One of the most prominent issues in a first world country such as Canada relates to the abuse of illegal street drugs such as heroin. Thus, any treatments involving drugs are controversial, as addiction is extremely difficult to overcome. In order to gain a holistic understanding, it is vital that this issue be studied from varying perspectives including, but not limited to social, physiological, and psychological (Treatment, Rettig and Yarmolinsky, 1995). Fortunately, the recent implementation of methadone to treat patients may prove to be an effective form of treatment.
Methadone (refer to Fig. 1) is a potent synthetic analgesic, thus having a similar function to morphine. One key difference between the two is that methadone takes longer for symptoms to withdraw. However, this results in less severe symptoms and a longer treatment time (Methadone, 2019; U.S. National Library of Medicine, 2019). To understand how methadone works, it is important to understand its mechanism and mode of action.
Methadone is a weak agonist of narcotics (refer to Fig. 2) and contains a very long half-life, which allows for two things to happen: 1) decreased symptoms involving narcotic withdrawal and 2) decreased euphoric effects of other drugs (Kheradmand, Banazadeh and Abedi, 2010; Anderson and Kearney, 2000; Peng, Tumber and Gourlay, 2005). It is a full µ-opioid receptor agonist, and as a result, it is able to mimic many of the body’s naturally produced opioids and endorphins (Methadone, 2019). Once methadone is present within the body, the associated neurotransmitter released will act as an opioid and lower pain transmission. Furthermore, it is also an N-methyl-D-aspartate (refer to Fig. 2) receptor antagonist, blocking a major excitatory pathway involved with the pain receptors (Methadone, 2019; Anderson and Kearney, 2000). On a physiological level, methadone binds to body tissues and limits the production of plasma total, which allows for the prolonged pharmacological actions of methadone (Treatment, Rettig and Yarmolinsky, 1995). One possible idea that is currently being implemented involves the use of the Methadone Maintenance Treatment (MMT), as this involves a daily monitored intake of methadone with the final goal being narcotic withdrawal (Kheradmand, Banazadeh and Abedi, 2010; Anderson and Kearney, 2000).
This is a program which involves giving a patient methadone hydrochloride to substitute the current opioid they are addicted to. In summary, patients will check in with an authorized doctor with methadone training to receive a defined dose every day. Depending on the severity of addiction, it may take an entire lifetime to completely eliminate any narcotic withdrawal effects (Anderson and Kearney, 2000; Kheradmand, Banazadeh and Abedi, 2010; Treatment, Rettig and Yarmolinsky, 1995; Joseph, Stancliff and Langrod, 2000).
Overall, methadone has also proven to generally improve the lives of those addicted to opiates. One study conducted showed that the MMT program reduces crime, transmission of diseases such as HIV and lowers the death rate related to addiction (Kheradmand, Banazadeh and Abedi, 2010). However, a general stigma exists within the general public since patients on the MMT program are still associated with the idea of “abusing drugs”(Anderson and Kearney, 2000; Joseph, Stancliff and Langrod, 2000).
Moving forward, it will be crucial to educate the public regarding drugs that are used to combat the effects of more potent drugs, as this is proving to be an effective technique in helping reintegrate patients back into society.
References
2-Minute Neuroscience: Methadone. 2019. Available at: <https://www.youtube.com/watch?v=dw6laQ4-Zgs> [Accessed 18 Nov. 2019].
Anderson, I.B. and Kearney, T.E., 2000. Use of methadone. Western Journal of Medicine, 172(1), pp.43–46.
DrugBank, 2019. Methadone. [online] Available at: <https://www.drugbank.ca/drugs/DB00333> [Accessed 30 Oct. 2019].
Joseph, H., Stancliff, S. and Langrod, J., 2000. Methadone maintenance treatment (MMT): a review of historical and clinical issues. The Mount Sinai journal of medicine, New York, 67(5–6), pp.347–364.
Kheradmand, A., Banazadeh, N. and Abedi, H., 2010. Physical Effects of Methadone Maintenance Treatment from the Standpoint of Clients. Addiction & Health, 2(3–4), pp.66–73.
Peng, P., Tumber, P. and Gourlay, D., 2005. Review article: Perioperative pain management of patients on methadone therapy. Canadian Journal of Anesthesia, 52(5), pp.513–523.
Treatment, I. of M. (US) C. on F.R. of M., Rettig, R.A. and Yarmolinsky, A., 1995. Pharmacology and Medical Aspects of Methadone Treatment. [online] National Academies Press (US). Available at: <https://www.ncbi.nlm.nih.gov/books/NBK232112/> [Accessed 31 Oct. 2019].
U.S. National Library of Medicine, 2019. Methadone. [online] Available at: <https://pubchem.ncbi.nlm.nih.gov/compound/4095> [Accessed 30 Oct. 2019].
Comments
14 Responses to “A Drug that Cures Addiction to Drugs?”
Hi Jonathan,
I really liked this blog, it did a really good job of explaining, the only thing I would add is a picture of methadone acting on the N-methyl-D-aspartate receptor. This would help enhance the understanding of this mechanism.
Overall really great post,
Jonah
Hi Jonah,
Thanks for taking the time to read my blog post. I have tried to look for an image which shows methadone acting on the NMDA receptor. However, it has been hard to find an image that shows the entire mechanism and mode of action. But, I definitely agree with your point.
