Starting Methadone
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•
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Take it once a day
Takes 5 days for
methadone to have its full
effect
No serious long-term
problems
But… hard to stop after
taking it for several years
Combinations of drugs
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•
•
Storage
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Methadone + alcohol or benzos
(valium, temazepam) = increased
risk of overdose
Heroin will have a reduced effect –
trying to get a hit increases the risk
of overdose
Methadone + Subutex =
withdrawals
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•
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5 or 10ml of methadone
could kill a child
Keep in a locked cupboard
Warn children of dangers
of medications
Use bottle with childproof cap
Methadone
Health Issues
Side Effects
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•
•
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Constipation
Sweating
Itching
Nausea
Drowsiness
Overdose
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Comments:
Taking more opioids (heroin,
methadone, codeine etc.) than your
body can handle = breathing slows
and then stops.
20mg Methadone can kill a nondependent person.
Client Name:
“Enabling Healthy Behaviour Change”
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•
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Avoid constipation – eat
fruit & veg and drink plenty
of water
Swill mouth out with water
after taking methadone
Brush teeth regularly (but
don’t share brushes)
Loss of sex drive
Date: / /
Storage
Starting Buprenorphine
Causes withdrawal effects if taken
too soon after other opioid drugs.
• First dose must be at least 8
hours after last heroin use
• At least 36 hours after last
methadone
• Less withdrawal symptoms
then Methadone but may be
hard to stop after taking for
several years.
•
Combinations of drugs
•
Buprenorphine + alcohol or benzos (valium,
temazepam) = increased risk of overdose
Heroin will have a reduced effect – trying to
get a hit increases the risk of overdose
Methadone + Buprenorphine = withdrawals
•
•
•
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A small dose of
Buprenorphine could kill a
child
Keep in a locked cupboard
Warn children of dangers
Use child-proof cap
Buprenorphine
Health Issues
Side Effects
•
•
•
•
Constipation
Sweating
Itching
Nausea
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Comments:
•
Overdose
•
Taking more opioids (heroin,
methadone, codeine etc.) than your
body can handle causes your breathing
to slow and then stop
Client Name:
“Enabling Healthy Behaviour Change”
•
•
•
Avoid constipation – eat fruit &
veg and drink plenty of water
Swill mouth out with water
after taking Buprenorphine.
Brush teeth regularly (but don’t
share brushes)
Loss of sex drive
Date: / /
Methadone ‘v’ Buprenorphine
Methadone
Advantages
Buprenorphine
Disadvantages
•
You know what’s in it (no street
adulterants)
•
Risk of overdose and
death
•
Tried and tested - proven to
help people stop using heroin
•
Small doses could kill
a child
Higher doses (over 60mg/day)
reduce craving for heroin
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Relatively few side effects
•
•
Relatively safe to take in
pregnancy and when breast
feeding
•
No risk of withdrawal effects
when you first start it
•
Doesn’t interfere with opioid
pain killers
•
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Advantages
•
Very low risk of
overdose if used on
its own
•
Possibly easier to
stop if used for short
time
Can be hard to stop if
used for a long time
Doesn’t solve
addiction problem merely the first step
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Feel clear headed
•
Acts as a ‘blocker’,
reducing or stopping
the effects of heroin
Client Name
“Enabling Healthy Behaviour Change”
Disadvantages
•
Taken under the
tongue – may take
several minutes to
dissolve
•
Feel clear headed
•
Unpleasant taste
Date: / /
Questions & Answers about Buprenorphine
Q: What is Buprenorphine?
A: It is a synthetic opiate which lasts over 24 hours in the body when you are on the right dose.
Q: What are the benefits?
A: Buprenorphine saves lives. People live longer & have better quality lives if they take Buprenorphine rather than street drugs. It has been used safely since
the 1980s. In high doses it has a ‘blocking’ effect so that if you use heroin ‘on top’ it may not work.
Q: What are the risks?
A: The greatest risk when ‘using on top’ of your Buprenorphine is there is a risk of accidently overdosing. There is a risk when starting Buprenorphine & you
have heroin or other opiates in your body, or if you are transferring from Methadone to Buprenorphine. This risk is called ‘precipitated withdrawal.’ If you
still have opiates left in your body then you will go into severe withdrawal which is worse than the normal ‘rattle.’ It is important you attend your first
titration appointment in absolute withdrawal with no opiates in your system to prevent this happening. If you do not attend in full withdrawal we will advise
you further or you can choose to start methadone instead.
Q: What are the side effects?
A: The side effects are the same as for other opiates; dry mouth, sedation (sometimes), constipation.
Q: Why do we prescribe Buprenorphine & not Subutex?
A: These are essentially the same drugs, with the same effect, & both are clinically evidenced & licenced to treat opiate dependency. Subutex costs more; we
therefore have made a decision to choose the best value for money option which does not impact on effectiveness. More importantly, Subutex is developing
a reputation for diversion, we want to prevent this.
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“Enabling Healthy Behaviour Change”
Questions & answers about Methadone
Q: What is Methadone?
A: It is a synthetic opiate which lasts over 24 hours in the body when you are on the right dose.
Q: What are the benefits?
A: Methadone saves lives. People live longer & have better quality lives if they take Methadone rather than street drugs. It has been used safely since the
1950s.
Q: What are the risks?
A: The greatest risk when ‘using on top’ of your Methadone is there is a risk of accidently overdosing. Methadone can slow down your breathing. If you take
alcohol, heroin, opiate tablets & benzos (which are all sedatives) ‘on top’ you can stop breathing, ‘go over’ & die.
Q: What are the side effects?
A: The side effects are the same as for other opiates; dry mouth, sedation (sometimes), constipation.
Q: Is replacing heroin with Methadone not just giving me another addiction?
A: Methadone is addictive, same as heroin, however we will work with you to provide a plan that will help you to reduce & detox off when you are ready.
Q: Doesn’t Methadone rot your teeth & your bones?
A: These are both myths, sometimes people are scared to go too high on their dose & are experiencing aching limbs as part of withdrawal syndrome. Good
oral hygiene will prevent tooth decay & gum disease, these are major factors for ‘tooth rot’ not Methadone. Your Recovery Worker will be covering oral
health promotion as one of your sessions.
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