Methadone and heroin are opioids with vastly different reputations. While heroin is considered one of the most dangerous drugs, methadone is often regarded as a safe alternative to heroin and other opioids. However, even though heroin is illicit and methadone can be obtained by prescription, they both carry similar risks, including those of abuse, dependence, and addiction.
This methadone vs. heroin comparison guide will discuss the key differences between these opioids and explain why methadone treatment isn’t as safe as you may think.
What Is Methadone, and How Does It Affect Your Body?
Methadone is a long-acting opioid drug most commonly used to treat opioid use disorder (OUD). It can also be prescribed for moderate-to-severe pain, typically for patients requiring around-the-clock pain relief.
Available as a generic medication and marketed under Methadose®, Dolophine®, and other brand names, methadone comes in numerous forms, including:
- Tablet
- Injection
- Oral solution
- Oral concentrate
Methadone affects the body by interacting with the same receptors as other opioids. When taken for pain, it alters the perception of it by interrupting the transmission of its signals between the body and the brain.
When used in opioid addiction treatment, methadone is usually used to replace short-acting opioids, such as heroin. It is most commonly used in medication-assisted treatment (MAT) in combination with counseling and behavioral therapy.
Methadone relieves cravings and other withdrawal symptoms while blunting the rewarding effects of other opioids by producing cross-tolerance. Although taking it as intended can help people get off more dangerous opioids and reduce the risk of overdose, it can still be abused. This dramatically increases the risk of adverse effects, including methadone overdose.
In 2023, 14.3% of Americans taking methadone for any reason abused it; worse yet, around 3,400 people lost their lives to a methadone-involved overdose. Amidone, Wafer, and Chocolate Chip Cookie are some popular street names for it.
What Is Heroin, and How Does It Affect Your Body?
Heroin (diacetylmorphine or diamorphine) is a highly potent and addictive opioid that comes as a powder, sticky tar-like substance, or granules. Its color may range from off-white to dark brown.
Unlike most opioids, heroin has no legitimate medicinal use in the United States. As an illicit drug, it is used—or, rather, abused, since it is an illegal substance—for recreational purposes. It can be smoked, snorted, or injected; the latter method of administration is particularly dangerous due to the risk of bloodborne diseases.
Heroin affects the body in the same way as other opioids, including methadone, as it acts on the opioid receptors in the central nervous system (CNS). Once consumed, it rapidly binds to these receptors, producing intense euphoria and relaxation. Although not used as a pain medication in most countries, it also has pain-relieving effects.
Heroin has played a significant role in the U.S. opioid crisis. Hundreds of thousands of people dependent on prescription opioids turned to heroin once they could no longer obtain them legally. This brought about the second wave of the opioid epidemic. Between 2010 and 2022, heroin has claimed the lives of more than 130,000 Americans.
Now that we’ve discussed the basics, let’s examine the key methadone vs. heroin differences.
Key Differences Between Methadone vs. Heroin
The key difference between methadone vs. heroin lies in their legal status: while heroin is treated as a Schedule I controlled drug, methadone is a Schedule II controlled substance. In other words, while any use of heroin is illegal, methadone can be legally obtained by prescription.
With this in mind, let’s compare methadone to heroin in terms of effectiveness, chemical composition, addictiveness, and more:
Methadone vs. Heroin Effectiveness
When it comes to methadone vs. heroin effectiveness, keep in mind that only methadone is FDA-approved for pain treatment. It is also often used to treat heroin addiction and other opioid use disorders.
Meanwhile, heroin is not approved for any medical use in much of the world. While diamorphine is used in some countries, such as the United Kingdom, there’s a lack of research on its efficacy.
Furthermore, heroin has a very rapid onset of action, yet its effects are short-lasting. Methadone, by contrast, exerts its effects slowly. However, as a long-acting opioid, it works for 24–36 hours.
Methadone vs. Heroin Chemical Composition
Methadone and heroin have different chemical compositions. Methadone hydrochloride (molecular formula C21H27NO) is a synthetic opioid, meaning it is entirely human-made. Meanwhile, heroin (molecular formula C21H23NO5) is a semi-synthetic opioid derived through the acetylation of morphine, an alkaloid extracted from opium poppy plants.
