Bethany is a certified OB/GYN nurse who has a master's degree in Nursing Education.
James is a doctor who is conflicted. His nine o'clock patient, Mary, admits she's addicted to heroin and needs his help to quit. Mary is crying, saying she wants to get herself clean for the sake of her children but is afraid of the withdrawal symptoms of detoxing and the social stigma of going to rehab. Dr. James tells Mary that there is a drug available he can prescribe, but it is highly controversial. The medication is called Methadone.
Methadone is helpful for drug addicts because it changes the way the brain and body respond to pain. It's what's known as an opiate analgesic (narcotic). In short, this means it controls pain. It's effective in preventing withdrawal symptoms in patients who are addicted to opiates such as heroin or opium. It's also used for patients who require long-term continuous pain relief for significant medical conditions. It should not be used if Mary has breathing problems such as asthma or intestinal problems such as an ileus, which can lead to pronounced constipation.
It's a controversial treatment for drug addiction because doctors are essentially replacing one narcotic (heroin) for another (methadone), as opposed to a detoxifying treatment where a patient is medically monitored in a treatment facility while withdrawing from the drug. However, Doctor James would be prescribing Mary a narcotic that's controlled and not as dangerous as heroin. Since heroin is bought off the street, it's often mixed with other dangerous chemicals, is associated with criminal activity and the spread of communicable diseases through needle sharing. Methadone is coming straight from a sealed environment like a hospital. This difference is definitely important.
Doctor James has the option of prescribing Mary methadone in pill form, liquid form, or concentrate, the last of which is like a juice concentrate. When used to relieve pain, it'll need to be taken every eight to twelve hours. Doctor James can develop a dosing schedule for Mary that controls her withdrawal symptoms but gradually decreases the amount of methadone she will require over time. He cautions Mary that methadone is a very dangerous medication and if not used exactly as directed can have serious risks.
Doctor James explains to Mary that if she stops taking her methadone similar to heroin she will experience withdrawal symptoms such as vomiting and diarrhea, muscle pain, back pain, joint pain, weakness and stomach pain, watery eyes, runny nose, sweats, chills, excessive yawning, and restless behavior.
Besides the withdrawal symptoms, there are regular side effects that Mary can experience with this medication. The side effects include, headache, nausea and vomiting, appetite loss, stomach pain, dry mouth and tongue pain, difficulty peeing, abnormal menstrual cycles, sweating and weight gain.
More serious side effects are allergic reactions such as itching, hives, rash, facial swelling, mouth, throat and tongue swelling, difficult breathing or speaking, extreme fatigue, seizures, and hallucinations.
Doctor James warns Mary that because methadone is a narcotic, it can cause depression of the respiratory center in the brain. An overdose can make her stop breathing, become comatose, and die. Drinking alcohol can increase the effects and should be avoided. He also warns her that as a mom, she needs to keep the medicine secure from her children, other family members, and pets. If it got into the hands of her children, even a small dose could cause death.
After a lengthy discussion with Doctor James, Mary will have to decide if the risks of taking methadone are suitable to her family life as well as the process of taking the drug in controlled doses, which can possibly lead to further abuse. However, she can also avoid the withdrawal symptoms that come detoxing 'cold turkey.' Needless to say, it's a big decision.
Methadone is a narcotic pain medication. It's effective in treating patients addicted to heroin by changing the way the brain responds to pain. It's also effective in decreasing the withdrawal symptoms associated with detoxing from narcotics, but can have serious side effects if not used as prescribed.
Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.
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Human Anatomy & Physiology: Help and Review20 chapters | 739 lessons
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