Methadone Treatment for Oxycodone

Author: Samantha Kilbourne

Oxycodone is the generic name for the brand name OxyContin, a semi-synthetic opioid medication. Oxycodone misuse can lead to harmful consequences, such as tolerance, physiological dependence, and oxycodone addiction. However, methadone treatment for oxycodone, also known as methadone maintenance, can help addicted individuals obtain and maintain sobriety.

In this article:

• Oxycodone Addiction
• Treatment for Oxycodone Addiction
• Who is a Candidate for Methadone Treatment?
• Is Methadone Safe?
• How to Start Methadone Treatment
• Learn More Today

Oxycodone Addiction

The addiction component associated with opioids is a three-step process and is the same for oxycodone addiction. First, there is biochemical activation, and then, a memory of the associated feeling is created, and replication becomes a compulsion. A few signs and symptoms of an opioid use disorder (OUD) include:¹

• Reducing or controlling opioid use unsuccessfully
• Having cravings for opioids
• Consuming more opioids more often than intended
• Developing a high tolerance to opioids
• Experiencing withdrawal symptoms when abstaining from opioid use
• Continuing to consume opioids despite physical or psychological problems caused by opioid use

Opioids like oxycodone become particularly addictive because, in the absence of pain (i.e., when they are prescribed to therapeutically manage pain), reward centers of the brain are activated instead, leading to repeated use to achieve pleasure.³ As you experience these good, pleasurable feelings, they are encoded via mechanisms of memory, creating a lasting record of good feelings that include the circumstances and environments in which they were experienced. Finally, these conditioned associations lead to cravings triggered by environmental cues, people, and places that remind you of opioid use. Your brain is biochemically and neurologically motivating you to seek out more opportunities to obtain oxycodone despite being aware of obstacles.³

Some of the research on oxycodone addiction suggests that accessibility, in part, fuels the rate of addiction to this substance. In the United States, 1 million individuals aged 12 and older have used oxycodone nonmedically at least once.^{4, 5}

Treatments for Oxycodone Addiction

Because of a surge in access and use of opioids like oxycodone, more focus has been placed on intervention. When someone goes into treatment for OUD, they often first go through detox to rid their body of the substance. Methadone is approved for use in oxycodone detox and can be administered to eliminate withdrawal symptoms and relieve cravings during the detox process.

Medication-assisted treatment (MAT), which involves a medication like methadone and counseling, may be used after detox to help some individuals with substance use disorder so they can continue pursuing recovery without being held back by cravings and addiction symptoms.

Methadone in Medication-Assisted Treatment

Methadone has been used to treat opioid misuse in MAT since 1947.⁶ Methadone is a synthetic, long-acting opioid agonist and is a Schedule II controlled substance, meaning it has high abuse potential but is FDA-approved for medical use in certain situations.^4,7,8

Methadone works by altering the communication between the nervous system and brain, resulting in a new response pattern to pain by decreasing experienced withdrawal symptoms while also blocking euphoric effects commonly associated with opioid medications or drugs like codeine, morphine, heroin, oxycodone, and hydrocodone.⁵

Recovery is at the epicenter of MAT, which aims to assist you in achieving a self-directed life through a clinically effective treatment.⁶ As a treatment approach, research shows that MAT:⁶

• Increases the likelihood that you will remain in treatment and your ability to gain and sustain employment
• Improves birthing outcomes among pregnant women who have substance use disorders (SUD)
• Decreases interactions with the legal system and opioid use among those with SUD

Methadone treatment for oxycodone is viable through MAT intervention for you or others who have OUD because it assists with the alleviation of withdrawal symptoms, cravings, and opioid load over time. When given in the appropriate dose and frequency, brain function improves, and stress hormones decrease because methadone is slower to enter and leave the brain than oxycodone.³ Because methadone acts upon the same opioid receptors that oxycodone and other opioids do, this process eliminates the euphoria often associated with opioid use.⁴

A 2009 study comparing placebo with psychosocial treatment to methadone with psychosocial treatment demonstrated that methadone treatment reduced criminalized behavior, the transmission of infectious diseases associated with opioid use, and overall opioid use.^8-14 The study also yielded results indicating that with the added support of methadone, patients were more than four times more likely to remain in treatment and had 33% fewer opioid-positive drug tests.⁹

Other Medications

Other medications can be used in MAT to treat OUD or specifically help those with an oxycodone use disorder. Buprenorphine is similar to methadone in that it reduces cravings and withdrawal symptoms and does not cause euphoria. However, it is different from methadone in that efficacy is much more sensitive to dose-dependency (i.e., it must be given at a sufficient dose and for a sufficient duration).

Another medication used to treat opioid use disorders is naltrexone, an opioid antagonist that does not build a tolerance or cause withdrawal. As an opioid antagonist, naltrexone completely blocks opioid receptors from activating. Unlike methadone and buprenorphine, which manage withdrawal and cravings, naltrexone prevents opioids from producing feelings of euphoria.⁴

Who is a Candidate for Methadone Treatment?

