There are some differences between oral methadone and heroin. There is no rush or hit - and the effect, which comes on more slowly, is less intense. Some people find the change takes some getting used to, others don’t find it a problem at all.

You can’t get a heroin-like hit from methadone - taking more will only increase the risk of overdosing. It is also possible that you will be prescribed too much methadone. This can make you feel like you are withdrawing (because it can make you sweat) and/or it can slow down your reactions. If this happens to you it might be worth talking it over with your doctor or drug worker - it viill be easier to drop now than later. There are a few rare effe’cts that can occur in the first few days of a script such as a swelling of the ankles and I feet, painful and swollen joints and a skin rash. These go withiri a few days.

There is a much bigger difference if you are stopping injecting to go on to oral methadone. The ‘draw of the needle’ can take a lot of overcoming, and, if you are finding it difficult your doctor or drug worker should be able to provide you with help.

If you aren't able to stop injecting make sure you have access to new, sterile works and find out what effect it will have on your script if you continue to use on top.

Although methadone doesn’t always feel like a powerful drug, it is, and using heroin, alcohol or other sedatives (such as valium and sleeping pills) in addition to methadone can all result in overdose.

Methadone is unusual in that it binds to cells in the liver, lungs and fat before moving back into the blood-stream to have an effect on you. This process is harm-less and doesn’t damage the cells at all.

The main impact of this fact is that over the first few days of treatment, as these ‘tissue reservoirs’ fill up, you won’t get the full benefit of your dose. As you can see from the graph below you have less methadone in your system at the peak on day 1 than you do before you even take it on day 4.

This coupled with the fact that methadone does feel different to heroin, is probably why people often feel like they haven’t got enough methadone to hold them in the early days of treatment.

Methadone is much more effective at helping people to stop using heroin when it is taken every day. As you can see from the graph, provided you take it every day, once the ‘reservoirs’ are full there are only rela-tively small changes in the blood levels of methadone. Having’heroin days’ and ‘methadone days’ results in the ‘tissue reservoirs’ of methadone emptying; as they take 3 days to fill up again your body never knows whether it’s coming or going and you’ll feel rough muc more often.

Although there are highs methadone can’t give you, it can give you stability and control - but only if you take it every day.

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