The Risks of Long Term Methadone Maintenance

Just after 9am outside most chemist shops in Scotland you can see groups of emaciated people gathering. They are waiting to get their ‘dose’ of Methadone, prescribed to help them withdraw from heroin.

It’s becoming a familiar sight all over the UK and it’s a lucrative business, with some chemists receiving over £100,000 a year for dispensing the drug.

But here are some reasons why prescribing Methadone is dangerous:

1. Methadone Kills. There has been an increase in deaths by Methadone poisoning, accounting for 25% of all deaths by drugs poisoning. Professor Neil McKeganey, a leading UK expert on addiction, says: “We are seeing a steady increase in the UK of the numbers of addicts who are dying alongside a massive explosion of the prescribing of methadone – more deaths than in any previous year. More addicts on methadone than in any previous year.”

2. It Lengthens Drug Dependency. Prescribing methadone without any end in sight means it can postpone recovery. The longer an individual is “in treatment” the less motivation they have to become drug free. The benefits of methadone diminish after the first eight months and some addicts receive no other treatment. Methadone is a highly addictive drug.

3. Malnourishment and OsteoporosisResearch shows there is a risk of methadone treatment resulting in low bone density. The risk of bone fractures will increase over time with continued use of methadone. Methadone addicts often suffer from malnutrition, have a poor quality of life and frequent physical illnesses.

4. Cognitive Impairment. Research that methadone contributes to depressed cognitive functioning raises serious questions about the medical ethics of this treatment. Long-term methadone treatment can also cause changes in the brain, according to a study from the Norwegian Institute of Public Health. The results show that treatment may affect the nerve cells in the brain.

5. Difficult to Return to a Normal Life. Being on long term methadone treatment can make it very difficult to return to a normal life. It can prolong the average drug injecting career from 5 to 20 years. This is the main finding of an Edinburgh study of 794 addicts followed over a 30 year period. (Source: N McKeganey et al, Key Findings from the Drugs Outcome Research in Scotland Study, University of Glasgow; 2008.)

Some view ORT (Opioid Replacement Therapy, also known as ‘Methadone Maintenance’) as just substituting one addiction for another.

ORT is the only addiction treatment option in many areas of UK. As a consequence the numbers of referrals to residential rehabilitation units are at an all time low.

The Centre for Policy Studies issued a report that stated “the total social and economic burden for this population is over £3.6 billion.” The report shows that the cost of maintaining addicts on methadone since 2002 has doubled to £730 million a year in England and Wales. In Scotland last year over £17.8 million was spent on methadone.

In addition, these drug users are estimated to receive £1.7 billion in benefits a year, while the welfare costs of looking after the children of drug addicts are estimated at a further £1.2 billion a year.

But is the treatment working? Is it saving lives? Is it getting people drug free? Is it value for money? Is it safe?

Prof. McKeganey wants to see a two-year reassessment: if the “highly addictive” methadone does not seem to be working for an individual they could try the more expensive suboxone or enter a drug-free residential home.

What is your experience with methadone?

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