Methadone – The History of Juice

Chemical structure of methadone.

Methadone's chemical structure

The Methadone Myths…

Methadone was first synthesised in Germany in 1938 by chemists working for IG Farbenindustrie. There are several widely-circulated stories about the birth of methadone which are of doubtful veracity. It is often said, for example, that the new pharmaceutical was dubbed Dolophine in honour of Adolf Hitler. In fact, it was originally tagged with the unimaginative name of Hochst-10820 (Hochst being the name of the factory where it was invented), and later named Palamidon. Another widely-circulated story has it that the chemical was synthesised for use as an analgesic, eliminating Nazi Germany’s dependence on Turkish opium for morphine, or that it was created on the personal orders of Reich Marshal and Luftwaffe commander Hermann Goering, a heroin addict, to ensure that cold turkey could be kept at bay if supplies of morphine were cut off. Attractive as this last story is, and while it is true that Goering was a junkie, it is probably apocryphal.

Methadone was not brought into wide production during the war at all, and its properties were only studied later. After the war the Hochst factory fell into American hands and as a part of the wholesale plundering of German scientific and technical knowledge (which saw V2 rocket technology and Nazi advanced weapons and intelligence expertise appropriated by the US military-scientific establishment under Operation Paperclip) the methadone molecule too, ended up as loot of war.

More Than Morphine?

It was the American pharmaceutical company Eli-Lilly who began the first clinical trials in 1947 and it was here that it was first christened Dolophine, probably derived from “douleur” and “fin”, the French words for, respectively, “pain” and “end”. The chemical was found to have a similar pharmacological action to morphine, despite its very different chemical structure, and it was much longer-acting. Once these facts were established, methadone disappeared into obscurity in the USA for over a decade. While its chemical cousin pethidine – which, incidentally, was produced in bulk in Nazi Germany as a morphine substitute -and is still used today to ease women’s labour pains, methadone never really caught on as a narcotic analgesic in America.

The earliest accounts of methadone use in the UK are from 1947, when a paper published in the medical journal Lancet described it as “at least as powerful as morphine, and ten times more powerful than pethidine”.

Methadone Treatment

By the end of 1968, the year when the Home Office notification/registration system of addicts was introduced, 297 people had been notified as being addicted to methadone. Doctors who thought it less addictive than other opiates had begun prescribing them the drug however, through the 1960s, patterns of drug use were changing; Opiate addiction, which had until then, primarily been an indulgence of the wealthy (or medical professionals themselves), was now being picked up by younger people, taking opiates for pleasure rather than for pain.

1968 also saw the introduction of drug treatment clinics and the abolition of free prescribing. The clinic system effectively removed the GP’s discretion in the prescribing of controlled drugs and specialist centres took over the treatment of the majority of dependent drug users, a practice that continues today. In the first years of the clinics, doctors freely prescribed pure pharmaceutical heroin and methadone in injectable form for addicts. The introduction in the mid 70s of smokable Middle Eastern brown heroin resulted in many users arriving for treatment not expecting to inject their drugs, encouraging the clinics to move towards using oral methadone for treatment.

Methadone Maintenance – The Minimum Vs the Maximum

Methadone maintenance treatment, as we recognise it now, was pioneered in the USA in the early 60s. In 1963, two New York doctors by the names of Marie Nyswander and Vincent Dole began exploring methadone as a possible treatment for opiate addiction. There was a screaming need for it – by the end of the decade, heroin-related mortality had become the leading cause of death in New York for young adults aged between 15 and 35. Dole and Nyswander identified the features of methadone that made it a suitable maintenance drug. At doses beginning at 80mg per day, it effectively blocks the euphoric effects of all opiate drugs. Patients stabilised on methadone do not experience euphoric effects and tolerance does not develop like many other opiates, necessitating ever-increasing doses. Tolerance to methadone’s pain-killing effects does develop however, meaning patients experience pain normally although trying to explain this to a nurse or doctor when you’re in A & E is another matter entirely. As it is a long-acting drug, it can be administered once a day, enabling a greater level of stabilisation as compared to shorter-acting opiates.

