Methadone Myth: Methadone Programs are Only for Heroin Addicts

In our recent blog post Methadone: Changing Attitudes, Saving Lives we discussed the benefits of methadone treatment for people struggling with an opioid use disorder. The purpose of that post was to highlight the advantages of methadone treatment – and Medication-Assisted Treatment (MAT) in general – and begin the work of removing the stigma surrounding both methadone and MAT programs.

After publishing that post, we decided to create a Methadone Mythbusters series for three reasons:

  1. MAT, including methadone, is recognized as the gold-standard treatment for people with an opioid use disorder.
  2. Stigma, misinformation, and common misconceptions keep millions of people from getting this life-saving treatment.
  3. If we can save lives by eliminating that stigma and getting people the treatment they need, then we’re all in.

Click here to read our first Methadone Mythbusters post, “The Addiction Bait and Switch,” click here to read our second Methadone Mythbusters post, “Do People Use Methadone to Get High?”, and click here to read our third Methadone Mythbusters post, “Do People on Methadone Lack Willpower?”

This is the fourth post in the series. We’ll use it to address the following misconception about methadone treatment:

Methadone treatment is only for heroin addicts.

Addressing this misconception allows us to discuss opioids in general, and educate our readers about the distinctions – or lack thereof – between opioids, opiates, heroin, and the misused prescription medications fueling the opioid crisis.

First, though, we’ll bust this methadone myth right away. According to the National Alliance on Mental Illness (NAMI):

“Methadone is a prescription medication that works in the brain to treat pain and dependence on opioids. Opioids include heroin and prescription pain relievers such as hydrocodone, oxycodone, morphine, and fentanyl.”

That’s the quick answer. Methadone treatment is not only for heroin addicts – it’s an effective treatment for any opioid use disorder.

Opiates and Opioids: So What’s the Difference?

Traditionally speaking, the term opioid refers to any natural substance derived from the opium poppy. Examples of opiates include morphine and codeine. Opiate, on the other hand, refers to chemical substances that act on the same human physiological systems as opioids, but are chemically manufactured in a laboratory. They’re also known as synthetic opioids. Examples of synthetic opioids include fentanyl and methadone. There’s also a class of medication called semi-synthetic opioids, which are lab-generated hybrids formed by making chemical modifications to natural opiates. Semi-synthetic opioids include oxycodone and hydrocodone.

The reason all these chemical compounds are grouped together is because they all work the same way in the human brain. Here’s a quick tutorial: an opioid enters the bloodstream, makes its way to the central nervous system (brain and spinal cord), and attaches to small receptors on our neurons (brain cells). There are three classes of opioid receptors: mu, kappa, and gamma. Opioids attach to the mu receptors, which triggers a chemical cascade that results in slowed breathing, reduced pain, and a sense of euphoria – the high associated with opioid use. Continued use of any of these drugs leads to physical dependence, at which point people begin to experience withdrawal symptoms in the absence of opioids. That’s another reason these drugs are grouped together: the withdrawal symptoms are identical – symptoms that can be mitigated through Medically Assisted Detox, followed my Medication-Assisted Treatment (MAT).

It’s now common to refer to all chemicals – whether medications or illicit drugs – that attach to opioid receptors as opioids. When a medical professional refers to opiates, they’re typically referring to the natural derivatives of the opium poppy, such as heroin, morphine, or codeine. When a layperson uses the term opiate, however, they’re probably just using it interchangeably with the term opioid.

Opioid Use Disorder: Methadone Works

The myth that methadone treatment is only for heroin addicts is part of the cultural stigma around Medication-Assisted Treatment (MAT) that keeps many individuals struggling with an opioid use disorder from getting the best possible treatment available for their disease.

The statistics show the very real need for MAT for non-heroin opioid addiction. In the year 2017, data collected by the Centers for Disease Control (CDC) and the National Center for Health Statistics (NCHS) showed that while over 15,000 people died of heroin overdose, over 17,000 people died of prescription opioid overdose.

The sad fact is that every case of overdose – whether from heroin or prescription opioids – is preventable.

We’re not saying that everyone who enters a methadone program (or other MAT program) for opioid addiction will be successful, but rather, that anyone who enters a methadone (or MAT) program for opioid addiction has an opportunity to stop their disordered drug use and turn their lives around. This dramatically reduces their chance of overdose and increases their chance of escaping the destructive cycles of addiction that can lead from the misuse of prescription opioids like Oxycontin to the misuse of illicit opioids like black market fentanyl or street heroin.

In closing, we want to reiterate to anyone seeking treatment for themselves or a loved one struggling with an opioid use disorder: medication-assisted treatment programs such as methadone are considered by experts to be the most effective way to treat opioid addiction currently available. Do not be swayed by the stigma around methadone and MAT. Read our Methadone Mythbusters series, share your new knowledge, and help get people the life-saving treatment they need.