Announcement: New office hours

Starting March 6, 2017 Nationwide Medical Review will observe new office hours:

Monday through Friday:  8am – 7pm EST

Saturday:  9am – 12pm EST

Drug Overview

methadone

Important information regarding METHADONE: drug use.

German scientists synthesized methadone during World War II because of a shortage of morphine. Although chemically unlike morphine or heroin, methadone produces many of the same effects. Introduced into the United States in 1947 as an anlgesic (Dolophine), it is primarily used today for the treatment of narcotic addiction (Methadone). The effects of methadone are longer lasting than those of morphine-based drugs. Methadone’s effects can last up to 24 hours, thereby permitting administration only once a day in heroin detoxification and maintenance programs. Methadone is almost as effective when administered orally as it is by injection. Tolerance and dependence may develop, and withdrawal symptoms, though they develop more slowly and are less severe than those of morphine and heroin, are more prolonged. Ironically, methadone used to control narcotic addiction is frequently encountered on the illicit market and has been associated with a number of overdose deaths.

Closely related to methadone, the synthetic compound levo-alphacetylmethadol or LAAM (ORLAAM) has an even longer duration of action (from 48 to 72 hours), permitting a reduction in frequency of use. In 1994 it was approved as a treatment of narcotic addiction. Buprenorphine (Buprenex), a semi-synthetic Schedule V narcotic analgesic derived from thebaine, is currently being investigated as a treatment of narcotic addiction.

Another close relative of methadone is dextropropoxyphene, first marketed in 1957 under the trade name of Darvon. Oral analgesic potency is one-half to one-third that of codeine, with 65 mg approximately equivalent to about 600 mg of aspirin. Dextroproxyphene is prescribed for relief of mild to moderate pain. Bulk dextropropoxyphene is in Schedule II, while preparations containing it are in Schedule IV. More than 100 tons of dextropropoxyphene are produced in the United States annually, and more than 25 million prescriptions are written for the products. This narcotic is associated with a number of toxic side effects and is among the top 10 drugs reported by medical examiners in drug abuse deaths.

[Abstracted from D.E.A. website q.v.]

Drug Effects

Methadone
Effects
Sedation, euphoria, reduced anxiety, and reduction in urge for the stronger opiates are the features which create the abusers’ market. Side effects are drowsiness, nausea, constipation, constricted pupils, and slowed breathing. WITHDRAWL WILL REQUIRE HOSPITALIZATION!
Incidence of Abuse
Frequent and widespread!
Chemical Name
Methadone Hydrochloride (a synthetic narcotic) Trade names are Methadone and Dolophine.
Forms and Street Names
Fizzies, Dollies
Preferred routes of admission
Manufactured as tablets, though probably injected frequently by heavy abusers.
Length of time detectable after user
7-10 days! [Half life is 36-48 hours]
Prescription (Legal) Use:
Methadone is an opiate of fairly low potency and less tachyphylaxis and addiction potential than other opiates. For this reason, methadone has long been used as an “intermediate” adjunct in detoxification and rehabilitation programs. Often persons in rehab (especially if numerous relapses have occurred) will be on Methadone for very long periods of time and will have a prescription. It must be remembered, however, that Methadone itself is an opiate and is addictive… so much so, that there is actually very active “marketplace” of Methadone abusers. It is also important to remember that the savvy abuser [who may be in need of help] will probably obtain a prescription to cover the contingency of “getting caught” on a drug test!
Immunoassay Screen Sensitive To:
Only to Methadone!
Confounding drugs (or factors):
None Known!
Screening Cut-off:
300 ng/ml
Confirmation GC/MS Cut-of
300 ng/ml
Facts for Verifying M.R.O
Sometimes straightforward. There will almost always be a history of previous opiate addiction or other abuse problems.