Brain scans have shown that the brain needs a least a year to heal and repair itself after active use. There are chemical imbalances and extensive physical damage to brain tissue. MAT or medication assisted treatments are designed to normalize brain chemistry, relieve cravings, block the pleasurable effects of opioids and alcohol, , separate them from “the lifestyle,” receive counseling and give them time to fix problem areas of their lives. When someone is on MAT they are less likely to over-dose and have to prostitute, commit crimes and deal drugs to support their habit.
*Outpatients will give addiction medications alongside their services and groups.
What’s methadone?
A synthetic or man-made opioid. It is an agonist which means that it completely binds to the opioid receptors in the brain.
Aren’t we just switching one drug for another?!
Opioids bind to the brain’s receptors and produce euphoria. Methadone binds to the same receptors and blocks the ability of other opioids to produce a high. There is still a mild pleasurable feeling associated with methadone. Methadone causes dependency. People are physically dependent, meaning they can become tolerant and need higher doses sometimes. If they stopped, they would have withdrawal symptoms. It does not necessarily cause addictive behaviors: obsessive thoughts about use, stealing, manipulating, lying etc. To understand the difference between street opioids (addiction) and methadone (dependance) think about other health medications. A person on insulin is physically dependent on it and they cannot stop taking it. A person stable on prescribed methadone, using it as directed, is also physically dependent on it. Usually, they are not exhibiting addictive behaviors and have separated themselves from “the lifestyle.”
Why is methadone making a comeback?
- It is a higher level-of-care in a way. Methadone requires people to show up and it is highly controlled. It is harder to divert and abuse.
- The risk of fatal over-dose on street opioids is so high and people on methadone are not likely to relapse.
- It can help with pain management
- It is long-lasting
- It is inexpensive
What about pregnancy and nursing?
Being on methadone during pregnancy is not ideal and negative side effects can occur. Having active use during pregnancy is much less ideal. The benefits of regularly taking methadone in a program during pregnancy outweigh the risks of being on the streets using unregulated drugs. Women can successfully carry a child and deliver on methadone. If someone were to abruptly stop taking prescribed methadone, they could stress their baby and increase the risk of negative long-term side effects called NAS (neonatal abstinence syndrome). Withdrawal can also trigger pre-mature birth and miscarriage. After delivering, mothers are encouraged to breastfeed because only a small amount of methadone passes to the infant. This can help the baby with withdrawal symptoms. Babies born to methadone dependent mothers tend to stay additional days after the mother is discharged for observation.
Should people really be taking methadone for years?
Many people take methadone for years. This is especially true if they have chronic pain issues.
What are the drawbacks of methadone?
- It can accumulate in the body and cause overdose. If a person uses alcohol or benzodiazepines while on methadone they are at risk for respiratory failure.
- Methadone causes dry mouth which can cause plaque and dental decay.
- It can decrease a person’s sex drive
- Can cause constipation
- It requires that a person is transported to the MMTP clinic. Some insurances must pay a cab for an hour ride every day. This also takes a person away from their family or work obligations.
- Some people relapse on crack, meth, or other substances while on methadone. It is important to get therapy and go to meetings to change thoughts and behaviors. Also, if the lifestyle of people- places- & things doesn’t change a person is at risk of relapse. “If nothing changes, nothing changes.”
- It takes 6-12 months to be taper off methadone.
Providers:
ACCA Addictions Care Center
Mobile Recovery Unit- Joseph Cavallo CRPA
Cell: (518) 410-5285 or 518-419-1578
*Working to help people to get mobile services, telehealth in van for M/H meds and MAT
*Coordinates to get Warren or Washington County Jail for inmates medication
*Meets clients around town, example: Stewarts
Community Health- part of Saratoga Hospital
Joshua D. Zamer, MD, DABAM
24 Hamilton Street Saratoga Springs, NY 12866
(518)886-5600- Phone
(518) 886-5880- Fax
*Suboxone, Sublocaid (suboxone injection), vivitrol, needs to come for MAT, does not need to come there for treatment
*Responsible provider, careful with patients
*Hudson Headwaters also has responsible providers
This person represents sublocade and does company presentations.
Kristen Czajkowski INDIVIOR 518-466-3014 kristen.czajkowski@Indivior.com