The Importance of Keeping with a Methadone Dosage Schedule

Adequate dosages of methadone have proven safe and effective in the treatment of opioid dependency and chronic, severe pain, but, keeping with a methadone dosage schedule is important because it also has its risks.

How Methadone Works

Methadone is an opioid agonist that works by attaching to some of the same opioid receptor sites that other opiates do, but, at a steadier rate that can last up to 24-36 hours. It effectively blocks the effects of other opiates, reduces cravings, decreases withdrawals, and stabilizes functioning when taken in appropriate dosages on a daily basis.

Because methadone is slower acting, it does not produce euphoria, but, nonetheless, it is highly addictive. It also has primary advantages for treating chronic and severe pain over other opiates because of its strong analgesic effect, long duration, and relatively low cost.

Methadone Risks

Methadone acts as a central nervous system depressant to decrease pain stimuli, but, also decreases respiration, has multiple interactions with other drugs, especially benzodiazepines, cocaine, and alcohol and can cause irregular heart rate when toxic levels accumulate, overdose and death.

The increase in methadone prescriptions for pain has subsequently raised the rates of overdose occurrences and according to the Centers for Disease Control and Prevention, “rates of deaths and emergency department (ED) visits involving methadone have increased nationwide.”

The Importance of Keeping with a Methadone Dosage Schedule

When taken in high doses methadone is dangerous.

There are several reasons that methadone treatment centers must require daily visits for dosing and why it is so important to keep the methadone dosing schedule prescribed by the physician.

• Methadone is metabolized in the liver and stored in the blood until it is needed with a half-life that is unpredictable, but, much longer than other opiates making methadone a dangerously deceiving drug for some individuals because when they think that the effects have worn off it is still active in the body.
• Methadone works differently in everyone with variable rates of metabolism, absorption, and analgesic potency. Methadone should be taken once a day unless otherwise prescribed. It should only be used for chronic severe pain, taken in the least dosage levels possible to control symptoms, and never taken on an as needed basis or for “breakthrough” pain.
• Respiratory depression is a major concern when taking methadone and the most significant overdose symptom because the peak respiratory depression effects may not occur until later and persist longer than the analgesic effects. If the conditions of pain relief are not being managed effectively, it is important to contact your physician prior to changing the dosage amounts or frequency.
• Keeping the methadone dosage schedule is also important because when methadone is not taken for 3 consecutive days, tolerance is lost and there is a risk of overdose.
• Methadone causes withdrawals when abruptly discontinuing and dosages should be gradually tapered off under the supervision of a doctor.