Introduction to Methadone

W
Document Sample
scope of work template
							Mixing Methadone With Other Drugs                           slowly to reduce withdrawal symptoms, you may ex-
                                                            perience some aching, insomnia, and lack of appetite
Can Be Dangerous                                            for a few weeks. You also may feel a sense of loss,
Methadone interacts with many medications. This             sadness, and sleeplessness for months. However,
can change the safety of the methadone you are tak-         over time this should dissipate.
ing and potentially can cause withdrawal. It is impor-
tant to tell your doctor about all of the drugs you take.   Long-term withdrawal can take from 6 months up
                                                            to a year before you can completely taper off of
                                                            methadone treatment. You should never set time
Combinations With Methadone That                            limitations on yourself—taper off at your own pace in
Can Result in Withdrawal Syndrome                           cooperation with your treatment provider.
                                                                                                                    What Every Individual Needs To Know About Methadone Maintenance Treatment

                                                                                                                                                      Introduction to Methadone
                                                            Throughout treatment and after treatment ends, be
          Opiate analogs such as:                           sure to maintain and extend your support network.
           • Nubain                                         You can request to come back to the program ev-
           • Talwin                                         ery few weeks for the first year and expect to have
           • Stadol                                         the same privileges that you did before tapering off.

          Opiate antagonists such as:
                                                            Should you feel that you may relapse, return to your
                                                            program immediately for re-dosing. You always can
                                                                                                                    What Is Methadone?                                        Have you been using opioids such as heroin, co-
                                                                                                                                                                              deine, or oxycodone but can’t seem to stop? MMT
           • Naloxone                                       return to treatment. Returning to treatment is not a    Methadone is a long-acting opioid medication that is      can help you quit using those drugs and focus your
           • Naltrexone                                     failure—it’s a choice about what is best for you.       used as a pain reliever and, together with counsel-       life.
                                                                                                                    ing and other psychosocial services, is used to treat     Are you pregnant and using heroin? Seek MMT right
          Partial agonists such as:                         Important Resources                                     individuals addicted to heroin and certain prescription   away to prevent miscarriage and protect your baby
            • Buprenorphine                                 Substance Abuse and Mental Health Services              drugs.                                                    from life-threatening withdrawal.
            • Alcohol                                       Administration (SAMHSA)
                                                            www.samhsa.gov                                                                                                    Have you tested positive for HIV or Hepatitis C? If
                                                                                                                    What Is Methadone Maintenance                             you have tested positive, MMT can allow you to re-
                                                            SAMHSA’s National Helpline
                                                                                                                    Treatment (MMT)?                                          gain your quality of life and begin essential treatment
How Long Will I Be on Methadone?                            1-800-662-HELP (4357)                                                                                             of your viral infection. If you have not tested positive,
                                                                                                                                                                              MMT can help you stop using needles, which is the
                                                            SAMHSA’s Center for Substance Abuse                     MMT helps normalize your body’s neurological and
The longer you’ve been dependent on opioids, the                                                                                                                              primary route of infection for drug users.
                                                            Treatment (CSAT)                                        hormonal functions that have been impaired by the
more likely it is that you would benefit from being on      www.csat.samhsa.gov                                     use of heroin or misuse of other short-acting opioids.    Beginning MMT can help stabilize and improve your
methadone. Those who withdraw from methadone                                                                        Opioids are a group of drugs that act on the cen-         health and can move you toward getting the care you
after short-term treatment are more likely to return to     SAMHSA’s National Clearinghouse for Alcohol             tral nervous system. They include opiates such as         need.
drug use than those who stay in treatment until they        and Drug Information                                    codeine, morphine, and heroin as well as synthetic
have obtained the optimal benefits.                         1-800-SAY-NOTO (729-6686)                               drugs such as oxycodone, oxycontin, hydrocodone,
Remember the risks that come with drug use: high            www.ncadi.samhsa.gov                                    and methadone.                                            Starting Methadone Maintenance
rates of HIV and Hepatitis C infection among people
                                                            SAMHSA’s Substance Abuse Treatment Facility             Appropriate MMT provides several benefits:
                                                                                                                                                                              Treatment
who inject drugs, greater odds of committing crimes
                                                            Locator                                                 • Reduces or eliminates craving for opioid drugs          Depending on where you live, you may have a
and going to prison, and possible death from over-
                                                            www.findtreatment.samhsa.gov                            • Prevents the onset of withdrawal for 24 hours or        choice of methadone providers, or you may live in an
dose.
                                                                                                                      more                                                    area where methadone treatment is not available. If
Recovery to a normal life is possible. You should           Patient Support and Community Education
                                                                                                                    • Blocks the effects of other opioids                     you have not already made contact with a doctor or
stay in treatment as long as you are benefiting from        Project (PSCEP)
                                                            www.dpt.samhsa.gov/patient/index.htm                    • Promotes increased physical and emotional health        clinic that treats opioid addiction, find out whether
it. The length of time you stay in MMT is an issue                                                                                                                            treatment is available nearby.
                                                                                                                    • Raises the overall quality of life of the patient.
that should be decided solely by you and your physi-
cian. Some people are in MMT only for a few weeks,                                                                                                                            • Talk with your family doctor. Generally, your
while others choose to stay in MMT indefinitely.                                                                    Is Methadone Maintenance                                    doctor is not authorized to prescribe methadone

