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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