2-Minute Neuroscience: Methadone

Methadone is commonly used to treat opioid use disorder even though its pharmacological action is very similar to that of other opioids like morphine. In this video, I discuss the qualities that make methadone an effective treatment for opioid addiction, along with how it acts to reduce the risks associated with opioid abuse.

TRANSCRIPT:

Welcome to 2-minute neuroscience, where I explain neuroscience topics in 2 minutes or less. In this installment I will discuss methadone.

Methadone is best known for its use in the treatment of opioid addiction, although it can also be used for treating chronic pain. It’s usually administered by mouth in the form of a liquid, pill, or sublingual tablet. Methadone’s primary mechanism of action is as an agonist at opioid receptors. In other words, it activates opioid receptors similar to the way other opioid drugs like morphine would. It also acts as an antagonist, or blocks, NMDA glutamate receptors, which is thought to contribute to its pain-relieving effects.

Because it has a similar mechanism of action to other opioids, methadone causes enough stimulation of opioid receptors to reduce cravings for other opioid drugs and to prevent a patient from experiencing withdrawal symptoms. Unlike most other opioids, however, methadone typically only has to be administered once a day to achieve these effects. Additionally, methadone occupies opioid receptor binding sites, which diminishes any effect administration of another opioid might have, further discouraging someone from using other opioid drugs while taking methadone. Altogether, methadone’s pharmacological action lowers the likelihood a patient will abuse other opioid drugs.

Since methadone has a similar mechanism of action to other opioids, patients also often become dependent on methadone, and some may need to take the drug for a prolonged period of time, or even for the rest of their life. Because the drug is administered by a medical professional, however, doses can be controlled, and the risk of fatal and nonfatal overdose for someone on methadone is much lower than for someone who continues abusing opioids. Additionally, methadone treatment is associated with a reduction in intravenous drug use, and thus a lower risk of contracting blood-borne diseases like HIV.

References:

Blanco C1, Volkow ND2. Management of opioid use disorder in the USA: present status and future directions. Lancet. 2019 Apr 27;393(10182):1760-1772. doi: 10.1016/S0140-6736(18)33078-2. Epub 2019 Mar 14.

Salsitz E1, Wiegand T2. Pharmacotherapy of Opioid Addiction: "Putting a Real Face on a False Demon". J Med Toxicol. 2016 Mar;12(1):58-63. doi: 10.1007/s13181-015-0517-5.

[johnhartsock]

I got tips for anyone wanting to get off. There was an old handbook some years back that Drs would use for slow tapering. Drs were recommended to lower patient doses by 10% in 1 week intervals to allow for stabilization. In the lower milligrams they use 2 week intervals. At beginning of the tapering process focus on eating right especially breakfast and getting some kind of exercise routine together. Vitamins especially vitamin c and I've used fish oil for dha and apa which is said to improve brain health. I abused opiates for 10+ years and went and stood in line at a clinic for 3 years. I know the struggle and my route may have been a placebo effect but it got me through. I pray it helps someone. The clinic helped me get my life back but its hard to ignore the cash grab it was especially when the Dr tells you to count on coming for life. I couldn't accept that. Its a fight but it feels so good to wipe those happy tears when you beat it

[jessicam]

I've been clean for 8 years, and now I'm tapering off of methadone, I'm blind dosing but I know its under 50mgs. The first day I took methadone was the last day I used. I believe the reason medication assisted treatment can work is because it allows you to rebuild your life where you are. I've known so many people who went to residential treatment and did really well until they went back home to the same stressors and triggers they had before only now they don't have the support of the rehab staff.

[darthdonkulous]

Methadone has saved my life. I went down a very stupid path from 2011 to 2018 and did things i have to live with the rest of my life. I'm very lucky as my family have stood by me and helped rebuild me. I'm 6ft 6in and was down to 12st 6lbs at the height of my heroin addiction. Been on Methadone since December 2018, 80mgs a day. I am now back to my natural weight ( actually just a little over weight ) of 18st 4lbs. I have maed amends with people in my life bar a few who want nothing to do with me which is absolutely understandable, I did wrong them. I'm so thankful for being given access to methadone treatment. Thanks for the video, nice to understand what it is actually doing lol. Take care everyone

[amberwestfall]

Methadone saved my life I died 6 times in February I'm so thankful to be here today

