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Differences between Short-Acting Opioids and Methadone

From: Chapter 3: The Fundamentals of Methadone Maintenance Treatment, in Methadone Maintenance: A Counsellor's Guide to Treatment (© 2003).

In contrast to short-acting opioids such as heroin, methadone:

  • is more effective orally; taken orally, methadone is slower acting than injected heroin (30 minutes for effect vs. immediate effect)
  • does not cause a "high" or drowsiness (in stabilized clients)
  • does not cause impairment in thinking, behaviour or functioning
  • does not dull normal emotions and physical sensations
  • diminishes opioid craving
  • reduces the likelihood of a heroin-induced "high," should the client use heroin
  • will continue to be effective with long-term use without dose increases
  • is medically safe
  • is longer acting than heroin (24 to 36 hours vs. three to six hours) and is administered less often (once a day vs. three or more times a day)
  • decreases drug-seeking behaviour (U.S. Department of Health and Human Services, 1995).