WHAT & WHY?

6
Methadone meth : physeptone : juice
No. 6 in a series of guides to help people understand
what drugs are and why people take them
SECOND EDITION
What?
Methadone is one of a large number of drugs
that have been manufactured to mimic one
or more of the effects of natural opium.
It is a much longer-acting drug than heroin,
so people who are dependent on opiates
can usually take it once a day and be free
of withdrawal symptoms.
Methadone is manufactured as a white crystalline powder that is mixed into
a medicine or, less commonly, dissolved in an ampoule ready for injection or
pressed into tablet form.

There is an often repeated myth that methadone is ‘much more addictive

than heroin.’ Although the physical withdrawals from methadone may last
longer than those from heroin, there are two parts to drug dependence:
the physical and psychological.

Overall there isn’t much difference between methadone and heroin because,
psychologically, people tend not to crave methadone (because it doesn’t give
the same high) as much as they crave heroin.
However, this is not always the case. Some buy it as a cheap intoxicant and mix
it with other drugs such as alcohol and diazepam (Valium). Most of the overdose
deaths in which methadone is implicated are due to using it in this way.

Attempts are being made in many places to reduce the illicit sale of methadone
by arranging for those people who are in treatment, but whose drug use is
not yet stable, to take their methadone either at the drug service in front of
a member of staff or at the chemist in front of the pharmacist.

To achieve maximum effectiveness in terms of reduced risk, health improvements

and crime reduction, the methadone prescription should be part of a treatment
programme that includes effective psychological and social support.
Why?
Although it doesn’t give a ‘high’ like that
of heroin, methadone gives most users
the sense of having taken an opiate – some
feeling of warmth and the absence of
withdrawals – and so reduces or removes
cravings for heroin.
People usually seek methadone treatment when they reach a point where heroin
is more of a problem than a solution, and they are prepared to give up the
heroin high for less euphoria and more stability.
It is prescribed because a large number of scientific studies have shown
that methadone can help people who are dependent on opiates to stop
using heroin or greatly reduce the amount they use. It can also assist people
to stop injecting (or to inject less often and with less risk of HIV and hepatitis
infection), improve their physical health and stop committing crimes to get
money to buy drugs. So, although people remain opiate dependent, they are
much safer.
There is no simple answer to the question of why people get into a situation
where they need to be prescribed methadone. Although there are theories which
say that those who take drugs or become dependent are ‘victims of peer pressure,’
or different because they have an ‘addictive personality,’ there is very little,
if any, scientific evidence to support them.
It is probably more helpful to try and understand opiate use on an individual
basis, weighing up the relative importance of factors to do with the person –
their psychological make-up, history, coping skills, self-esteem, mood, emotional
state etc; society – the ease with which drugs can be bought, the number of
people using them, the attitudes of the person’s peer group as well as social
circumstances, employment status etc; and the drug – the physical and
psychological effects of the drug on the individual. The balance between these
factors may be fairly straightforward or very complex; it may also change
over time.
 For some, the physical dependence may include their body having temporarily
‘given up’ production of its own endorphins (a natural ‘feel good’ chemical in
the brain) in the face of such powerful ‘competition.’ Little is known about
the exact science of this, but after detox ex-users often report feeling low for
many months. It is thought that, for some, this may in part be due to a delay
in endorphin production returning to normal levels.

The need to have enough endorphin-like chemicals – natural or not – in the

brain may be a biological factor in triggering relapse, and, for some, may be
a contributing factor in methadone treatment lasting for many years.
However, although such problems may be due to endorphin suppression
by opiates, they can also have psychological or social causes.

Methadone can be prescribed safely for many years, provided it is reducing

harm from heroin use. For many, reducing the methadone dose simply
precipitates a return to heroin use – with all its attendant risks. Methadone
treatment – which may last years – means that more people can make it to
the point where they are ready and, more importantly, able to come off opiates
alive, free of HIV and hepatitis, and with their lives in some semblance of order.

The success of methadone treatment should, therefore, be measured by

the number of people prevented from catching HIV and reductions in
crime and overdose, rather than in the numbers who become drug free.
01 Some patients have their methadone dispensed daily to take home
Photo: David Hoffman Photo Library

02 Photomicrograph of recrystallised methadone

Photo: Dr Michael Davidson,
Natural High Magnetic Field Laboratory, Florida State University

03 A week’s supply of methadone may be dispensed to more stable patients

who have been in treatment for some time
Photo: fluke

04 Supervised consumption of methadone in a community pharmacy

Photo: David Hoffman Photo Library

05 Measuring the dose

Photo: David Hoffman Photo Library

06 Drinking methadone out of the bottle may look alarming but if the
patient only has one day’s supply, and if they are dividing the doses,
they don’t really need to measure it out
Photo: David Hoffman Photo Library

07 Methadone tablets should not normally be prescribed for the treatment

of drug dependence (because they can be crushed up and injected)
Photo: fluke
Written by Andrew Preston

What & Why? 6: Methadone. Second edition.

Published by Exchange Supplies.
ISBN 1-903346-05-3
© Exchange Supplies 2000 –2004.
Designed by fluke.

Printed in the UK on recycled paper made from 100% chlorine-free post-consumer waste.
Responsibility for all errors, omissions and opinions lies with the author.

Exchange Supplies is an independent social enterprise producing information and resources to reduce
drug-related harm. For more information go to: www.exchangesupplies.org

The What & Why? series covers cannabis, amphetamine, ecstasy, cocaine, heroin, methadone and harm reduction.
All titles in the series are available direct from: Exchange Supplies, tel: 01305 262244.
Additional information on LSD, mushrooms, addiction and motivation are available on our website:
www.exchangesupplies.org

Exchange Supplies, 1 Great Western Industrial Centre, Dorchester, Dorset DT1 1RD.
Tel: 01305 262244 Fax: 01305 262255 Email: info@exchangesupplies.org
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WHAT & WHY? WHAT & WHY? WHAT & WHY? WHAT & WHY? WHAT & WHY? WHAT & WHY?

Crack &
Cannabis 1
weed : dope : bud : skunk : hash : oil
No. 1 in a series of guides to help people understand
Amphetamine 2
speed : whizz : base : amphet : sulphate
No. 2 in a series of guides to help people understand
Ecstasy 3 mdma : E : pills
No. 3 in a series of guides to help people understand
Cocaine 4
c : coke : charlie : rocks : freebase
No. 4 in a series of guides to help people understand
Heroin
smack : brown : skag : diamorphine : H
No. 5 in a series of guides to help people understand
Methadone 6 meth : physeptone : juice
No. 6 in a series of guides to help people understand No. 7 in a series of guides to help people understand
what drugs are and why people take them what drugs are and why people take them what drugs are and why people take them what drugs are and why people take them what drugs are and why people take them what drugs are and why people take them what drugs are and why people take them
SECOND EDITION SECOND EDITION SECOND EDITION SECOND EDITION SECOND EDITION SECOND EDITION SECOND EDITION
 What & Why? is a series of booklets for anyone who
wants to understand illicit drug use.

Illustrated with stunning photography, What & Why?

explains what drugs are (how they are made, sold and used),
their effects and why people choose to take them.

Essential reading for anyone confronted

with illicit drug use at home or at work.

What & Why? is written mainly for professionals, parents

and the relatives and friends of drug users. The booklets may also provide
a useful contribution to secondary school discussion about drugs.

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