Nyswander and Dole operated on the premise that heroin addiction is in effect a metabolic disorder, comparable perhaps to diabetes. Large doses of methadone – 80 to 150mg – were used to normalise the disorder, as insulin is used for diabetes. They combined this theory of treatment with efforts at psychological counselling and social rehabilitation, including help and encouragement in finding work. Many of their patients benefited greatly from the treatment and were successfully re-integrated into “normal society”, such as it is. The use of the treatment spread, but was not necessarily implemented with the innovation displayed in the work of Nyswander and Dole. For example, more than half of the USA’s 120,000 methadone patients today are treated with dosages well below those recommended by their research.

The Trials of Treatment

The innovation and courage of the two New York doctors’ work has to be seen in the context of the American drug laws, which have been considerably more draconian than the UK’s ever since the 1920s. From 1922 it was, for example, a crime for a doctor to prescribe a narcotic to an ‘addict’. By 1938, an astonishing 25,000 doctors had been prosecuted on drugs charges, and an equally astonishing 3,000 had served prison time. Often these convictions were secured by bribing users with drugs, effectively scaring doctors away from the whole field of treatment of addiction. When Dr Dole was approached by Federal narcotics agents and threatened with being “put out of business”, he courageously dared the Feds to drag him into court, so that a proper legal ruling on the whole question could be made. They left him alone.

Although there are thought to be at least 90,000 patients (2008) on methadone in the UK today, the state of methadone maintenance in the UK varies from health district to health district, and from the NHS to the private sector. The whole area of opiate addiction treatment is always politically contentious, the most recent example of prescribing under fire being the General Medical Council hearings on Dr Colin Brewer and the Stapleford Clinic doctors (we covered this issue in issue 11 after the court case -ed).

The Pro’s and the Con’s…

More than twice as many people die each year from methadone as they do from heroin. (2006). Further, while physical withdrawal from heroin is over in a week, for methadone the sickness can carry on and on and on, for a month or even longer. These two facts are often cited by opponents of methadone treatment, who include both Daily Mail-reading junkie-hating chemical puritans, and experienced ex-addicts.

Connoisseurs of opiates, on the other hand, complain that methadone lacks the euphoria and intensity of heroin. Methadone feels different. While it is an opiate, it is not like heroin and maintained methadone users regularly talk of side effects such as lethargy, depression and fluid retention amongst others (injectable meth ampoules pose other health problems yet to be properly investigated). Dosage problems such as under prescribing or the ‘capping’ of doses are common despite national guidelines that state clearly amounts of 80 – 120mgs are most effective for maintaining opiate users in treatment. Many users can wait up to 6 months or more for doses of around 40mg.

Methadone has its place. There are no easy and painless solutions when it comes to opiate addiction. Methadone, so far as it has unquestionably helped some people to live a better life still has its place but importantly, any universal one-size-fits-all solution, like methadone and it’s blanket prescribing approach for all opiate addictions, is bound to leave many dependent users hanging.

Mike Haskins Black Poppy issue 8

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Proper Nutrition for Methadone Detoxification (brighthub.com) NOTE: this is a very negative text on methadone however it does have some interesting nutrition info for people on methadone.

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15 Comments

  1. Brandy

     /  October 4, 2016

    I was just curious because someone just said that liberals are to thank for methadone clinics but what I’ve read it was the nazi who invented and Nixon who is a republican who signed the bill for openings of clinics because there was only doctors prescribing methadone. Can you please clarify who is to thank for clinics is it republicans, liberals, nazis or all of them ? I just need to know so I can respond to her insults with facts

    Reply
  2. Peeshqua

     /  September 19, 2015

    While I battled both heroin and methadone addiction for 30 yrs, I can tell you that Methadone is FAR worse. The EU has the right approach. The US is in the stone age with treatment and its war on arresting low level addicts. I myself have been thru the NYC jail system 40 times for possesion. I’m now clean from everything and I did it myself. It took 2 years to detox myself using methadone that I bought from an illegal supplier. When I finally got down to 5 mg, that’s when it really became difficult. I even started taking 5mg every other day, then every third day, then stopped. I didn’t sleep for 6 months and my circulation left my hands and feet buzzing. Have no allusions my friends, It is HELL! I don’t recommend this unless you are determined to get clean, otherwise stay at your clinic and remain a slave.Ther is a cost for everything we do in life. This was the most expensive thing I ever experienced. I’m now 57 yrs of age and hopefully will die free of drugs when my time comes. I wish you all health, happiness and the ability to stay sober.

