Methadone - Heroin replacement therapy

• What are drug replacement therapies?

  > given an alternative drug

  > controlled by medical professional

  > reduces the amount of drug use over time

  > getting drugs from a safer source and not contaminated
• What are the social factors?

  > prevents contact with drug dealers

  > prevents contact with other heroin users
• How is it a safer solution?

  > does not involve sharing needles which reduces the chance of getting HIV or hepatitis
• How does methadone work?

  > agonist for opioid receptors

  > reduces cravings and reduces withdrawal symptoms

  > occupies binding sits for longer so discourages other opioid use
• What is methadone?

  > synthetic opiate

  > prescribed to 90% of heroin addicts (in the UK)

  > taken in liquid form, rather than injection

  > allows addict to function normally

  > stays in body longer (24 hours)

  > doesn't lead to the same high as heroin
• How does an addict start methadone?

  > taken under supervision at pharmacy

  > can be harmful if too much is given, start with a low dose

  > does might be increased until it has a therapeutic effect

  > when trusted they can keep it in a secure place at home to self administer
• What are the benefits of methadone?

  > lower risk of fatal and non-fatal overdose

  > easily controlled by medical professional

  > associated with lower IV (injection) drug use
• What are the costs of methadone?

  > can become addicted to methadone
• PARAGRAPH 1

  AO1

  • how does methadone work

  AO3 +

  • Amato et al: reviewed 52 studies and found that high doses of methadone were more effective than alternative therapies

  Development point +

  • large sample of 52 studies, findings are generalisable to a large population of heroin addicts

  AO3 -

  • Beil & Trojan: 59 heroin addicts and 56 alcoholics were given apomorphine, 65% were drug free for up to 6 months, 41% longer than 6 months

  Development point -

  • apomorphine was more successful for the alcoholics than the heroin addicts
• PARAGRAPH 2

  AO1

  • what is the effect of methadone

  AO3 +

  • side effects: therapeutic effect and inhibits withdrawal

  AO3 -

  • time: can take years
• PARAGRAPH 3

  AO1

  • setting + starting methadone

  AO3 +

  • social control: trust is, eventually, given to addict

  AO3 -

  • eclectic approach: only focuses on withdrawal
• CONCLUSION

  AO3 +

  • ethical: less invasive than aversion therapy

  AO3 -

  • addicted to methadone: chance of new addiction to methadone