Cheers,
Jon
Hi Jonathan,
Great blog post! This is a very interesting topic and you did a good job of explaining the chemistry behind methadone. I just have a few suggestions for you:
– Don’t forget to add a comment describing why you wrote this blog post
– I would centre your image so it aligns with the figure caption
– This sentence from your second paragraph is a bit confusing, so I’d consider rewording it or splitting it up into 2 sentences: “However, unlike morphine methadone takes longer for symptoms to withdraw, though this results in less severe symptoms and a longer treatment time”
Overall, good job and I look forward to seeing your final blog post!
Gemma
Hi Gemma,
Thank you for reading my blog post. Your feedback is greatly appreciated. I have made the appropriate changes, so hopefully this makes my blog post flow more smoothly!
Cheers,
Jon
Hey guys,
Sorry for the late response, I completely forgot about writing a comment to explain why I chose my blog post! I chose to write about methadone because I currently work at a pharmacy, and filling drugs for patients has naturally lead me to wonder what the function of each drug is. Since in second year we are learning about drug discovery, I thought it would be really interesting to see how the mode of action of methadone can help patients addicted to heroin or other opioids. I welcome all comments, suggestions and feedback!
Cheers,
Jon
Hi, Jonathan. This is a strong first draft!
Here are some suggestions for edits:
In your first paragraph, you say that “Fortunately, the recent implementation of methadone to treat patients may prove to be the most effective treatment”. Consider denoting it as the ‘most effective treatment yet’, since it may be subject to change due to future advances.
In your second paragraph, “However, unlike morphine methadone…”, there should probably be a comma after morphine. Also, that overall sentence may need to be broken down into two or more sentences, since it has some properties of a run-on sentence.
In the sentence, “To understand how methadone works, it is VERY important to understand its mechanism and mode of action.”, it may be somewhat redundant to use the word ‘very’.
In your fourth paragraph, “..a SET dose every day…”, perhaps change ‘set’ to ‘defined’ or some other synonym.
Overall, this is well done!
Keep it up,
– Michael Celejewski
Hi Michael,
Thank you for your feedback and suggestions. I have made the changes you have suggested. I also greatly appreciate the words of encouragement.
Cheers,
Jon
Hi Jonathan,
Excellent blog post, this was a very captivating and fascinating read. I love reading about drugs and their implementation in society, and this was truly something that I found really interesting.
As it was so well-written, I only have a few suggestions for the final version:
1) I would consider rephrasing the following sentence, “This issue must be analyzed with many changing perspectives including, but not limited to social, physiological and psychological (Treatment, Rettig and Yarmolinsky, 1995).” to something along the lines of, “Thus, in order to gain a holistic understanding, it is vital that this issue be studied from varying lenses, such as social, physiological, and psychological perspectives (Treatment, Rettig and Yarmolinsky, 1995).” I believe this would help increase the flow of the sentence.
2) I would consider combining the final two sentences of the concluding paragraph to make it flow better and emphasize its societal impact by saying, “Moving forward, it will be crucial to educate the public regarding drugs that are used to combat the effects of more potent drugs, as this is proving to be an effective technique in helping reintegrate patients back into society”.
Overall, great work! I wish you the best with your final edits.
Thanks,
Saif
Hi Saif,
I am glad that you found interest in this blog post! Thank you for your feedback and suggestions. I have made the changes you have suggested.
Cheers,
Jon
Hi Jonathan,
This was a super interesting blog post! I’ve heard about methadone before so it was cool to read more about it. I just have a few suggestions:
– I don’t think you need a comma before “such as heroin” in the first sentence
– Consider adding a comma after “unlike morphine” in the second sentence of the second paragraph
– Check the reference for the end of that sentence as well, it seems that you cited the title of the webpage instead of the author. Also, be careful of the quality of references you’re using, consider using a scientific article that details the information you’re using rather than DrugBank
Happy editing! 🙂
Peipei
Hi Peipei,
Thank you for your comments and suggestions. I have made the appropriate changes. Although I agree that DrugBank is not a scientific article, as stated by Dr. T-B in class it is a reliable database. Thus, I believe that it is a credible source that can be cited.
Cheers,
Jon
Furthermore, regarding the PubChem site, the link directs you to a webpage created by the U.S. National Library of Medicine. There is no author to be found and this is why I have cited the webpage instead of the author. However, I will cite the “U.S. National Library of Medicine” instead as the corporate author.
Hi Jonathan,
First of all, your post is really great. It focusses on a very significant issue in modern society and you demonstrate knowledge regarding a potential solution in a solid manner. I particularly liked how you mentioned the stigma surrounding the concept which I think is extremely important.
In terms of suggestions, I think that it would be great if you could elaborate a little bit more on the recap aspects of the conclusions. Additionally, I think that mentioning the stigma surrounding the concept should not be done in the conclusion and should be introduced somewhere within the body of the post. That way you elaborate on it a little bit more while still maintaining that short summary aspect in your blog post. I also think that you could really benefit from expanding on your introduction a little bit more. I think adding a little bit more information about addiction in general, could really strengthen the blog post overall as readers will have information regarding the prominence of addiction while reading about methadone as a solution.
Overall, I really enjoyed your post and I hope that these suggestions were helpful.
Best wishes!
Zach
Hi Zach,
Thank you for your interest in my blog post. It is clear that you were captivated by the topic, and as such have learned a lot from this blog post. Regarding your suggestions, due to word count limit restrictions, unfortunately I cannot make all the changes. I will however, aim to reword some sections so that blog post is strengthened.
Cheers,
Jon