Does methadone simply substitute one addictive drug (such as heroin or prescription pain medications) with another (methadone)?
Methadone Maintenance Treatment (MMT) is a form of drug replacement therapy, using a medication (methadone) to overcome the compulsive need for other opioid drugs (such as heroin or other abused opioids). While the person is, indeed, physiologically dependent on methadone, the pharmacologic actions of methadone are quite different from addictive opioid agents – methadone is not a mere substitute.
An analogy is how prescribed insulin is used as replacement or “substitution” therapy in an individual with diabetes. The person remains “dependent” on insulin; however, a chronic disease condition is kept under control and effectively managed by the administration of a licensed, prescribed medication.
With adequate methadone, addictive behaviors cease. Persons on methadone may not be “drug-free”; however, they are being helped to overcome the debilitating influence of illicit opioids and lead to healthier, more normal lives in recovery. It also is important to note that the behavioral hallmarks of true addiction – such as unsuccessful efforts to cut down on drug abuse, the endless search for more drug, avoidance of obligations in pursuit of drug, and use despite personal harm – are eliminated during MMT.