272 Methadone
performance and exhibit assorted types of personality problems that leak over
into driving habits.
In the 1970s methadone was suspected of causing memory trouble, but a
group of researchers who investigated the question found no such difficulties.
In 2000 a study reported significant memory problems in a group of metha-
done maintenance recipients, but the same group also had confounding con-
ditions such as head injury and alcoholism that may have affected memory
test performance. Another 2000 study comparing methadone users to nonusers
concluded that life factors other than methadone were the best explanation
for differences in scores on thinking tests.
Abuse factors.Although methadone is sometimes described as blocking her-
oin’s effects, the two drugs simply have cross-tolerance, meaning one of them
can substitute for the other in some ways. In addition, persons who find one
of the drugs pleasant will probably find the other one just as appealing. For
those reasons, heroin addicts can often be switched to methadone in order to
maintain their drug habit legally, but the switch does not cure their drug
addiction. Some heroin users even like methadone better; some methadone
recipients continue using heroin on the side. On the basis of death statistics,
some authorities feel methadone is more dangerous than heroin.
Addicts in methadone maintenance programs have chaotic lives. One study
of program participants found 7% were likely to be pathological gamblers;
another study of methadone program participants found 16% to be patholog-
ical gamblers and an additional 15% to have a gambling problem. Researchers
have noted that violent traumas are more frequent among methadone pro-
gram participants than among the average population. In one survey 34% of
patients said they received treatment for mental disorder, 64% of the women
said they used psychoactive drugs during pregnancy, 80% of parents said they
were arrested while their children were growing up, and parents reported
that 30% of their children were suspended from school and 41% failed at least
one grade in school and had to take that year of education again. For meth-
adone maintenance patients and their families, drug abuse is simply one el-
ement in multiproblem lifestyles.
A rhesus monkey experiment showed the animals having no preference
between water and a methadone solution. Such lack of interest is consistent
with human experience. Some persons find opiates or opioids attractive, but
most do not. Personality and life circumstances have much to do with such
choices.
Methadone’s calming qualities dissipate if tolerance occurs, so some other
antianxiety medicine must then be used. Methadone’s abstinence syndrome is
reminiscent of morphine’s but is generally described as more gradual in de-
velopment and disappearance, longer lasting but with symptoms of lesser
severity. Some research, however, has found no difference in morphine and
methadone withdrawal, and some addicts say withdrawal from methadone is
more difficult than withdrawal from heroin. Evidence suggests that metha-
done withdrawal symptoms are harsher in nonblack infants than in blacks.
Drug interactions.Using other depressants (includingalcohol) or tricyclic
antidepressants with methadone can increase the risk of a cumulative over-
dose—each individual dose may be safe, but all together may be dangerous.