Methadone is mainly used in methadone maintenance programs for opiate addicts and on the street as a way to get high.  It is long-acting and powerfully addictive.  Even a single daily dose of the methadone used in maintenance programs (60-120 mg), can and does kill people who have not developed a tolerance to opiates.  Every year, methadone kills thousands of Americans.  It should be replaced with Suboxone (buprenorphine with naloxone), which is equally or nearly equally effective for maintenance and much less deadly.  It's time to close the methadone maintenance programs.

In addition to being highly addictive and very difficult to get off of, the #1 side-effect is weight gain, which is reported by 80%.  Delayed ejaculation is reported by 60% of males.  One report of 14 patients found an average 21 pound weight gain after 18 months.  

I haven't developed this page yet.  I think I did find one study comparing methadone to a non-narcotic for pain control, but I seem to have misplaced it.

Methadone Causes Osteoporosis: In a cross-sectional of 92 methadone maintenance patients, bone density was below normal in 83% with T-scores <-2.5 (osteoporosis range) in 35% and between -1.0 and -2.5 (osteopenia range) in 48%. Risk factors for low BMD were: tobacco use, 91%; heavy alcohol use, 52%; and HIV infection, 28%. Only 17% were on medications that lower the risk of osteoporosis: estrogen (n=5), testosterone (n=4), calcium (n=4), and Vitamin D (n=2). None of the participants reported a known diagnosis of osteoporosis. In bivariate analyses, significant predictors of low BMD were: male gender (p<0.001), lower weight (p=0.009), and heavy alcohol use (p=0.02). Low bone density in patients receiving methadone maintenance treatment. Kim TW, et al. Boston University. Drug Alcohol Depend 2006 Jul 19. Ed: I would think that vitamin K would be the best treatment.

Ritalin, Bupropion No Help for ADHD or Cocaine Abuse in Methadone-Maintenance Patients: In a 12-week DB PC study of 98 methadone-maintenance patients with adult ADHD, 53% also had cocaine dependence/abuse. Sustained-release methylphenidate or sustained-release bupropion did not provide a clear advantage over placebo in reducing ADHD symptoms or additional cocaine use in methadone-maintained patients. Treatment of methadone-maintained patients with adult ADHD: Double-blind comparison of methylphenidate, bupropion and placebo. Levin FR, et al. New York State Psychiatric Institute, Columbia University. Drug Alcohol Depend. 2005 Aug 12

Thomas E. Radecki, M.D., J.D.

www.modern-psychiatry.com