What is methadone hydrochloride? Let's learn about it together!

Methadone hydrochloride is an opioid receptor agonist, suitable for the detoxification treatment of various opioid drugs, especially for the replacement treatment of heroin dependence, and can also be used for the replacement treatment of dependence on morphine, opium, pethidine, dihydroetorphine hydrochloride, etc. At present, methadone hydrochloride has been promoted and used throughout the country as a drug for the treatment of opioid addiction, but it also brings some side effects and risks. Let's learn about the relevant knowledge of methadone.

1. Pharmacological Action

1. Methadone hydrochloride has synergistic effects with all narcotic analgesics, so when taking them together, please pay attention to reducing the dosage as appropriate. Methadone hydrochloride is a synthetic narcotic analgesic with the pharmacological effects of morphine. Methadone hydrochloride is antagonistic to naloxone and opioid receptor antagonists. It is used as a replacement therapy for patients addicted to opioid drugs such as morphine and heroin. It is not a "drug withdrawal" in the traditional sense, but a replacement therapy. Methadone hydrochloride is addictive. Pharmacological action: It is absorbed into the blood 30 minutes after oral administration, and it starts to take effect 2 hours later. The peak blood concentration is 4-8 hours after medication. The drug effect can be maintained for 24 hours to 36 hours, and the half-life is 15-18 hours. It can effectively eliminate morphine withdrawal symptoms and drug dependence. It is a potent and highly selective opioid receptor agonist. Methadone hydrochloride has analgesic effects similar to morphine and withdrawal symptoms similar to heroin, such as anxiety, euphoria, tension, insomnia, irritability, etc., but its side effects are relatively few.

2. Does methadone have any effect on liver and kidney function?

After reviewing a large number of clinical books, there is currently insufficient evidence to prove that methadone hydrochloride has a direct damaging effect on the liver and kidney functions of heroin-addicted patients undergoing maintenance treatment.

2. Indications

1. Who is not suitable for methadone hydrochloride maintenance treatment?

1) Non-opioid addicts;

2) Opioid addicts with criminal records;

3) Opioid addicts who have no capacity for civil liability;

4) Opioid addicts who have no desire for treatment and are unwilling to participate;

5) Opioid addicts with a history of methadone hydrochloride allergy;

6) Opioid addicts with severe respiratory, cardiovascular, liver, psychiatric, and kidney diseases;

2. Generally, the course of methadone hydrochloride maintenance treatment

The purpose of methadone hydrochloride maintenance treatment is to allow heroin-dependent patients to change their morbid psychology and abnormal behavior, establish a new and normal life pattern, restore personal functions, family and social functions, and become a normal person with the help of outpatient medical staff and social workers on the basis of taking methadone. Obviously, it takes time to achieve these goals, and the transformation of heroin-dependent patients cannot be completed in a short period of time. Therefore, the length of the treatment course cannot be determined simply by time, but should also refer to factors such as changes in all aspects of heroin-dependent patients and whether they relapse. If they return to the state of heroin addiction soon after stopping taking methadone hydrochloride, it is best to maintain such patients for a long time or for life in order to achieve an ideal heroin withdrawal.

3. Do heroin addicts need to take their pills twice a day?

After entering the human body, methadone hydrochloride is mainly metabolized by hepatic enzymes in the liver. The activity of hepatic enzymes is divided into high, medium and low. Therefore, there are three types of fast, normal and slow metabolism in the population. Therefore, individual differences lead to different times of taking medicine. Generally, people with normal metabolism take the medicine once a day, and no withdrawal symptoms will appear within a day. For patients with slow metabolism, they take the medicine once a day, and no withdrawal symptoms will appear. For fast-metabolizing heroin-dependent patients, although withdrawal symptoms can be quickly controlled after taking the medicine, withdrawal symptoms will appear when the blood concentration of fast-metabolizing drugs quickly drops below the therapeutic concentration, so that the action time cannot be maintained for more than 24 hours. For this type of heroin-dependent patients, it is not because the daily dose is insufficient, but because the metabolism is too fast, so it cannot be solved by simply increasing the dosage. It is best to take the total amount of the day in two times, which can eliminate withdrawal symptoms and avoid the risk of overdose.

4. The average recommended dose in China is 60-120 mg/day or more, and the average recommended dose abroad is 80-120 mg/day or more. In actual clinical work, there is no fixed dose, and it varies from person to person. The usual suitable dose: 1) Ideally controls withdrawal symptoms and signs for more than 24 hours; 2) Can effectively suppress the craving for heroin; 3) No obvious overdose symptoms and adverse reactions; 4) Does not affect the work, family life and social functions of heroin-dependent patients.

5. Heroin-dependent patients with chronic diseases can also take antihypertensive drugs, hypoglycemic drugs, etc. while taking methadone hydrochloride for treatment, provided that they follow the doctor's advice and do not use them at will.

6. According to clinical data, methadone hydrochloride treatment may cause a decrease in semen in a few people, but it will not affect the quality of sperm. For female patients, there will be abnormalities in the first 2-3 months for a very small number of patients. It has no effect on pregnancy and childbirth, and pregnancy and childbirth can be normal. However, there are a few points to note during pregnancy:

1) Take the medicine as directed by your doctor to avoid withdrawal symptoms that may lead to miscarriage, premature birth, etc.;

2) Ensure a stable living environment and normal nutrition to ensure the growth and development of the fetus;

3) Receive regular prenatal check-ups.

3. Adverse Reactions

Common side effects of methadone hydrochloride maintenance therapy: constipation, increased sweating, nausea, drowsiness, abnormal appetite, sleep disorders (insomnia), decreased libido, nervousness, tension, headache, etc.

4. What are the consequences of taking an overdose of methadone hydrochloride?

When taking methadone hydrochloride, you must follow the doctor's instructions and avoid taking an overdose, which can easily cause poisoning. When the dose is too large, it will inhibit the respiratory center. If not treated in time, the patient will experience severe hypoxia and cerebral edema, and eventually die from central respiratory failure.

I hope that through the above description, more people will understand methadone and help heroin addicts and opioid addicts to use methadone hydrochloride effectively. Methadone hydrochloride must be used under the guidance of a doctor, especially during the treatment of methadone hydrochloride. The detoxification treatment should be gradually reduced, and the reduction speed should not be too fast, otherwise withdrawal symptoms will occur.