Candidacy criteria for methadone treatment at opioid treatment programs (OTPs) are determined by the federal government and include the following:^1,5

• Maintenance treatment: As part of their procedures, facility staff using accepted medical criteria (i.e., DSM-5) shall be qualified to determine whether an individual is addicted to an opioid-based substance and if that individual has been addicted for at least one year before treatment. A program physician shall ensure three things: the patient is there voluntarily, a clear and adequate explanation of all relevant facts concerning opioid use is explained to the patient, and the patient provides consent to treatment.
• Maintenance treatment for individuals under 18 years old: If under the age of 18, it is required that you have documentation of two unsuccessful attempts at either short-term detoxification or drug-free treatment within 12 months. If an individual is under 18 years old, they cannot be admitted unless a parent, legal guardian, or designated state-recognized authority consents in writing to treatment.
• Exceptions to maintenance treatment admission: There are three conditions under which a waiver, if clinically appropriate, may be issued by a program physician. The one-year history of addiction can be waived for patients within six months after release from a penal institution, for patients with a physician-certified pregnancy, and previously treated patients up to two years after discharge.
• Detoxification treatment: Qualified personnel (e.g., a program physician) at OTPs will maintain current procedures to ensure that patients are admitted to short– or long-term detoxification treatment. These qualified personnel will follow established diagnostic criteria to determine that treatment is appropriate for a specific individual. Program physicians will assess patients for other types of treatment should they have more than two detoxification attempts in 12 months. Therefore, programs are not permitted to admit any patient who has two detoxification treatment admissions in one year.

Is Methadone Safe?

When taken as prescribed, methadone is safe and effective for oxycodone addiction treatment. Since your dosage plan is catered specifically to you, it’s important to let your medical provider know your full medical history and the other medications you are taking. Best practices to ensure safety while taking methadone include:⁶

• Always take only the amount prescribed at the times prescribed. If you miss a dose, do not double up or take an extra dose.
• Do not drink alcohol while taking methadone.
• Call emergency services immediately if you suspect you have taken too much methadone or are experiencing severe side effects, such as difficulty breathing, feeling faint, racing heartbeat, or the development of rashes or hives.
• Do not share your doses of methadone with anyone else or take any methadone besides your own prescription.

How to Start Methadone Treatment

After being assessed by medical practitioners and determined a candidate for MAT, you must receive methadone doses under supervision from your MAT program practitioner. After a period of stable progress and consistent compliance with treatment, you may be allowed to take methadone doses at home between visits to your program. The length of your treatment will vary based on your needs and progress, but it will be at minimum 12 months. During this period, you will work with your MAT program to slowly reduce methadone doses and taper off the medication.

Learn More Today

If you find it challenging to reduce or abstain from oxycodone consumption, you may consider seeking treatment such as methadone for opioid use disorder. Call 800-994-1867Who Answers? to speak with a treatment specialist.

Resources

• 1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
  2. S. Department of Health and Human Resources. (2021). What is the U.S. Opioid Epidemic?
  3. Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: implications for treatment. Science & practice perspectives, 1(1), 13–20.
  4. National Drug Intelligence Center, Department of Justice. (2003). OxyContin Fast Facts.
  5. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2020). Monitoring the Future National Survey Results on Drug Use 1975-2019, Volume II: College Students and Adults Ages 19-60. Ann Arbor: Institute for Social Research, The University of Michigan.
  6. National Institute on Drug Abuse. (2021). Medications to Treat Opioid Use Disorder Research Report.
  7. Psychiatric Research Institute. (2022). What is Methadone?
  8. Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Methadone.
  9. Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Medication-Assisted Treatment (MAT)
  10. Mattick, R.P., Breen, C., Kimber, J., Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. The Cochrane database of systematic reviews, (2), CD002209.
  11. Yancovitz, S.R., Des Jarlais, D.C., Peyser, N.P., Drew, E., Friedmann, P., Trigg, H.L., & Robinson, J.W. (1991). A Randomized Trial of an Interim Methadone Maintenance Clinic. American Journal of Public Health 81, 1185-1191.
  12. Schwartz, R.P., Highfield, D.A., Jaffe, J.H., Brady, J.V., Butler, C.B., Rouse, C.O., Callaman, J.M., O’Grady, K.E., & Battjes, R.J. (2006). A Randomized Controlled Trial of Interim Methadone Maintenance. Archives of General Psychiatry, 63(1), 102.
  13. Kinlock, T.W., Gordon, M.S., Schwartz, R.P., O’Grady K., Fitzgerald, T.T., & Wilson, M. (2007). A Randomized Clinical Trial of Methadone Maintenance for Prisoners: Results at 1-month Post-release. Drug and alcohol dependence, 91(2-3), 220–227.
  14. Dolan, K.A., Shearer J., MacDonald, M., Mattick, R.P., Hall, W., & Wodak, A.D. (2003). https://pubmed.ncbi.nlm.nih.gov/14563543/. Drug and alcohol dependence, 72(1), 59–65.
  15. Law Information Institute. (2015). 42 CFR § 8.12 – Federal Opioid Treatment Standards.