Can Methadone Give You High Blood Pressure?
When people take methadone or when they plan to go to a methadone maintenance clinic, to take methadone for opiate addiction treatment, they often do have concerns about the possible side effects from the medication. People worry about the effects that methadone may have on their heart.
Can methadone raise blood pressure? Can it cause a heart attack or a stroke? What risks are there for the cardiovascular system?
It is possible that there could be some confusion between two different drugs, methadone and methamphetamine. Both drugs are referred to by the name “Meth” on the streets, which could be the source of confusion.
Methamphetamine is a completely different drug for methadone. Methamphetamine is a very powerful and highly addictive stimulant drug, similar to cocaine.
Methamphetamine will certainly raise a person’s blood pressure, and in some cases very dramatically. There is a high risk when using methamphetamine of developing high blood pressure and possibly even heart problems such as a heart attack or stroke. Methamphetamine can also cause serious permanent heart damage.
The stress put on the cardiovascular system as a whole by methamphetamine is very serious. Methadone, on the other hand, is an opioid, which is more of a sedative.
Opioids tend to relieve pain and relax the user, causing them to be sleepy in many cases.
When a person takes methadone, the effect that it might have on blood pressure would be more likely to lower it. However, this does not make methadone in any way a beneficial medication to take for the purpose of lowering blood pressure. There are many effective blood pressure lowering medications, and none of them are addictive or habit forming.
Opioids are known to be habit forming and addictive for some people who are at risk for substance abuse. Opioids can also cause severe drowsiness and respiratory depression. Methadone has a particularly high risk for causing a person’s breathing to slow down.
There is one specific situation in which there may be a methadone blood pressure problem. When a person takes methadone for a long period of time and then they suddenly discontinue it, they will experience an opioid withdrawal syndrome that can cause elevated blood pressure.
While, this increase in blood pressure may not be dangerous for a person who has no health issues, for someone who already has heart problems or cardiovascular problems or other cardiovascular problems, they may be at high risk for a serious incident such as a heart attack or stroke. So, when stopping treatment suddenly, methadone and blood pressure may become an issue.
It’s very important that methadone be continued under close medical care.
Usually, it is tapered gradually to avoid significant withdrawal effects. Additionally, there are medications that can be taken for the opioid withdrawal caused by stopping methadone.
For example, there is Clonidine. Clonidine is a blood pressure medicine and it has the additional side effects of reducing the severity of opioid withdrawal symptoms.
When clonidine is taken to help with opioid withdrawal, not only will reduce the severity of symptoms, it will also lower blood pressure. This could be a good thing in which blood pressure is lowered to a safe level as part of the effects of clonidine.
However, it could also be dangerous if the effect is pronounced or if the person already had an issue with low blood pressure where their blood pressure drops to an unsafe low level. A new medication named Lucemyra makes this risk lower because it has similar effects in the body as clonidine in reducing opioid withdrawal symptoms, but it does not have, as pronounced, an effect on lowering blood pressure.
Does methadone affect the heart in any other ways?
Methadone is one of many drugs known to cause an issue known as QT prolongation. When you have an electrical heart test known as an ECG, one of the measurements taken is called a QT interval.
If the QT interval is longer than it should be, the person could be at higher risk for certain types of arrhythmias of the heart. Drugs that cause QT prolongation should be avoided by people who already have the condition. Also, multiple drugs that cause QT prolongation should not be taken in combination.
If you are concerned about the possibility of a prolonged QT interval, ask your doctor before starting methadone maintenance. It is possible that the methadone clinic will require an ECG before starting treatment.
Methadone maintenance treatment may be related to heart conditions indirectly where methadone is not the cause of the problem. Unfortunately, street opioid use can lead to serious heart problems.
If you go to a methadone clinic, the doctor may want to order some heart screening tests to evaluate you for other conditions other than simply a QT prolongation. Depending on your drug use history and possible symptoms, there could be concern over other cardiovascular issues.
Intravenous heroin or fentanyl use can introduce dangerous bacteria into the vascular system, which, of course, should be sterile and bacteria-free. Where do the bacteria go when they enter the bloodstream through a needle and into a vein?
As the bacteria travel through the turbulence of the human cardiovascular system, they look for a quiet place to settle down, colonize, and reproduce. One place that bacteria find to be desirable is on the valves in the heart.
A bacterial infection of a heart valve is called “endocarditis,” or an inflammatory infectious process of the heart. Bacterial endocarditis can destroy a heart valve, which becomes a surgical emergency if left untreated.
What kind of surgery do they do for a damaged heart valve? The valve must be replaced with either a mechanical valve or a pig valve. The pig valve will require the patient to take anti-rejection drugs.
The mechanical valve requires that the patient take blood thinners. Valve replacements may eventually fail and have to be performed again years later.
Should I avoid methadone treatment?
Methadone maintenance clinics have a bad reputation. They are often accused of keeping patients hooked for life by putting them on high dosages of methadone.
If you are concerned about the dangers of methadone and you don’t want to go to a Suboxone clinic, you may try to quit opioids by going to rehab and recovery meetings. Some people are able to quit heroin and fentanyl by going to abstinence-based programs.