                                                                                                                    Treatment Right for You?
                                                                                                                                                                                for addiction treatment or withdrawal manage-
                                                                                                                                                                                ment purposes. Ask to be referred to an authorized
Ending Treatment
                                                                                                                    Have you been through detoxification and found you
If you are thinking about ending MMT, talk with the                                                                 couldn’t feel normal? MMT can allow you to regain a
doctor at the program. It can be a slow process to          DHHS Publication No. [SMA] 06-4123                      sense of normalcy.
                                                            NCADI Publication No. PHD1124
taper off of methadone. Though doses are tapered            Printed 2006
  doctor or a methadone clinic, or ask whether other        you have been using other illicit or inappropriate                        whether you are experiencing side effects, in which         Methadone and Employment
  treatment options such as buprenorphine are avail-        drugs and whether you have been taking your meth-                         case an adjustment may be necessary. After a few            Once you’re on a stable dose of methadone, it
  able.                                                     adone. You may have to give supervised samples                            months, your provider may let you take home or              shouldn’t affect the work you do or how well you do
• Contact a referral service. To find the treatment         to ensure they are yours. With continual negative                         “carry” doses for unsupervised use. Ask to find out         your job. For most jobs, there’s no need to mention
  provider closest to you, call SAMHSA’s National           results, you’ll be asked to take drug tests less often.                   when and under what conditions you will be given            that you take methadone. Your employer has no
  Helpline at 1-800-662-HELP at any time of the day                                                                                   carry doses.                                                right to know.
                                                            If you test positive for other drugs, it may hold up
  or night, or search online for a treatment facility at    your schedule for taking home doses, and your pro-                        It is likely that you will be asked to sign an agree-
  www.findtreatment.samhsa.gov.                             vider may ask that you take drug tests more often.                        ment claiming responsibility for using and storing          HIV, Hepatitis, and Methadone
                                                                                                                                      the doses safely. Your provider may take away your             Methadone can be a great benefit if you are HIV/
Assessment                                                  Some providers expect zero drug use while others
                                                                                                                                      take-home privileges if you do not comply with the             AIDS or Hepatitis B (HBV) or C (HCV) positive.
Assessment includes determining your history with           are more tolerant.* If you test positive for a drug                                                                                      Methadone allows you to lead a “normal” life so it’s
                                                                                                                                      agreement or if your drug tests are positive for drug
drug use as well as a physical examination by a doc-        when you know you haven’t used, you can request to                                                                                                         easier to take care of yourself, to
                                                                                                                                      use.
tor. You should be asked about medical problems             be retested.                                                                                                                                               eat better, and to take your medi-
that are commonly associated with opioid addictions,
                                                            Confidentiality                                                           Safety and Storage                           Tips on Taking                      cation at the right times. However,
and you may be asked to consent to a blood test to                                                                                    Your maintenance dose of metha-                                                  prescription drugs for your HIV/
check for HIV, Hepatitis, and other infectious or sexu-    Drug treatment patients are protected by special
                                                                                                                                      done could seriously harm or kill
                                                                                                                                                                                       Methadone                       AIDS or HBV/HCV may interfere
ally transmitted diseases.                                                     Federal confidentiality regulations.                                                                                                    with methadone, and your dose
                                                                                                                                      someone who has no tolerance for        • Methadone usually works best
                                                                               No one will be told you are in treat-                                                                                                   may need to be changed. Talk
                                                                                                                                      the drug. Take precautions:
Expect questions. You may be
asked about your drug use, your
                                          Methadone Facts                      ment or what you talk about in                                                                    when it’s taken once a day at         with the program doctor about
                                                                               treatment, except for certain situa-                   • Never transfer your medication           the same time every day.              other drugs you have been pre-
physical and mental health, your        When methadone is taken as             tions:                                                   to a container that might make it     • You drink your dose of metha-          scribed.
home and family, and your employ-       directed:                                                                                       easier to mistake what’s inside.         done, usually in a mixture with
ment.                                                                          • Information about a client often is                                                             orange juice.
                                        • MMT can improve your health.
                                                                                 shared within a treatment team in
                                                                                                                                      • Keep your doses in a locked                                                    Patient Rights and
Ask questions. What are you be-         • Methadone will not cause                                                                      box, such as one sold for fishing     • It takes a few days to feel the
ing tested for? What other services
                                                                                 the clinic.                                                                                     full effects of a dose adjust-        Responsibilities
