No Stupid Questions

There are no stupid questions. I have no knowledge to share on the subject of opioids, but it does make me wonder whether the reasons could be similar to why benzodiazepines are the only official drug that they treat benzodiazepine addiction with. The reason here being that there are no other known mitigating substances and a controlled detox is the only way out.

From the exact same Wikipedia article:

"The principal goals of methadone maintenance are to relieve opioid cravings, suppress the abstinence syndrome, and block the euphoric effects associated with opioids.

When used correctly in treatment, maintenance therapy is medically safe, non-sedating, and can provide a slow recovery from opioid addiction."

It's literally just an effective and proven treatment for withdrawal.

from what i understand, part of it is because methadone has a very long half life, which means that patients don't bounce from rush to crash every day but instead taper down slowly. also because it touches other receptors than opioid receptors in a way that helps in this case

Because with methadone, long-term success rates are significantly higher (60-90% vs 5-10%), relapse rates are far lower, withdrawal symptoms are massively reduced or eliminated, and methadone doesn't come with the euphoric high that most other opioids confer, which can have a major impact on the ability of a user to function normally.

Opiate withdrawal can kill I think, they give methadone to spread it out longer to make it easier on the patient. This is what I remember reading, but it's been a while so if I'm mistaken, apologies.

Unrelated to your question but a loved one of mine had a lot of success with Naltrexone to reduce addictive behaviour. It's on label for both opoid- and alcohol- use disorders, and sometimes used off label for others. It's covered by medicaid in my state so not sure how much it might be through regular insurance.

My pharmacology knowledge is basically non-existent, but I understand two things: 1) clinical addiction is a physiological dependency and can only be effectively treated through physiological means, and 2) in general, step-down treatment is a valid and more effective approach than total withdrawal.

Those two points taken together, I believe methadone scratches the same physiological itch that other opioids do, but without as many side effects. And if those side effects are more biological (eg causes vomiting or high blood pressure; idk) than physiological, then a treatment plan can include conventional medications to treat those side effects. Overall, the complex problem of opioid treatment is transformed into a smaller, manageable problem, which doctors know how to tackle.

Is it not-great that methadone is still in the family of opioids? Yes, but my concern is more about availability in some countries: in places that heavily restrict all opioids without regard for therapeutic uses, this can result in the unavailability of methadone to treat opioid addiction, something that otherwise has a wealth of research supporting its use for that purpose.

Doctors use what works! If the research says that methadone plus rehab is a more effective treatment for opioid addiction than just rehab, they'll use methadone plus rehab.

It's basically the same reason people use nicotine gum to help quit smoking. The cravings can be really tough to manage, so having something that allows you to reduce those gives you a much better chance to successfully quit.

Interesting note, you know what the treatment for severe alcoholism is? More alcohol! Alcohol addiction can get to the point where patients will literally die if they go cold turkey. Doctors can and do prescribe alcohol in those cases.

From what I understand, methadone is used to prevent or reduce withdrawal symptoms from other opioids without providing the same high, with the goal being to taper off eventually. That is safer and easier to accomplish with clinically approved opioids in regulated doses where purity is consistent across batches than with street drugs.

I think other comments already answered way better then i could but what i was tought is that going cold turkey with a physical addiction can cause shock and death.

Methadone is a very clean/pure opiod and the most safe one to give the boddy what it needs in decreasing amounts while therapy works on the psychological needs.