Methadone treatment Information for service users Page

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1 South London and Maudsley NHS Foundation Trust Methadone treatment Information for service users Page

2 What can happen if I stop using heroin? If you are addicted to or dependent on heroin, you develop withdrawal symptoms within a day or so of the last dose. Therefore, if you are addicted to heroin, you need a regular dose to feel "normal". Withdrawal symptoms include sweating, feeling hot and cold, runny eyes and nose, yawning, being off food, stomach cramps, feeling sick or vomiting, diarrhoea, tremor, poor sleep, restlessness, general aches and pains, and just feeling awful. Withdrawal symptoms tend to ease and go within five days. However, you may then have persistent craving for heroin, remain tired, and have poor sleep for some time afterwards. What can help with this? Methadone is a drug that is similar to heroin, but lasts a lot longer in the body. It can be prescribed by a doctor. If you take methadone, you are unlikely to get withdrawal symptoms if you stop taking heroin (or the symptoms will be much less severe). If you take methadone under supervision from this service, you are: more likely to be able to get away from the street drug scene likely to feel better in yourself more likely to achieve your life goals which may include stopping for good. You can use the blank page at the back of the leaflet to make notes about your treatment. Page 2

3 What does treatment involve? A typical care plan A nurse or drugs worker will briefly assess you and agree the next stage with you. This could be: an appointment for a fuller assessment with us an appointment with your GP, or another agency that can help you. What is an assessment? An assessment usually includes: taking details of your health and social situation taking details of your past and current drug taking, whether you need methadone a urine test to confirm the drugs you are taking finding out what you think you need agreeing a care plan with you which sets out what you want to achieve talking about how information is shared and who with, with your consent. It will also involve talking about: testing for hepatitis C and HIV hepatitis A and B and immunisations for these information about safer injecting and the risks you may be facing. Page 3

4 Starting off with methadone Methadone is started after assessment when the results of your urine test are back. The aim is to prevent withdrawal symptoms, but a methadone overdose can cause serious harm or death. So, at first, your doctor will prescribe a fairly low dose for your safety. You will be seen frequently to increase the dose. Be patient - this early stage is very important. The first dose is usually gradually increased to a regular maintenance dose. But you need to remember that: methadone takes 2-4 hours to reach peak effect methadone builds up in your body-you will feel a greater effect of the drug over a few days, even without an increased dose it may take a few weeks to get to the correct dose that prevents all withdrawal symptoms you should not take any street drugs or drink excessively when you are taking methadone, as there is a risk of overdose try to accept that you may have some withdrawal symptoms during this time. Page 4

5 How should I take methadone? You usually take methadone once a day. It is a liquid. We may ask you to take it under the supervision of a pharmacist (or at the drug service) who gives you your methadone. This supervision may be relaxed if you are stable and taking regular dose after twelve weeks or so. You will then be able take a daily dose home, gradually picking up less often as time goes on if you are stable. Once you are on a regular, stable dose of methadone you may stay on it for many months or even several years - this is called 'maintenance' and helps you to stop taking street drugs. Some people gradually reduce the dose and come off it. This is called detoxification or 'detox'. It may take several months or even years before you are ready to think about this. Care and review You will have a keyworker who will see you regularly to talk about how things are going and help you make plans for the future. Your keyworker may suggest that you need extra help from another service and will help you sort this out. You will also have the chance to look at your progress at regular intervals. Your keyworker will see you less frequently as time goes by if all is going well. Page 5

6 Some other points about taking methadone You are more likely to succeed if you have support from your keyworker, your family and friends, and maybe other self-help or voluntary groups in the area. Some prescribed medicines may interfere with methadone, for example some drugs used to treat TB and epilepsy. Tell the doctor who prescribes methadone if you are taking any other medication. Most prescribed medications can be taken in the normal way. You may be asked to have an Electrocardiogram (ECG) if you need a high dose. Other street drugs such as benzodiazepines ("benzos") and alcohol can affect methadone. It is best not take any other drugs, and don't drink too much alcohol as there is a risk of overdose. We will ask you to give a urine sample from time to time. If you live with young children we will talk to you about how to store your methadone safely so there are no risks to them. Are there any risks or side effects of the treatment? common side effects are constipation and sweating care needs to be taken in individuals with severe kidney or liver disease heart problems (arrhythmias) have been reported in those taking high dose methadone (100mg) and taking some other drugs overdose can be fatal, especially in the early days of treatment, in non opiate users and in children. Driving If you use illegal drugs, or are prescribed methadone or buprenorphine, you must tell the Driver and Vehicle Licensing Authority (DVLA). They may take away your driving licence until you can show you are drug-free. If you do not tell the DVLA, we will assess your risk and may have to tell them that you are still taking drugs. We will talk about this with you. Sometimes, people who only use prescribed methadone and buprenorphine may be able to keep their driving licences. Page 6

7 Notes Use this space to write down anything you want to remember or talk to your keyworker about. Page 7

8 South London and Maudsley NHS Foundation Trust Options available If you d like a large print, audio, Braille or a translated version of this leaflet then please ask us. Useful contact details SLaM Switchboard: SLaM 24hr Information Line - Advice on how to access SLaM Services: Contact our Patient Advice and Liaison Service (PALS) for help, advice and information: T: W: E: Complaints If you are not happy about something but not sure if you want to make a formal complaint you can speak to a member of staff directly. Alternatively you can contact the PALS Office on freephone If you decide you want to make a formal complaint this can be done by contacting the Complaints Department: Complaints Department, Maudsley Hospital, Denmark Hill, London SE5 8AZ T: (020) /2499 E: W: For the quickest way to plan your journey anywhere in greater London use journey planner: 00 (hrs) Date of Publication: Reference: 04/07/2011 lc Page

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