Do you think methadone is safe for staying off of heroin, or other narcotics? I have a friend who has been on it for a long time, has never gone back to using street drugs and has been successful in staying off all other drugs.
Originally published 7/2/2007
Methadone is a synthetic narcotic that has been used for more than 30 years as a treatment for heroin addiction. It works by "pre-empting" the effects of heroin, blocking its euphoric qualities while eliminating withdrawal symptoms and relieving the craving for the drug. Methadone only works for those addicted to heroin or other opiates - it won't help those hooked on cocaine or other drugs.
Over time, long term use of methadone has proved more effective than short-term use. (Once they complete a short-course of methadone, addicts tend to go back to heroin.) Although your friend is now addicted to methadone, long-term use of this drug is relatively safe with no serious or long term adverse side effects to the heart, lungs, liver, kidneys, bones, blood, brain or other vital organs. However, in November 2006, the FDA warned of serious, potentially fatal, side effects when methadone is taken too often, in too high doses or with certain other medications or supplements. Among those side effects: difficulty breathing; extreme drowsiness; fast, slow, pounding, or irregular heartbeat; faintness; severe dizziness; or confusion. These dangers tend to occur among patients new to methadone treatment.
Taken in the correct doses, as instructed, the side effects of methadone are relatively minor and don't occur in everyone - these include constipation, water retention, drowsiness, skin rash, excessive sweating, and changes in libido. The symptoms usually disappear once the dosage is adjusted and stabilized or tolerance for the drug increases. Methadone does not impair cognitive functions and has no adverse effects on mental capability, intelligence, or the ability to hold a job. It isn't sedating or intoxicating and doesn't interfere with the ability to drive a car or operate machinery.
Withdrawing from methadone, if desired, should be supervised by a physician who probably will reduce the dose gradually. Those who stop taking the drug suddenly may experience withdrawal symptoms as unpleasant as withdrawal from heroin. If your friend is doing well on methadone maintenance, he or she probably can safely continue on it. It would be great to get off opiates entirely, but if the potential result is going back to heroin, methadone maintenance is certainly better.
Andrew Weil, M.D.
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译文:
能克服上瘾吗?
你认为美沙酮是远离海洛因安全,还是远离其他的麻醉剂安全?我有一个朋友在很长一段时间没有再回去吸毒并且成功远离其它所有的毒品．
最初发行于２００７年７月２日
美沙酮是一种综合麻醉剂，在过去超过３０年的时间里它被用来治疗海洛因上瘾．它的作用是在海洛因产生效果前先发制人,随着消除撤回症状和缓和对毒品的渴望来阻碍因吸食海洛因而产生兴奋的质量.美沙酮只作用于那些对海洛因和鸦片上瘾的人,对可卡因和其它毒品上瘾的人没有帮助.
随着时间的过去,长期使用美沙酮比短期使用更有效果已被证实.(曾经他们完全是短期用美沙酮治疗,上瘾的人都趋向于重新吸食海洛因).虽然你的朋友现在沉溺于美沙酮,但长期使用这种药是相对安全,它对心脏、肺、肝脏、肾脏、骨骼、血液、大脑或其它维持生命所必须的器官没有严重的且长期不利的方面。然而，在2006年11月，美国食品药品管理局警告，严重的，潜在的致命副作用时，美沙酮是采取往往在过高的剂量或与其他某些药物或补充剂.这些副作用有:呼吸困难,易困,快慢不一或猛烈不规律的心跳,衰弱,严重的头昏眼花或意识混乱,对接受美沙酮治疗的患者来说这些危险的副作用的发生并不陌生.
在采取正确的剂量，作为指示，副作用美沙酮是相对轻微，不发生在每个人-其中包括便秘，保水，嗜睡，皮肤出疹,过度出汗，性欲的改变.症状通常消失，一旦剂量是调整和稳定或容忍的药物增加.美沙酮不损害认知功能,且对精神、智力的能力，工作的能力没有影响。它不是镇静的，令人陶醉的且不影响开车或操作机器．
要想停用美沙酮就必须由医生监督剂量的减少.那些停用美沙酮的人会出现像不吸食海洛因一样痛苦的症状.如果您的朋友是做好对美沙酮维持治疗，他或她也许可以放心地继续进行。它对完全摆脱鸦片是有显效的,但如果潜在的结果是和吸海洛因一样,美沙酮的维持当然更好.
医学博士 Andrew Weil