Comparison Chart of Illicit Heroin Addiction and Stabilized Methadone Maintenance

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
Dependency Research Working Group (CDRWG) contact the Chair, Dr. Herman
Joseph at NYS OASAS, 55 West 125 Street, New York, NY 10025,(212)
961-8491, FAX (212) 961-8318

Similar Posts

  • BrugerForeningen’s 10th Anniversary November 3rd Copenhagen, Denmark

    Admin 02/13/2023

    Big Smiles on Joergen’s Face as he Calls the Group to Order Read Joergen Kjaer’s Speech (Danish) Thank You for Being Our Friend Charlotte Fich receives the Users Friend of the Year Award. An special nurse she helps users with health and injection issues and does so with compassion. This is the 7th year that…

  • Website Policy

    Admin 12/06/2021

    The National Alliance for Medication Assisted Recovery (NAMA Recovery) is an organization of methadone patients and patients receiving other medications to treat drug addiction, their families and healthcare and medical professionals. Therefore this website reflects the collaberative efforts between patients and professionals. NAMA Recovery is respected world wide as the premier medication assisted treatment advocacy…

  • Registering for Training and Certification

    Admin 04/25/2022

    You have to register for the Certified Methadone Advocate Training course through NAMA. The training course is one day. The first training will be at the AATOD Conference in Washington on Saturday April 12, 2003. The cost of course is $100 and includes 2003 membership in NAMA. Everyone who pre-registers and completes the requirements will…

  • Quick Links

    Admin 11/28/2022

    Treatment Facility Locator Buprenorphine Physician Locator Center for Substance Abuse Treatment US government search engine to locate all forms of drug treatment. Substance Abuse Mental Health Services Administration (SAMHSA) US government search engine to locate physicians prescribing Buprenorphine. Code of Federal Regulations Federal Register, January 17, 2001   CRF 42 Part 8 in text and…

  • OPTIMIZING RESPONSE TO METHADONE MAINTENANCE TREATMENT

    Admin 06/28/2021

    USE OF HIGHER-DOSE METHADONE   By Sarz Maxwell MD & Marc Shinderman MD Center for Addictive Problems 609 N Wells Chicago IL 60610   Abstract   Using signs, symptoms and serum methadone levels to guide evaluation, we treated 188 patients in a methadone maintenance program with doses of methadone exceeding 100 mg/d.  The mean dose…

  • Report

    Admin 08/04/2022

    Exciting Developments in the UK Alan Joyce Methadone Alliance November 21, 2003 There are exciting things happening in the UK that the Methadone Alliance has been involved with. In the UK there is a type of General Practitioner (Doctor, in what you call ‘office based practice’, what we call ‘General practice’), who gain additional qualifications…