                                          euphoria.                                                                                     tackle or cash.
are available? Remember, knowl-                                                • You may consent in writing that                                                                 ment.                                 If you are unhappy with your treat-
                                        • Methadone will not make you            your information be shared under                                                                                                      ment—for example, you feel your
edge is power.                            sick.                                                                                       Hospital Stays                          • Taking other drugs may inter-
                                                                                 certain specified conditions—for                                                                fere with the adjustment of           dose has not been adjusted cor-
You may be assessed again during        • Methadone will not affect your                                                              If you are admitted to the hospital,
                                                                                 example, to forward your records                                                                your dose.                            rectly—talk it over with your doctor
treatment to review your progress.        immune system.                                                                              let the staff there know that you
                                                                                 to another doctor or clinic.                                                                 • Taking more opioids won’t get          or counselor. If a treatment prob-
                                                                                                                                      are a methadone patient. This is
                                        • Methadone does not damage            • If your doctor or counselor has                                                                 you high, but you could over-         lem hasn’t been fixed to your satis-
Dosing                                                                                                                                vital so that you can receive your
                                          your teeth and bones.                  reason to think you might hurt                                                                  dose.                                 faction by talking with your doctor
                                                                                                                                      dose and because other drugs can
For safety, your first dose of metha-   • Methadone does not make                yourself or others, he or she must                                                           • Hang in there—give it 2 to 6           or counselor, you may consider
                                                                                                                                      be dangerous if combined with
done will be low or moderate. New         you gain weight.                       inform others.                                                                                  weeks to find the right dose.         changing your provider.
                                                                                                                                      methadone. Urge the hospital
patients usually start at a dose not                                           • If you are facing trial, the court                   staff to talk with your MMT doctor                                             You also can anonymously report
to exceed 30 to 40 mgs. A larger                                                 may subpoena your treatment                          about your medication and care.                                                problems with your treatment
dose of 60 to 120 mgs a day may be required for                                  records.                                                                                                         provider to his/her accrediting agency. To learn more
long-term maintenance. You and your physician
should determine what dose works best for you.
                                                           • If you test positive for HIV and other communicable                      Dealing With Side Effects                                   about grievance procedures, you can visit the Patient
                                                             diseases, these facts will be shared with public                         Methadone maintenance carries some side effects:            Support and Community Education Project online at
Your dose is right when withdrawal symptoms, drug            health officials. In certain States, your intimate                       • Constipation. Eat foods that are high in fiber and        www.dpt.samhsa.gov/patient/index.htm.
cravings, drowsiness, and side effects fade. With a          partners at risk for these diseases may be told that                       drink plenty of water. You also should avoid foods        As a patient in treatment, you are protected by a set
correct dose, you should feel more energetic, clear-         they have been exposed.                                                    that are high in fat; they are harder to digest and       of Medication-Assisted Treatment Patient Rights and
headed, and able to do the things that matter in your                                                                                   tend to make your system sluggish.                        Responsibilities. You can see the SAMHSA Guide-
life. Until you have adjusted, make sure not to drive
a car or operate heavy machinery.                           Living With Methadone                                                     • Excessive sweating. Adjusting the dose may
                                                                                                                                        stop the sweating, and there are other medications
                                                                                                                                                                                                  lines for the Accreditation of Opioid Treatment Pro-
                                                                                                                                                                                                  grams online at www.dpt.samhsa.gov/guidelines.pdf.
You should discuss a dose adjustment with your doc-                                                                                     available to help control this.
tor if you still are experiencing drug cravings. The        Take Home Doses                                                           • Changes in sex drive. Some people on metha-               Methadone and Pain Relief
majority of properly dosed patients have no physical        At the start of treatment, you will have to go to the                       done have little sex drive and are unable to have         Methadone can provide effective pain relief. Yet,
desire to use other drugs.                                  clinic daily to take your dose under observation. This                      an orgasm. You may be taking a medication that            once you are on a stable dose of methadone, you
                                                            daily contact confirms to the staff that you are taking                     affects your sex drive. Talk with your doctor about       may be tolerant to its pain-relieving effects and may
Drug Testing                                                the dose ordered by the physician. It also helps the                        possible treatments that will improve this side           require additional pain medication. Some MMT pa-
Routine tests of urine or oral fluids will show whether     staff to see if your dose is enough or too much and                         effect.                                                   tients need more pain medication than patients who
                                                             *No one should be discharged solely on the basis of drug test results.
                                                                                                                                                                                                  are not a part of MMT.

						
Related docs