(Updated on 1/24/2005)
Methadone, a synthetic opiate, has been used to treat heroin addiction for more than 30 years. Methadone is taken orally; it blocks the euphoric effects of heroin for about 24 hours and suppresses the symptoms of narcotic withdrawal for 24 to 36 hours. It isn't intoxicating or sedating, and its effects don't interfere with normal activities, such as driving.
According to the National Institute on Drug Abuse (NIDA), methadone is medically safe even when used continually for 10 years or more. It can cause constipation because it influences the activity of the digestive tract, but it doesn't slow metabolism.
Research on the use of methadone to treat heroin addiction shows that long-term use combined with psychological counseling is much more effective than using methadone temporarily to get past drug detoxification, even when more intense psychotherapy is included in a detox program. Study results published in the March 8, 2000, issue of the Journal of the American Medical Association showed that participants who had 14 months of methadone maintenance treatment followed by a two-month detox period remained in treatment longer and had lower relapse rates than did participants in a methadone detoxification program that lasted only 180 days.
While you're on methadone, whether for heroin-related reasons or for pain management, it is important to maintain a healthy lifestyle. Choose nutritious foods, exercise regularly, and take a daily multivitamin/mineral supplement. I would also take a bowel regulator like psyllium or triphala to overcome the constipating effect of the drug. Obviously, methadone is a better alternative than using heroin or other illegal narcotics, but ideally, it would be good to phase off of it after about a year.
Andrew Weil, M.D.