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Methadone

6 important questions on Methadone

How does Methadone helps in Heroin addiction

Block the euphoric and sedative effects of opiates
● Reduce cravings for opiates
● Relieve opioid withdrawal symptoms
● Enable individuals to work and function normally in society;
● Be taken once daily due to its slow elimination from the body.

What differentiates methadone and heroin?

It has a longer duration of action than heroin (more than 24 hours) when taken orally.

Induction phase of MRT

initial dose between 20–30 mg
● Patients should be monitored for 3–4 hours for first 3 days to observe for any signs of toxicity or withdrawal
● If shows signs of withdrawal 4 hours, a supplementary dose of 5 mg can be given
● Max induction dose is 40mg.

Dose titration of MRT

● DO NOT increase the methadone dose during the first 3 days of treatment as the methadone effect increases day by day
● Consider increasing the dose by 5–10 mg every three days
● Total weekly dose increase should not 50mg

Maintenance dose of MRT

Generally, an effective methadone dose ranges between 60–80 mg daily
● Any changes in treatment dose should consider the following:
○ Ongoing use of opioids may require higher methadone doses
○ Individual methadone metabolism rate
○ Use of other medications (e.g., anti-TB, ARVs, psychotropics)
○ Pregnancy
○ Polysubstance use

Investigation and monitoring of MRT

Infective status -TB/HIV/HEP B Hep C
- LFT
- Urine for drugs : initial tx, weekly x4weeks, 2weekly next 1 mo, random on the next month onwards
- ECG - for those taking 100mg and above. (QTc)

The question on the page originate from the summary of the following study material:

Addiction Psychiatry

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