Heroin use has been steadily increasing in our country with the number of first time users having grown by about 60 percent in the last decade. This hardcore drug has spread from the inner-city to the suburbs, even infiltrating isolated rural communities. The abuse of prescription opiate painkillers, such as Oxycontin, is one of the main reasons for this rise in use of heroin. As users of prescription opiates struggle to fulfill their cravings with expensive pills, they oftentimes turn to the much cheaper alternative of heroin to get high and stave off withdrawals.
The heroin problem in America is devastating communities and lives. Heroin is extremely addictive and coming off of the drug results in such a painful detox, accompanied by cravings so intense, that many addicts find themselves unable to stop using the drug. Heroin is considered to be the most addictive street drug, and even a short period of abstinence may seem unattainable for a chronic user.
Does Methadone Help Heroin Addicts?
Methadone use is a controversial issue. However, there’s no controversy over the fact that heroin is a persistent and severe social problem, one that must be effectively addressed. When solving the problem, it has to be geared toward the individual addict, the person who is experiencing extreme detox and withdrawals when they stop using. Most professionals in the field of chemical dependency treatment agree, medically assisted treatment is necessary to taper the heroin addict off of opiates during the throes of their withdrawals. Methadone, an opioid medication that was originally developed to treat pain, has been a primary pharmacological treatment of heroin addiction since the 1960’s.
The use of methadone itself is somewhat controversial due to the fact that it is also addictive. When used in the treatment of heroin addiction, it is taken orally on a daily basis to lessen or prevent withdrawals. Although it doesn’t produce a high, a dependence can be formed. This is because stopping methadone results in painful and nearly intolerable withdrawals, similar to heroin.
Benefits of Methadone Treatment
Proponents of methadone treatment view it as applicable in two possible ways: a way to gently taper down a user’s dependence on opioid drugs, or as a maintenance treatment. Maintenance treatment is not ideal, but due to the fact that methadone doesn’t provide a high like heroin, long-term use does not preclude a person from living a normal life. As a maintenance regimen, taken over an extended period of time, a person may become dependent upon the drug to prevent life-disrupting withdrawals. However, they are able to participate fully in society and can hold down a job, participate in family life, go to school etc., without the psychological or emotional impairments associated with heroin use. Some of the benefits of methadone treatment that proponents advocate include:
- Reduction in use of heroin
- Reduction is risks associated with intravenous drug use, such as blood-borne illnesses or injection site infections
- Relives cravings for opiates
- Prevents withdrawals
- Does not get the user high
- Is metabolized slowly, so can be taken once per day
- Reduction in associated criminal activity
- Reduced death rates
- Improved possibility for employment and familial stability
Drawbacks of Methadone Treatment
Opponents of methadone treatment believe that, at its core, the treatment is flawed and ineffective. Replacing one highly addictive substance with another does not treat the addiction. Instead it causes a major delay in the addict’s recovery process. Maintenance therapy, they point out, can drag on for months into untold years. Drugs fuel an addiction but do not actually cause the behavior. Opponents of methadone treatment believe that opiate addicts should receive intensive inpatient therapy with abstinence from opiates being the singular goal of treatment. They believe the dysfunctional behavior itself must be changed, not avoided by replacing one drug with a more socially acceptable substitute. Opponents of methadone therapy point out the following flaws in the treatment model:
- Methadone itself is addictive and withdrawals can be as bad – or worse than – as when stopping heroin
- Like heroin, a tolerance is developed, leaving risk for potential overdose
- Methadone is thought to cause tooth decay and skeletal issues
- Methadone can be dangerous for those who experience respiratory or autoimmune diseases
- Long-term therapy is expensive
- Addicts may still engage in heroin use in between methadone doses due to lack of treatment to address the core cause of their addiction
Which is More Addictive – Heroin or Methadone?
The crux of the issue is this: is methadone more addictive than heroin? Like most controversies, there is no definitive answer that can be spelled out in certain terms. It’s true that methadone is a opiate and is thus addictive. While the recipients don’t get high, they do develop a tolerance. This means they must take more and more of the medication to avoid going into withdrawals.
When examining the two primary components of addiction, physiology and psychology, we can see that methadone does cause a physically-based addiction. Since it is metabolized much more slowly than heroin, the withdrawals also take longer to work through. In terms of psychology, it doesn’t provide an intoxicating effect like heroin. However, there is a level pf psychological dependence because users fear experiencing withdrawals. Unlike heroin addicts, methadone users are able to function and complete activities of daily living to build a more stable life that is separate from hardcore drug use.
Heroin, as we have examined, is the most addictive street drug available. Physiologically, users crave it every few hours due to the fact that it is metabolized quickly. Withdrawals set in rapidly but also run their course more quickly than do those experienced with methadone. A tolerance is also developed over time so users must use more as their addiction progresses. Due to the unknown composition and potency of street heroin this can lead to death by overdose. Psychologically, users crave the euphoric high that heroin provides. They also fear the devastating withdrawals they experience if they don’t have regular access to the drug.
Is Methadone a Solution for Heroin Users?
Methadone is as full of drawbacks as it is benefits. It is legal, less dangerous to use, allows a heroin user to stabilize his or her life and has less criminal activity and incarceration associated with its use. However, it is an addictive substance, users develop a tolerance, withdrawals can last longer than those of heroin and long-term therapy is expensive.
Heroin is illegal, extremely unpredictable in potency (resulting in risk of death with every use), wreaks havoc upon the user’s life and is associated with crime and jail. Heroin offers no benefits, only hopelessness. The debate over methadone’s addictive properties is ongoing, but experts in the field of substance abuse should never lose sight of the fact that the patient’s best interests are of the utmost importance. Heroin addiction doesn’t come with an easy fix, so it’s almost logical that its treatments would also be as controversial as the problem.