Re: Methadone
From: cathy:- (anonymous@medispecialty.com)
Mon Apr 29 10:04:20 2002
If you are addicted to something, there are two distinct effects. The
first effect is that it makes you "high" and the other effect is that
you get withdrawel if you try to quit. (This is true of nicotine, true
of alcohol, true of cocaine, true of heroin, etc., although how "high"
you get varies from drug to drug, and how bad withdrawel is varies from
drug to drug, too. For example the nicotine in cigarettes gives a
fairly minor pleasure compared to heroin, but it seems to be the most
addictive of the lot.) The way I understand it, methadone is an opiate
in that it fills the opiate receptors in the brain so that you won't go
through withdrawel, but it doesn't give you a high, or much high. So if
you are trying to break an addiction to heroin, then methodone lets you
break the psychological addiction to getting high without requiring you
to go through withdrawel at the same time. Then the logic is that AFTER
you break the psychological addiction then you wean off the methadone
very slowly and you will get minimal if any withdrawel symptoms.
If I understand the biochemistry correctly, if you take opiates when you
are in pain you typically will NOT get "high." This is because the
neurotransmitters that are flooding your brain with pain signals prevent
the opiate from binding to the brain receptors that cause that "high"
feeling. (Although if you have been in agony and the pain goes away,
then this is of course an exquisitely pleasurable outcome -- it's just
not the same thing chemically as a drug-binds-to-receptor kind of high!)
And I can speak from personal experience that if you DO get "high" when
you are also in agony it is a pretty horrific experience...
But anyway, methadone does have similar pain-relieving properties as the
rest of the opiates, and of course you do get physically dependent upon
it so that if you are no longer in pain (like you get cured from ARD!)
then you will have to wean off of it over some period of time to prevent
really nasty withdrawel symptoms. It was invented as a painkiller, and
it's utility as a tool in weaning off of opiate addiction was figured
out later.
Imagine that you were an ARD patient who was in terrible pain and you
took heroin as a painkiller. As long as you were in pain it wouldn't
make you high, it would just take your pain away. So then you have
adhesiolysis, and you are one of the lucky ones and it works and you are
no longer in any pain. So then you would need to wean off the heroin,
which means you would need to keep taking it for awhile after the
surgery in smaller and smaller amounts. But the problem is that since
you are not in pain anymore you don't have those pain chemicals washing
around your brain protecting you from getting "high" anymore, so then
what happens is that you get addicted to the heroin instead of just
dependent upon it. The whole advantage of methadone over heroin (which
is a nicely effective painkiller, too) is that you won't get into this
little pickle where getting cured of the pain-causing disease will
result in your physical dependence upon the drug turning into
addiction...
I'm not a biochemist, and this understanding mostly comes from reading
those links that Helen Dynda posts, so I hope that I didn't garble that
too badly, or get it downright wrong!
At Sun, 28 Apr 2002, Sally Grigg wrote:
>
>I don't understand methadone at all? Isn't it just a substitute for opiates? So why not give the opiates? Answers will be awarded a nickel for each good one. Love, Sally Oops, forgot, no heavy gambling on the adhesions board.
--
cathy :-)
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