Methadone patients commonly think it’s okay to use other substances because they’re not “addicted” to those. As with any medication, it’s important to be aware of possible interactions with other drugs as well as cross addictions.
It’s easy to get trapped into switching one drug for another. Usually, it’s because the individual has not received counseling and education to help resolve old issues or improve relapse prevention and life skills. The intended goal for any methadone treatment program is total abstinence.
Mixing illicit and even legal substances like alcohol can not only endanger a recovery program, but could be fatal. In this post, we’ll examine common questions we get about methadone interaction with other drugs and how to protect yourself in your methadone treatment program.
Methadone’s Interaction with Other Opioids
Using methadone with other opioids is extremely dangerous. For instance, a methadone and oxycodone interaction can increase the risk of respiratory depression, hypotension, coma, overdose and death. The same is true for mixing methadone and hydrocodone, heroin or any other known opiates.
Opioid overdoses have continued to rise and should be taken seriously, especially by anyone in a methadone treatment program. However, if someone starts to overdose from a methadone and oxycodone interaction — or any other opioid — a dose of Narcan can be a lifesaver.
Narcan is an antagonist medication used to reverse the effects of opioids and prevent overdose. When a methadone recipient, or anyone using opioids, is given Narcan, they immediately have withdrawal symptoms. Narcan only lasts a short while and an individual can go back into an overdose once it wears off. Therefore, it’s important to seek medical attention immediately.
At MedPro Treatment Centers, we have started training our patients and their family members how to use Narcan in case of an emergency. They also receive a dose of Narcan to take with them. Many states have equipped first responders with the medication and in most states, Narcan is available without a prescription.
Methadone and Benzodiazepines: A Fatal Combination
Benzodiazepines like Ativan, Valium and Xanax are typically prescribed for sedation, anxiety, alcohol withdrawal and seizures. A dose of methadone will immediately be less effective if the person is taking benzodiazepines, whether they are prescribed or illicit.
Taking methadone and benzodiazepines at the same time can be deadly. Both medications affect the central nervous system causing a synergistic effect. Additionally, they can slow breathing and cause fatigue, which is often the deadly combination for overdoses.
Due to the deadly combination, the FDA released a “black box warning” — their most severe — stating that opioids and benzodiazepines should not be used together.
All prescribed medication, over-the-counter medication, and illicit use should be reported to a counselor and physician for safety and prevent medical complications.
The Dangers of a Methadone and Alcohol Interaction
Alcohol is often a sensitive subject in methadone treatment as patients believe it’s okay because they never had a problem with alcohol in the past. However, alcohol can and will deplete the methadone in your body before it is fully absorbed. Since your therapeutic level of methadone is being shortened, you won’t receive the full benefit of methadone maintenance therapy.
Taking methadone is no different than taking other prescribed medication. There are usually warnings on prescription bottles about possible drug interactions or side effects, but for methadone, there’s not a constant visual reminder for patients.
Additionally, a methadone and alcohol interaction can impair performance, cause liver damage, reduce oxygen in the respiratory system and even result in death. Any patient in a methadone treatment program who is currently drinking alcohol should immediately contact their doctor and counselor.
How Methadone Interacts with Marijuana
Marijuana is a controversial topic for most of the country, and federally, it’s still considered an illicit substance.
All methadone clinics in the United States are regulated by the DEA (Drug Enforcement Agency), which is a federal agency, so marijuana use is considered illicit use in our clinic.
Despite that, another concern is marijuana’s interaction with methadone. Marijuana is much like alcohol, in that it will deplete the methadone in your body before it is fully absorbed, causing patients to receive much less than their actual dose.
When methadone is not absorbed at a therapeutic level, it can cause you to go into withdrawals. If it seems like your dose is not lasting a full 24 hours, this may be the reason.
Can “Safe” Substances Be A Trigger For Relapse?
“Safe” substances is a subjective term, but may include things like caffeine, ibuprofen, vitamins, or other over-the-counter medications.
Over-the-counter medications, like Tylenol PM and Benadryl, may trigger relapse because their side effects are similar to opioids with slower breathing and drowsiness. These substances may affect the central nervous system, which is also affected by methadone and Suboxone.
So, even though these over-the-counter medications are not dangerous to the public at large, they are a treat to a methadone patient. That’s why we recommend patients sharing any and all medication they take with their doctors and counselors. What may seem like a small thing could be a huge detour in a patient’s recovery program.
Protecting Your Recovery from a Methadone Interaction with Other Drugs
The best thing a patient can do for their recovery is educate themselves! It’s important to understand the addiction process, prepare a relapse prevention plan, and participate in treatment.
Participating in a medication assisted treatment program means patients are responsible for understanding all components of this level of care. It’s more than just taking medication daily.
Medication assisted treatment has a higher chance of success if patients are active in all parts of the program. This includes individual counseling, group counseling, and life skills education.
Methadone patients are responsible for their own recovery and for gaining the skills and education to aid them in maintaining sobriety. It can be very empowering, and the team at MedPro Treatment Centers is here to help.