Talk:Methadone

Foucaldian critique

I am probably fighting a losing battle, but I think the prominent place given to this critique is not appropriate. It's essentially saying that methadone is no different than heroin (or only different in terms of its legal status) which is not true. This misinformation could have a real effect on public health. 173.167.251.225 (talk) 16:57, 3 March 2023 (UTC)

I agree with you on this. Methadone is an OLD drug, discovered in the 1940's when the Allies took German scientific research once they had dispatched the Nazis. The scientists that created it, the original German scientists, didn't see a place for methadone, they found it to be just too toxic. But we thought it could serve a purpose as a powerful painkiller that was completely opium free! Well, in the mid 1960's, a pair of doctors, Dr. Vincent Dole and Dr. Marie Nyswander, were doing experiments with the idea of opioid substitution. They tried morphine, hydromorphone, levorphanol, a brand new molecule called fentanyl, metopon, dihydrocodeinone, codeine, and methadone, among others. Every other opioid would cause the person to nod out and then when it wore off the person would be violent and aggressive. But methadone seemed to calm people down. People who hadn't painted in years were asking for art supplies, and conversation seemed to come easily to the normally jittery, drug craving, angry people. It was night and day. They presented their findings and the race to open the first clinic was on. Methadone has saved so many people, myself included. Yet we have states like West Virginia who have been trying for a while to make methadone clinics ILLEGAL, as they see it as enabling addicted people instead of looking at the data in regards to how many people have been saved because of it. Methadone produces a tolerance, and once it's sat in, you are immune to opioids. They don't work. So now you're in a position that even if you got a rig ready it wouldn't do a thing. Your mind really starts to let go of the dope. My whole point is, methadone is VILLIFIED. It's called poison. Indiana (where I am) only allows like a really small amount of clinics, and they have to be spaced 50 miles apart or some BS. The comparison of methadone and heroin is extremely inappropriate and impossible to do. Methadone has a very high, albeit variable from person to person, oral bioavailability. Swallowing the tablets or the syrup is literally the most effective way to take it. Heroin needs to be administered directly into the body. You could technically swallow enough to elicit an effect, you'd be wasting it big time. A shot of heroin rushes to your brain and slides on in, concentrating the rush and euphoria and the warm hug the universe wraps you up in is because the brain is a fatty organ, so the initial concentration is found in your brain. But that high concentration slowly dissipates into the rest of your body, and the intense euphoria is no more. You are trying to recreate the feeling you had the first time you shot up. You chase that. You're chasing the intense rush of a shot, that feeling in particular is the driving force of your opioid addiction. Everytime you inject tar, you are risking your life, compromising your immune system, there's a risk of developing absecesses at the injection site, but if you don't take some heroin every 6 hours or so, you get violently ill. You are chasing that rush. But you're tired of the chase, finding a good vien, collapsing veins permanantly, nodding out instead of actual sleep. But you can't get sick for a week, you have a family to support, you just can't take a week-long vacation to bed, so I guess I just keep shooting the heroin. But then, you see an old friend, and she looks amazing! She was the wildest party girl at one time, there's nothing she wouldn't do. But she's in a business suit that had been pressed and she smells like sunshine and kittens. You can't believe she went from puking off the roof and served as the cameraman if anyone wanted to have sex and make a video to GirlBoss? She has one word. "Methadone". Thank you for the comment, good sir(s) Kchollingsworth67 (talk) 22:56, 12 May 2026 (UTC)

Waiting 15-20 minutes after dosing before you can leave is bad information

So the article says that 'some' clinics make you wait 15-20 minutes after you dose before you can leave, to make sure you aren't going to run out and puke your methadone up into your friend's mouth.

There is not one clinic I have come across that makes you wait to leave. I'm in the methadone community on Reddit and have even asked this question to ths group: "does your clinic make you wait 20 minutes after you dose so the methadone can get completely absorbed and you can't throw up in a jar and sell it?" No one said yes.

Now, this might have been true in the early days of methadone, there were more security measures in place to prevent diversion. 40mg of methadone could kill someone who is 'opioid naive', meaning they have never taken a narcotic analgesic before. I take 130mgs a day, and I was up at 210mg a little while ago, so there is a real risk when the highly potent, incredibly long lasting, lipophilic NDMA antagonist, serotonin/norepinephrine reuptake inhibitor, CYP3A4/CYP2B6 ligand known as methadone.

I just think the line about 'some clinics make you wait 20 minutes to prevent diversion' is out of touch, makes methadone sound too complicated, and isn't factual.

Thank you and good luck. Kchollingsworth67 (talk) 21:38, 12 May 2026 (UTC)

Its the World Health Organisation guidelines and I am a lot more inclined to go with those than the word of a self-admitted junkie. Traumnovelle (talk) 09:59, 13 May 2026 (UTC)

No need to raise an editor's personal status here. WP:MEDRS doesn't care if you're a junkie, a mobile health clinician, or the ER chief doc. Instead, need published secondary review articles or other authoritative publications rather than anecdotes or unpublished personal knowledge. DMacks (talk) 10:05, 13 May 2026 (UTC)