Methadone mental effects

Fudala P., Johnson R., Jaffe J. Outpatient comparison of buprenorphine and methadone maintenance. II. Effects of cocaine usage, retention time in study and missed clinical visits. In Harrison L., Ed. Problems of Drug Dependence. Natl. Inst. Mental Health Res. Monogr. 105 587, 1991. 

Methadone and all other opiates produce multiple effects on a user s psychological and mental status. These effects are generally dose-related, with more powerful effects seen at higher doses. 

In order to influence a person s mental state, methadone, along with any other drug or substance, must first be able to cross what is known as the blood-brain barrier. The blood-brain barrier is an actual physical barrier, made up of tightly interspaced blood vessels that protect the brain from substances that might be harmful. The more effective a substance is at getting through the blood-brain barrier, the greater the effect it has on the person s mental status. Methadone and other opiates cross the blood-brain barrier quite easily. 

There are some reports by users that methadone use may cause hallucinations. While it is well known that heroin users often describe a dream-like mental state when using heroin, this effect is rarely seen in people who use methadone. The reason behind this is probably due to methadone s slower onset of action and reduced level of intensity. Likewise, while users of heroin and other harder narcotics sometimes report feelings of acute anxiety, especially when first using the drug, users of methadone rarely report these psychological effects. 

In the second study there were 174 patients in two similar experimental groups in whom injectable rather than inhaled heroin was used (5). A response to treatment was defined as at least a 40% improvement in physical, mental, or social domains of quality of life, if not accompanied by a substantial (over 20%) increase in the use of another illicit drug, such as cocaine or amphetamines. After 12 months those who took methadone and heroin (smoked or injected) had significantly better outcomes. The incidences of adverse effects (constipation and drowsiness) were similar in all the groups. However, owing to the limitations of the study and the complex nature of drug dependence, the therapeutic outcomes could not be justifiably and solely attributed to the specific drug(s). 

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