Yet, if you have found that going to 12-step meetings is not working for you because you keep relapsing, you should consider medication-assisted treatment. Each use of street opioids puts you at risk for an overdose or serious health problem.
Methadone, when administered by a registered clinic, is relatively safe. A methadone treatment program is far safer than continuing to snort or shoot up heroin and fentanyl on the streets.
You may hear people in meetings put down methadone as bad or even evil. They will tell you that abstinence is the only way to quit drugs.
I was once speaking to a man who had recovered many years ago from heroin addiction and he was going on, talking about how bad the methadone clinic was back in the old days when he first quit heroin. His description of the clinic made me think that he hated going through the methadone experience.
Not knowing any better at the time, I agreed with him, saying that methadone is a terrible drug. He stopped and looked at me, not speaking for several seconds.
Then, he said to me, “methadone saved my life.” It never occurred to me that, even though he hated the methadone clinic experience, that he was grateful to the methadone maintenance program for being there for him to keep him alive and get him off of heroin.
Who should consider methadone?
If you are using heroin or fentanyl on the streets and you walk into a methadone clinic to start treatment, you have made an excellent decision. You can figure out later if you want to work towards transitioning to Suboxone or naltrexone treatment. Or, you may want to taper off of methadone and get off of medications completely.
After you have been stabilized and had some time to heal and recover, you can start planning for the future. The important thing is to get off of street opioids as soon as possible. Every time you use those drugs, you risk serious health consequences.
Of course, we now have Suboxone treatment as an alternative to methadone maintenance. You may choose to go to a Suboxone doctor instead of the methadone clinic.
In many ways, Suboxone treatment is superior to methadone treatment. Suboxone is safer and doctors are allowed to prescribe it for up to a week, or even a month at a time. You don’t have to line up every morning at the clinic for your daily dose.
However, in some cases, Suboxone treatment does not work well. It is an excellent treatment, but not 100% successful. If you have tried Suboxone treatment and it is not working for you, you may want to consider going to a methadone clinic instead.
Methadone is still considered to be the gold standard of treatment for opioid addiction. It has the highest success rate, even higher than Suboxone.
What should I do about my blood pressure while on methadone treatment?
While methadone does not cause high blood pressure, and at therapeutic dosages, it does not usually cause seriously low blood pressure, it is still important to keep track of vital signs. Your clinic should be checking your blood pressure periodically.
Sometimes, when a person has been using opioids on the streets, they avoid addressing basic health issues and getting regular medical checkups. It is possible to neglect a medical problem or not even know that it is there.
When you quit heroin or fentanyl, it is important to get caught up with your medical care. Start taking your health seriously and see your doctor about important tests that should be done.
Men and women should get a colonoscopy at age 45, or sooner if there are family risk factors. Men should have their prostate checked and women should get mammograms.
Routine screening is important. Basic blood testing can screen for liver problems, kidney problems, and issues such as diabetes or blood disorders.
If your blood pressure is high while on methadone, it is not likely to be caused by the methadone. High blood pressure is something that some people have without any specific underlying cause.
You should get treatment for high blood pressure, which may include lifestyle changes and medication. Lifestyle changes usually involve improving your diet and exercising regularly.
Is it possible to quit methadone if I am not happy taking it?
While methadone does not cause high blood pressure, you may still not be happy with the process of showing up to a clinic each and every morning. After a few months of treatment, you may start to wonder if it is possible to stop methadone.
Unfortunately, it is not easy to just stop the treatment medication. Methadone is associated with a very unpleasant withdrawal syndrome. If you stop methadone, you will go into opioid withdrawal.
The first place to bring up the issue of stopping methadone should be with your methadone clinic staff. Talk to your doctor and to your counselor to see if they believe you are ready to taper down and work towards finishing treatment.
If you are unhappy with your care at the clinic, you may want to see an addiction specialist outside of the methadone clinic to see if they can help you to transition off of methadone and onto Suboxone therapy. While the transition can be difficult, it may be worth it to help improve your lifestyle.
Suboxone is highly effective and it allows for you to go away on vacations and take days off where you do not have to go to the clinic in the morning. Imagine being able to sleep in on a Saturday morning.
What if I am happy with my methadone treatment. Is it safe to continue long-term?
Everyone is different with respect to medication-assisted treatment. Some people are ready to finish treatment after a year, and some people take several years.
In other cases, some people do best to stay on medication indefinitely. They simply continue to go to the methadone or Suboxone clinic on a regular basis without making definite plans to quit treatment.
These medications are safe to take long-term. If your doctor recommends that you continue treatment, you can continue treatment without concern for methadone side effects or Suboxone side effects. If you do have concerns, you may want to get a consultation with another doctor to get their opinion.
There is no problem though if you are happy with your treatment and you believe that it is best to continue it long-term. Most importantly, there is no shame in continuing treatment. You are living successfully in recovery as long as you continue your medication-assisted treatment plan.
If you are in Fort Lauderdale and you are interested in learning more about our program, please use the contact page on this website.