    Reply
  3. Ashes

     /  October 28, 2014

    I’ve been on opiates for about ten years now. I’ve been taking methadone for the past five. I started off going to a methadone maintenance clinic, but the clinic was two hours from where I lived. For five or so months I traveled six days a week to get my medicine. Saturday’s I was sent home with a dose for Sunday. It was exhausting, scary, and just annoying. I couldn’t keep it up, it was too expensive, I was spending about $1,000 a month on medication and gas. So in order to not get sick, I had to buy it off the streets and that’s what I continue to do to this day. It’s scary not knowing if I’m going to have enough to get me through the day, week, or month. If I can go to a private doctor this would solve my problem. I wouldn’t be breaking any laws, I wouldn’t have to worry about getting through the day, or if I’m going to get sick because I can’t find enough. My old doctor, who once prescribed me suboxone, told me how she wished she could prescribe me methadone because she knew how much it worked for me. The suboxone just didn’t work. I was constantly nodding off on it and I even had an allergic reaction to where my lips swelled up! I’m not a bad person. I’ve never been arrested, I’ve had one traffic ticket which was for having my phone in my hand while driving. I take great care of my kids, they get good grades, they have great attendance, go to school dressed nicely with their hear combed and homework done everyday,they have everything they need and want and more. But I could have all that taken away from me if I was caught with my non prescribed medicine. I can go to jail/prison for something I’m doing to my own body. It is beyond my understanding why drug use is so looked down upon. Yes I understand there are violent drug users, but there are so many users who are not violent, who wouldn’t hurt a fly, who are genuinely kind, caring, and compassionate people who just happen to need certain substances to help them live. I just hope one day this bullshit war on drugs will end and we can all truly live FREE like we are meant to.

    Reply
    • Hi, if you would like to email me directly we could try and see how we could try and help you get scripted on methadone? Have you contacted NAMA? Im assuming your in the USA but maybe youre not? I would be happy to see if there is someone near you who could advise about a private doc or some way to get scripted? Yes, it is desperately upsetting re the drugs war, but we are fighting back! Go to http://www.inpud.net -a global network of drug user activists fighting to end the war on drugs! Things are changing, one step forward two steps back….good luck, let me know if we can try and help? Erin x

      Reply
      • ashes

         /  November 3, 2014

        Hey Erin. I would love to email you directly. What is your email? I do live in the USA, Northern California. I live in a small city and have been told by a few doctors that they cannot personally prescribe me methadone for opiate dependence. They can only prescribe it for chronic pain. But once they find out I’m an opiate user or (abuser in their mind) they say they cannot possibly prescribe me narcotics. They tell me to get in the suboxone program we have here, which I have done. I’m treated like I’m worthless once they find out my story. They even have stated that I don’t “look like an addict.” Anyway, thank you so much for getting back to me so fast! When I came across this site I was so elated to know there are people just like me, that know exactly what I’m going through, and are fed up with being treated like trash. I appreciate all and any help I can get. Thank you Erin

      • Ashes

         /  November 23, 2014

        Hello Erin, I would love to get some help from you! My email is ashley_martin@hotmail.com. Email me when you have the time. Thank you for getting back to me. I appreciate it very much!
        ~Ashes

  4. Felicia

     /  September 12, 2014

    I work at a for profit methadone clinic I have seen people turn there life around by being maintained on methadone .You can’t tell they take anything most would stay on it but the price is 5000 per year these people work at low wage jobs now I see girls selling their body to pay the clinic in other countries the government pays for methadone treatment like England . Methadone is very cheap like Tylenol is but with all the rules. There are state rules federal rules local rules Dea rules in the U.S. the price has doubled in the last 5-6 years because of all the government red tape and rules. I feel sorry for them having to hold a job while driving to a medical appointment everyday before going to work who could hold down their job under such conditions and no one even counts the cost to get to the clinic 7 days a week only in the U.S. could this happen while the law and rule makers live off 10 times the pay methadone maintained people make. If it was free a lot of addicts would stay in treatment and the harm and cost reduction to society would pay for the methadone which cost about 15 cent per dose..

