Many people believe that methadone is “more addictive” simply because the withdrawal period is longer. However, that is not what determines the addictiveness of something. Addictiveness is determined by the reinforcing factor in using it–by how intensely it creates a desire to use it again. Crack cocaine, for example, is intensely addictive even though the physical withdrawals are minor compared to many other drugs, because it creates such a strong urge to use it again–the high is so intense.

Methadone, on the other hand, is very slow to cross the blood-brain barrier. For this reason it provides no rush and a less intense high than short acting opiates. ANd for stable patients, it provides no high at all. When people leave methadone treatment and relapse, for example, they almost never relapse on methadone–they relapse on heroin or vicodin or oxycontin, etc–something that gives them that rush and intensity. If methadone were TRULY so much more “addictive” than heroin, why would people not relapse on IT instead?

Additionally, most folks have the idea that methadone treatment should not be open ended–that the patient should be on it for a short while and then get off. This is also untrue. Methadone treatment was never intended as a short term detox aid. The founders of MMT, Dole and Nyswander, knew from the outset that methadone treatment was aimed at correcting an imbalance in the brain chemistry–an endorphin deficiency–and that many patients would require long term–even life long–treatment to maintain stability, just as with any other chronic physical or mental illness. We don’t push schizophrenics to get off their medication, or manic depressives, or epileptics, because we know that if they do, the likelihood is that their symptoms will return. The same is true of this disease. 90% of those leaving MMT relapse within one year. Yet despite this statistic–and despite the fact that those who remain IN mmt have the best success rate of any treatment modality in existence today–people continue to push them to “get off that stuff” and get into “real recovery”.
The lives this well meaning but misguided advice has destroyed are many.

Just to be clear about terminology, the term “addiction” implies compulsive use of a substance in spite of negative consequences. Methadone is taken as a medication in a healthy, non-compulsive way as a recovery support because of positive effects.

Having said that, it is true that the body becomes physically dependent on methadone in the sense that if methadone use is abruptly terminated, the body goes into withdrawal. This is true for many medications, of course.

Methadone withdrawal symptoms are more uncomfortable than heroin withdrawal symptoms for many people. The good news is that methadone doses can be tapered over a long period of time, such as six months, making the detox experience much less uncomfortable than a “cold turkey” detox.

I’m not trying to nitpick…it’s just that using the term “addictive” to describe methadone plays into the inaccurate idea that methadone treatment is “trading one drug for another” meaning trading “one addiction for another.” This idea contributes to stigmatization of methadone patients, and may prevent some people who would benefit from methadone from accessing a potentially life-saving treatment.

Blessings to you, your son and family.