This chart was prepared by Herman Joseph and Joycelyn Sue
Woods and is reprinted from METHADONE TREATMENT WORKS: A COMPENDIUM FOR
METHADONE MAINTENANCE TREATMENT
| Topic | Illicit Heroin Addiction | Stabilized Methadone Maintenance |
| Onset of action | Immediate | 30 minutes |
| Duration of action | 4 – 6 hours | 24 – 36 hours or half-life |
| Route of administration | Injection, snorting, smoking ( several times a day ) | Orally administered once per day |
| Effective dose | Not applicable | For many patients 60 mg/day is lowest effective dose; doses between 80 and 120 mgs/day are most effective for preventing HIV transmission retention in treatment, reducing the use of other drugs and increasing social productivity. |
| Overall safety | potentially lethal | Medically safe, no toxic effects found in patients maintained on methadone for up to 18 years. |
| Overdose | Can die from overdose of narcotics; potentially lethal, even for tolerant individuals death can occur quite fast without proper medical treatment with narcan. |
A degree of protection from death by overdose is achieved when receiving 100 mg/day or more; methadone is potentially lethal for non-tolerant individuals, death can occur but more slowly than heroin overdose however, overdose reaction can be reversed and person’s life saved if narcotic antagonist such as narcan is prescribed for 24 – 36 hours |
| Narcotic effects of other opiates ( if tried ) | Feels narcotic effects of opiates | At 80 mgs/day or more narcotic effects of opiates are blocked |
| Withdrawal syndrome | Can be severe, but can be controlled with methadone | Less severe than heroin but more extended, can be controlled by slow reduction in methadone dose |
| Mood alteration | Constant swings | None, if patient is not emotionally disturbed or using other drugs |
| Euphoric effects | Approximately 2 hours duration after administration | None after administration |
| Tolerance level | Increasing dosage needed | Stable level at some dose |
| Narcotic craving | Recurring | Relieved and blocked |
| HIV transmission | Effective transmission | Transmission of HIV by injection reduced or eliminated for patients who remain in treatment |
| Immune and endocrine functioning in HIV- persons | Impaired | Normalizes during treatment |
| Immune and endocrine functioning in HIV+ persons | Rapid progression to AIDS | Preliminary studies indicate that the progression to AIDS is slower |
| Hypothalamus Pituitary Adrenal Axis | Suppressed | Normalizes during treatment |
| Sexual functioning / libido | Impaired | Normalizes during treatment |
| Female menses | Impaired | Normalizes during treatment |
| Pregnancy | Serious problems difficult to treat | Problems can be brought under control with medical, social and prenatal care |
| Emotional affect | Impaired | Normal, if patient is not emotionally disturbed or using other drugs |
| Pain and emotion | Blunted | Feels normal pain and experiences normal range of emotion if not abusing other drugs |
| Intellectual functioning | Impaired | Normal if person is not emotionally disturbed or using other drugs |
| Physical reaction time | Impaired | Normalizes during treatment |
| Personal relationships | Disrupted | Restored with counseling |
| Social functioning | Impaired | Normalizes with counseling |
| Vocational rehabilitation and education | High proportion of failure | High proportion of success in vocational rehabilitation, education and employability |
| Employment | Difficult if not impossible to hold a job | Can function in every level ant type of profession e.g.: bus driver, lawyer, doctor, teacher, pilot |
| Mental illness | Difficult to treat | Treatable if integrated resources exists, however many psychiatric services discriminate against methadone patients and will not accept them |
| Poly-drug abuse | High level ( alcohol, crack, cocaine, nicotine, etc. ) | High level but potentially treatable |
| Criminal drug abuse | Constant high level | Reduced level or eliminated |
| Effect on community | Destructive, high crime and death rates, transmission of disease | A good methadone program contributes to public safety, reduces mortality and improves quality of life for all |
| Criteria for addiction | Fits criteria for addiction as listed in the “Diagnostic and Statistical Manual of Mental Disorders” |
Does not fit criteria for addiction, methadone maintenance is a thoroughly researched and effective medical treatment |
| Life-style | Heroin addiction is about acquired infection and death | Methadone maintenance treatment is about good health and life. Methadone chemotherapy normalizes a deranged physiology so patients can stabilize their lives |
| This chart was prepared by Herman Joseph and Joycelyn Sue Woods and is reprinted from METHADONE TREATMENT WORKS: A COMPENDIUM FOR METHADONE MAINTENANCE TREATMENT (Part 1) 1994: p 19-20. From the Chemical Dependency Research Working Group Monograph Series, No. 2. New York. New York State Office of Alcoholism and Substance Abuse Services (OASAS) and Mental and Health Research Association of New York City, Inc. (MHRA). For more information about the activities of the Chemical |
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