Methadone: The Opioid for Pain Management and Addiction Treatment
What is Methadone?
Methadone is a synthetic opioid used both for managing severe pain and as part of opioid addiction treatment. It works by mimicking the effects of other opioids, but has a slower onset of action and stays for a longer duration in the body hence reducing cravings and withdrawal symptoms.
How Methadone Works
Methadone binds to opiate receptors in the brain and spinal cord, blocking pain signals and altering the perception of pain and relieving pain. It also reduces withdrawal symptoms by providing a controlled dose of opioids, preventing misuse while helping patients overcome addiction. It is also shown to have NMDA(N-methyl-D-aspartate) receptor antagonism.
When to Use Methadone
● Pain Management: It is used for the treatment of moderate to severe pain, especially in cancer patients or those with chronic pain.
● Opioid Addiction Treatment: Methadone is used as part of a maintenance program for individuals addicted to heroin or other opioids.
Dosage
● Adult Dose for Pain: Starting dose of 2.5 mg to 10 mg every 8-12 hours, adjusted based on pain intensity.
● Adult Dose for Addiction: 20 mg to 30 mg daily as part of opioid maintenance therapy, with gradual adjustments. Total dose on first day should not exceed 40 mg. For maintenance dose the usual range is 60-120 mg/day.
Side Effects
● Common Effects: Drowsiness, constipation, nausea, and sweating.
● Serious Adverse Effects: Respiratory depression, dependence, and cardiac arrhythmias (QT prolongation).
