- Methadone has two separate purposes: managing chronic pain and managing opioid addiction; the focus of the guideline will be methadone and its use in substitution therapy for opioid addiction
- Methadone is a long-acting synthetic opioid that binds to the opioid receptors in the body. An opioid agonist, it can significantly reduce the rate of withdrawal and craving associated with opioid dependence (Thomas, 2005).
- As Methadone is a long-acting drug, there are no euphoric effects, a factor that contributes to lower rates of relapse (CPSO, 2005; Thomas, 2005).
- Methadone has a long half-life and generally only needs to be administered once daily (usually mixed in a fruit drink and taken orally).
- Due to the nature of methadone as a full opioid agonist, overdose is an important safety concern (Mattick, Kimber, Breen & Davoli, 2005). All dosages must be client-specific to reduce the effects of respiratory depression and sedation. In addition, there are considerable dangers to be aware of concerning methadone diversion and accidental ingestion or misuse in non-MMT clients or non-opioid-dependent individuals.
- Buprenorphine is often considered an alternative to methadone with respect to maintenance therapy.
- MMT should encompasses a range of comprehensive services to provide holistic care, enhance treatment outcomes and provide better quality of life (Health Canada, 2002). Services can include: counseling, employment, education, housing services and access to health services.
- Long-term treatment is optional for positive treatment outcomes. Some clients may require lifelong use of methadone (Kerr et al., 2004).
- Nurses and health-care professionals should work with clients to determine their goals and needs regarding length of treatment. Retaining clients in treatment can be facilitated by promoting client autonomy and participation in decision-making with respect to treatment planning
Addiction and Mental Health
Supporting Clients on Methadone Maintenance Treatment