the kidneys, liver and heart have been laid to rest. Methadone's most common side effects - constipation and sweating - usually fade with time, and are not serious health hazards.

Q: Is it safe to take methadone during pregnancy?

Methadone maintenance treatment during pregnancy does not impair the child's developmental and cognitive functioning. It is the medically recommended course of treatment for most pregnant opiate-dependent women.

Q: Is methadone maintenance appropriate for all drug users?

No. Methadone, a treatment for opiate dependence, is not appropriate for users who are not dependent. There are also drug-free treatment options and, increasingly, other medications - including buprenorphine and LAAM - that may help some addicts.

Source: The Lindesmith Center, New York