Kû Aloha Ola Mau
A place of healing and recovery

The Truth About Methadone

Methadone is a prescribed medication used to target addiction to heroin. At the right dose amount, methadone staves off withdrawal signs and allows the addicted person to function “normally”. It does not create a “high” but acts to block craving. Its most significant action occurs in the brain.

Addiction

In order to talk about methadone it is important to understand addiction. The former director of the National Institute of Drug Addiction, Dr. Alan Leshner, describes addiction as a brain disease.

What makes it a brain disease?

The mechanisms that are affected and that affect addiction are located deep within the inner portion of the brain, called the nucleus accumbens, which is the “grand central station”. This is the part of the brain that controls our primitive functions that keep us alive. The pleasure/reward system is located in this part of the brain. For instance without the sense of hunger and then pleasure or reward, we might not be motivated to eat and drink and without food and water, we cannot survive.

The area of the brain where judgment and decision control rests is the outer cerebral cortex, a place where we make decisions; we might call it the location of “willpower”. Because this is not the primary area where drug use affects the brain, the person who is addicted may not be able to decide to stop using drugs. That is why they continue despite the harm, the losses the tragedies of continued use. It is very difficult for people to stop using because they simply care about their family or job or etc. more. Although a pill or drink of alcohol may affect this part of the brain, addiction is not located in the cerebral cortex.

Back to the nucleus accumbens. Let’s look at how our brain transfers messages and leads to addiction. Each cell in the brain has fibers called dendrites. Dendrites receive information from their receptor sites (located at the end of the fibers like a tiny ball), like an input center. Each dendrite has a long fiber attached to it called an axon fiber. The axon fiber sends messages to the next cell, like an output system. The message is then picked up by receptor sites from another dendrite and the message continues to move through the brain.

A message begins down the axon fiber as an electrical impulse. This impulse turns into a chemical message when it gets to the end of the axon so that it can jump the distance between the end of the axon in one cell and the receptor sites of a dendrite of the next cell. The gap between them is called a synapse. The chemical message is called a neurotransmitter. The neurotransmitter can inhibit, excite or modify the response. Dopamine and serotonin are two well known neurotransmitters. These can cause a sense of well being, or happiness in normal doses. The neurotransmitter stimulates the nearby dendrites and the messages are multiplies with lightening speed. Neurotransmitters can result in changes in perception, memory, behavior and personality.

In a normal brain, the neurotransmitter is “mopped up” so it does not flood the brain.

Each class of drug has a corresponding neurotransmitter that is peculiar to its own class. That is why different drugs create different effects. Drug use, depending on the kind of drug, can “order” an increase of amount of neurotransmitter to be released flooding the brain, or it can prevent the reuptake from happening, which will also flood the brain.

This scenario, repeated over may weeks, months, and years is suspected to have a possible permanent effect on altering the brain function in this area making the discontinuation of alcohol and drug use extremely difficult and with poor prognosis.

Methadone

Methadone has a normalizing effect on this mechanism of the brain. It allows the person to function normally and prevents continued heroin or opiate use by blocking any craving and preventing withdrawal symptoms from occurring.

There are some studies that suggest that the brain can return to normal through counseling and support groups as well. Methadone, together with counseling and Alcoholics/Narcotics/Methadone Anonymous groups can have a tremendous positive effect on the brain, solidifying the recovery process.

This is why it is important for opioid treatment (methadone) programs to provide counseling with the medical care. Kû Aloha provides comprehensive services that address the changes in thinking pattern needed after years of drug use; direct and referral services for those who have no stable living arrangements and encouragement and referral to work or seek higher education. Changing the thinking, the beliefs and values, the lifestyle and becoming more productive with the help of methadone maintenance is a solid formula helping many people recover from a once intractable disease.