What is methadone maintenance treatment?
Methadone maintenance treatment (MMT) is a comprehensive treatment program that involves the long-term prescribing of methadone as an alternative to the opioid on which the client was dependent. Central to MMT is the provision of counselling, case management and other medical and psychosocial services.
Methadone is a long-acting opioid agonist that is prescribed as a treatment for opioid dependence and the management of chronic pain. MMT addresses only the treatment of opioid dependence.
Methadone may be substituted for other opioids because tolerance to one opioid, such as methadone, also blocks the effects of other opioids. This phenomenon is known as cross-tolerance. Cross-tolerance develops between substances that act on the same types of receptors in the brain. For example, people who have built up tolerance to morphine are also tolerant to other opioid agonist drugs.
Methadone is taken orally:
• suppress opioid withdrawal symptoms
• reduce cravings for opioids
• not induce intoxication (e.g., sedation or euphoria)
• reduce the euphoric effects of other opioids, such as heroin.
• Benefits of MMT
Methadone alleviates the symptoms of opioid withdrawal. Once methadone reaches a sufficient level in a client's blood, his or her cravings are reduced. Methadone is longer acting (24 to 36 hours) than most other opioids. For example, heroin, which is short acting (three to six hours), is often injected several times a day while, in MMT, methadone is administered only once a day.
Tolerance to methadone develops slowly, so clients can be maintained in MMT indefinitely. If it is prescribed properly, methadone is considered medically safe as a treatment for opioid dependence.
Research shows that methadone is a cost-effective treatment for opioid dependence. A variety of studies have found that MMT is associated with a reduction in:
• the use of other opioids
• injection drug-related risk behaviours
• high-risk behaviour associated with the transmission of HIV and other sexually transmitted diseases
• criminal activity.
In addition, MMT improves:
• physical and mental health
• social functioning
• quality of life
• retention in treatment programs.