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Methadone

Methadone (physeptone) is an opiate drug commonly used to counter the effects of opiate withdrawal syndromes without the euphoriant effects of heroin or morphine. The effects of methadone are longer lasting than for heroin, such that it is common to prescribe a daily dose, whereas a heroin user would need to take the drug every 4-6 hours.

The prescribing of methadone is tightly-regulated, with safeguards to prevent diversion of supplies to the illicit market. For this reason, heroin addicts under treatment are commonly prescribed oral linctus to be taken under supervision by the dispensing chemist or clinic. Only once users have complied with a treatment programme for some time would they normally be allowed more than one days supply at a time.

Prescribed dosages range from virtually nil up to around 100mg per day, more in special cases, depending on the severity of addiction and stage of treatment (i.e. in a reducing maintenance regime smaller doses are prescribed over time). If too much is prescribed, methadone may be sold on to other users, sometimes with tragic consequences for naive users with no tolerance level who may overdose. However, the general prescribing practice is to allow the addict the minimum quantity required to stabilise his/her condition - the tendency is to underprescribe. If too little is prescribed, addicts will usually supplement their prescription with street heroin.

Methadone was included in the list of named drugs in the IDMU survey for the first time in 1999.. A total of 93 respondents (4.3%) had ever used the drug, (based on age of first use responses rather than frequency data) of those 11 used daily - a relatively high proportion, and similar to the incidence of daily heroin use. Only nine users reported monthly spending, of whom 6 reported "free" (suggesting prescription) and 3 reported positive spending - one at 90 per month, probably reflecting purchase of illicit supplies; the other two spent 5 and 10 respectively, possibly reflecting prescription charges.

Table 2 - UK use of heroin & methadone

IDMU 1999 Survey

Frequency of use

Heroin

Methadone

Experimental

128

33

Occasional

18

9

Regular

18

1

Daily

14

11

Ex-Users

62

30

Would Never Use

487

536

Might Use

42

31

Never heard of

4

11

Blank response

1399

1510

Total

773

662

Total Used

240

84

 

The average user-rating of Methadone, 1.86 out of 10, was one of the lowest for any drug. A handful of people gave it a positive rating (fig 1). Only 5% of non-users (but users of other drugs) would try the drug if offered, one of the lowest ratios for any drug. It is unlikely that methadone tablets could be sold to any drug users other than heroin addicts or recovering addicts in treatment seeking to self-medicate. As such, the abuse potential of methadone is low.

Fig 1 - Subjective ratings for Methadone

 
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