If you stop taking heroin, methadone can prevent or reduce the unpleasant withdrawal symptoms. Many people stay on methadone long-term, but some people gradually reduce the dose and come off drugs altogether. You should not take any street drugs or much alcohol when you are taking methadone.
If you are addicted to heroin it means that you develop withdrawal symptoms within a day or so of the last dose. Therefore, if you are addicted to heroin you need a regular dose to feel 'normal'.
Withdrawal symptoms can include: sweating, feeling hot and cold, runny eyes and nose, yawning, being off food, stomach cramps, feeling sick or vomiting, diarrhoea, tremor, poor sleep, restlessness, general aches and pains, and just feeling awful. Withdrawal symptoms tend to ease and go within five days. However, you may then have persistent craving for heroin, remain tired, and have poor sleep for quite some time afterwards.
Methadone is a drug that is similar to heroin, although it lasts a lot longer in the body. It can be prescribed. If you take methadone, you are unlikely to get withdrawal symptoms if you stop heroin (or the withdrawal symptoms are much less severe). If you take methadone under supervision from a doctor instead of street heroin, you are:
Most GPs will refer you to a community drug team to be assessed. Following assessment, a member of the community drug team will usually contact your GP quite quickly to recommend a dose of methadone, and a plan for follow-up. Some GPs who are specially trained may assess some cases and prescribe without the need for referral.
If you have been injecting drugs such as heroin, it is also common to advise:
Methadone is usually started some time after assessment when the results of the urine test are back. An initial dose is chosen. The aim is to prevent withdrawal symptoms. However, methadone can cause serious harm, or death, in overdose. Therefore, at first your doctor will prescribe a low-ish dose to 'play safe' and see you frequently to adjust the dose. Be patient, this early stage is very important. The initial dose is usually gradually increased to a regular maintenance dose. But note:
Try to accept that you may have some, or partial, withdrawal symptoms until the correct dose is found. The correct dose varies from person to person depending on how much heroin you were using and how your body deals with (metabolises) the methadone. You should not take any street drugs or much alcohol when you are on methadone.
Once established on a regular dose, most people stay on methadone for a long time or even long-term. This is called maintenance and helps you to keep off street drugs. Some people gradually reduce the dose and come off it. This is called detoxification, or 'detox'. However, it usually takes months, and sometimes years, before most people are ready to consider detox. It is often safer to stay on methadone than to detox before you are ready.
Methadone is usually prescribed as a once-daily dose in liquid form. You will usually be asked to take it under the supervision of the pharmacist who dispenses the methadone to you. This means there can be no doubt about how much methadone you take at each dose. This supervision may be relaxed after a few months of your taking a regular maintenance dose.
Important note: it is essential that you take the methadone regularly. If you miss three or more daily doses your body may lose its ability to break down the drug (tolerance). You can still continue with the withdrawal programme but you may need to start again with a lower dose.
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National website and 24-hour helpline for people with concerns over drugs and addiction.
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The Alliance is a user-led organisation which provides advocacy, training and helpline services to those currently in drug treatment, those who have accessed drug treatment in the past and those who may access drug treatment in the future.
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