[madmikemackas]

The reason I think it helps so many people is that it gives you something… anything to take. People living that life understand what I mean. I was ready to be off drugs but I wasn’t mentally ready or strong enough to beat the feeling I needed something everyday to function. The one and done dose is another huge help. Pills and other stuff is taken all day everyday and is a never ending cycle. I call it the “search” for it. Which never ends and tires you mentally, emotionally, and physically. Hope you all make it to whatever goals you’re aiming for but don’t feel bad for yourself if you need it to not do the bad $hit. Listen, people with diabetes need insulin. People with high blood pressure need meds for the rest of their lives. You aren’t a weak person for having an addiction and doing what you can to reduce the risk of dying. Bless all yall

[SomeOne-zwkh]

Been on 110 a few years now. Helped me more than I ever thought it would. I just got my phlebotomy certifications a couple weeks ago.

[Birdmomma]

I've been on methadone since January 2014 and I'm on 79mgs. I get a month's worth of bottles at a time. It saved my life!

[mattsmith]

15 year chronic pain patient here, had my first appointment at the methadone clinic today. I am booked for next Monday. Ive made so many bad choices and im overwhelmed mentally with everything. I am truly humbled by my family and friends who stood by me, my wife has gone 😢

Have been on Opioids for years and currently need such a high dose to feel any relief.
I cannot wait to rebuild my life. My work, Therapist and GP have been awesome too.

[clc-gljn]

Been on methadone for a month now. It mostly contributed to saving my life because of being able to safely get dosed and not have to worry about being in physical agony because of doctors not prescribing pain meds

[slayerofsouls]

Saved my life … Iam currently using it and I went back to school and current make close to 3 figures a year.. used to
Live in prison.. haven’t been back in over a decade.. you rarely see the success stories cuz most of us who it helped are chasing success..

[Langevinhomestead]

Methadone saved my life. I never exceeded 80 milligrams. I've been on it one year. I have a normal life again.

[BinaryzeroNYC]

I went from small town P.A. homeless broke script kiddy opiophile dope head ...to NYU grad, cSec specialist in Manhattan; partially thanks to this medicine.

[bathingapes]

I love the comments of people’s experiences. I work in a clinical lab and have to process specimen for methadone peak and trough testing. I got curious as to why a patient would need methadone and now I know all about the treatment. Very informative video

[Thecatnamedkiwi]

Methadone saved my life as well! I’ve been sober off herion and pills and all other drugs for 2 years. I used drugs from age 15 to age 24.

[JayLang]

This drug saved my life. For those who abuse opioids and want to quit, methadone absolutely works.

[howtomedicate]

My favorite youtuber posted again. Great video mate! 👍

[LDBYNL]

Watched all 90. I'll post my exam grade as a review of this playlist.

Nah kidding you're a legend man, 10/10.

[chrissy_crumbles]

I abused opiates for years. When I got pregnant with my now 10 years old daughter my OB referred me to a methadone clinic. My family thought it was just trading one drug for another so I quickly detoxed after giving birth and also quickly relapsed despite only using methadone while going to the clinic.
When I got pregnant again I was once again referred to a methadone clinic, but this time I stayed despite y family's thoughts on it and have only taken my prescribed medicines since 2015. I highly recommend methadone treatment for fellow opiate addicts, as it does work if you take it seriously and find a decent clinic who will put the patient above profit.
You can do it. Methadone can work.
There was a time i thought id never be able to be sober.
And yes, you can be on methadone without nodding out and being "high" you just need to find your stable dose.

And my family that once hated methadone clinics now support them as they have seen the difference its made.

[mikeylikesit]

It saved my life and allowed me to get my family back !

[iamjustawife]

Good for pain patients since doctors are terrified to prescribe opioids, I’m in chronic pain burst fracture of spine at t12. Constantly arguing with my doctor about opioid dose I went to methadone clinic, no argument anymore. I say I need such and such dose I get it no questions asked. Living easier now, needless to say. It’s disgusting, the government NEEDS to get out of the doctor patient relationship. Lives are being lost....

Edit; 90mg/day for those curious. Sometimes I break it up depending on pain levels. Worst part is my clinic makes me come in twice per week and doesn’t open until 9. But I’m on disability anyways, just glad I can be a good dad now. Couldn’t while in as much pain as I was in.