    Reply
  5. Lisa

     /  December 7, 2013

    Was heroin addict 25 years $60.00 a day, also methadone for the last 34 years. Clean from boy for 17 years, but the price on my clinic is over $730.00 a month!! And in La. they DONT take MEDICAID/ MEDICARE!! HUSBAND AND I ARE BOTH OVER 100 MGS. CANT JUMP OFF THIS LIKE HEROIN, WOULD KILL US. WHY ISNT SOMEONE IN POLITICS IN LA. LOBBYING FOR US OLDER AND ALL THAT CANT AFFORD THE METHADONE, WE ARE BROKE AT END OF EVERY MONTH!!!! PEOPLE, HELP US LA. ADDICTS…SEND E-MAILS TO CITY COUNCILMAN. PLEASE P.S. ALSO TIRED OF BEING TREATED LIKE A PIECE OF TRASH BY ALL THE STAFF AT CLINICS. HRLL, I GRADUATED COLLEGE AND HAVE A 23 YEAR OLD COUNSELOR ASKING ME ABOUT MY GOALS IN LIFE. I AM IN MY 50 FOR GOD SAKES.. SOMETHING MUST BE DONE

    Reply
    • Lisa – we know what you are talking about EXACTLY!!! It really sucks, the hypocrisy and ignorance of those in power about the drugs issue. There is an organisation in the States called NAMA, a methadone patients association found at http://methadone.org/ and they are all about lobbying for better conditions for people on methadone. Also on an International level, there is INPUD, the International Network of People who Use Drugs who fight for us at United nation level on issues such as HIV, Hep C, treatment, criminalization, harm reduction etc. There website is being redone at mo but you can see lots of news from them at http://inpud.wordpress.com. I am an INPUD member, you can be too, and in fect there are some fabulous organisations doing great things as drug user activists in the USA (and all around the world). Ill find out for you wo is available in LA in case youd like to go and see them. Tey will be drug users like yourself but politically minded and strong on cange and challenging ignorance and discrimination of drug users! Go get ’em! BP x (ill write back with details of LA group).

      Reply
  6. ash

     /  December 2, 2013

    i know this comment section is dead but methadone hasn’t come far at all. Addicts are still treated like cattle being led to slaughter. The rules and regulations make having a normal life near impossible. 4 meetings a month, daily vistits to dope up, usually before work. I went to a place that opened not until 7 a.m. Very high commute area too. How the hell you gonna tell your boss you can’t make it by 8 a.m. cause your methadone clinic opens late? That’s the kind of stuff and draconian rules that keep people done but it can be fixed. Allow addiction specialists to prescribe it in an office just like the do subutex and suboxone. Hell, my dr is pissed off because peole are dropping dead off suboxone and it’s been touted to them as some miracle drug for addiction. That’s even worse than methadone because I think agonists/antagonists wreak havok on your brain and physical body. (In my experience it was horrible, i tried it for 4 months and had horrific side effects)

    Reply
    • evHi there! No our comment section isn’t dead at all, we just operate in junk time so sometimes we are fast, as in instant replies, and other timez, a few weeks overdue. Or maybe even a bit later still if things are hard. But we will ALWAYS do our utmost to answer your questions and in fact I have just enlisted a very skilled dude indeed to help out in this section just so we get to you quicker. Now, re your response; damn right! Damn right we have only JUST moved out of the dark ages re drug ‘treatment’ and methadone clinics are too often places of ‘unbridled, unregulated power and of reprehensible attitudes held by staff and of humiliation and powerlessness for the drug user…”
      My friend, it sounds like u need to join forces with some drug user activists – if u let us know what state/country you are in we can pass on the contact details. Its high time we all began the fight back. Thousands of us are doing it – from the street to the united nations. Be sure to check out INPUD (international network of people who use drugs) and consider becoming a member. Link on our home page. Stand up for our rights! Don’t let the bastards grind u down! Make change, seek solutions with your precious knowledge. Nothing about us – without us! BPX

      Reply
  7. Frankie

     /  November 13, 2013

    Dole & Nyswander were truly great human beings and doctors. Their story is truly inspiring and their contributions to humanity and civil rights are up there with all the greats. One day I hope their story will be told to a wider audience because it is a story that has to be told and told soon, before it is too late.

    Reply
  8. Methadone has truly come a long way and i hope with time the number of deaths from its use can be brought down with better education on how to use it correctly.

    Reply
  9. Carl sutcliffe

     /  April 19, 2013

    Excellent reading highly informative

    Reply
  1. Methadone History Overview

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