Methadone vs. Heroin Cost
The main difference between methadone vs. heroin costs is that only one of them—methadone—can be obtained legally. Its price largely depends on the dosage form, prescription strength, and other factors. Generic methadone generally costs less than brand-name medications.
Meanwhile, heroin is a street drug, which makes it even more dangerous. Buying heroin (or any other drug) on the streets can have fatal consequences, as its purity and potency aren’t regulated. Worse yet, it may be laced or substituted with other drugs, such as fentanyl, which amplifies the risk of a potentially lethal opioid overdose.
Methadone vs. Heroin Overdose
Although all opioids can cause a life-threatening overdose, heroin users face a higher risk of overdosing than those who take methadone.
However, methadone can also cause an overdose, especially if mixed with other substances, taken in larger doses than prescribed, or otherwise abused. Ultimately, you should avoid methadone and heroin abuse, as both drugs are highly addictive and can cause an overdose.
Methadone vs. Heroin Side Effects
Methadone and heroin tend to cause similar side effects, such as:
- Nausea
- Vomiting
- Sedation
- Dry mouth
- Constipation
- Stomach ache
- Lightheadedness
- Difficulty breathing
Both methadone and heroin can also cause serious side effects, such as seizures or allergic reactions. Inform your doctor about any side effects, including those not mentioned above, you experience after taking either of these drugs. In case of severe side effects, seek medical help immediately.
Prolonged use of methadone and heroin enhances the risk of:
- Tolerance, dependence, and opioid addiction
- Heart, liver, and other organ damage
- Reproductive problems
- Hormonal imbalance
- Chronic constipation
- Opioid overdose
- Death
Mixing methadone or heroin with other substances significantly increases the risk of side effects.
On this note, let’s discuss methadone vs. heroin drug interactions.
Methadone and Heroin Drug Interactions
Common methadone and heroin drug interactions include:
- Barbiturates
- Other opioids
- Antipsychotics
- Antihistamines
- HIV medications
- Benzodiazepines
- Sleep medications
- Certain antidepressants, such as MAO inhibitors
In recent years, speedballing—or mixing heroin or other opioids with stimulants, such as cocaine—has become increasingly widespread. This polydrug combination can put your health and life on the line by amplifying the dangers and side effects associated with both substances.
Furthermore, mixing opioids with other substances, especially CNS depressants like alcohol, significantly increases the risk of respiratory depression, overdose, organ damage, and other adverse effects. Before initiating methadone therapy, inform your doctor about any medications, supplements, or herbal medicines you’re taking.
Other Risk Factors of Methadone and Heroin
Here are some medical conditions that may increase the risks associated with methadone and heroin:
- Pregnancy
- Liver disease
- Allergy to opioids
- Kidney impairment
- Low blood pressure
- Respiratory problems
- Cardiovascular issues
- Substance use disorders (SUDs)
This list is by no means extensive. To ensure you can safely undergo methadone therapy, discuss your medical history with your healthcare provider.
If you’re considering methadone therapy for heroin addiction, keep in mind that MAT does not address the root of opioid dependence; it only substitutes one opioid for another. Therefore, it’s not uncommon for people to suffer from methadone withdrawal symptoms upon quitting it.
Physical Dependence and Addiction to Opioids
Physical dependence and addiction often co-occur, but they aren’t the same. Anyone who takes methadone is, by definition, dependent on it; however, it doesn’t necessarily make you addicted.
Opioid dependence is caused by the chemical changes that occur in the brain as a result of prolonged opioid use. People dependent on opioids need them to function normally. For instance, someone taking methadone as part of their OUD treatment relies on it to keep cravings and other withdrawal symptoms at bay.
While dependence is purely physical, addiction is largely psychological. Those addicted to opioids cannot help but take them, even when it wreaks havoc on their lives. More often than not, addiction follows untreated opioid dependence.
Therefore, it is imperative to seek professional help as soon as you notice the signs of opioid dependence in yourself or a loved one.
Signs and Symptoms of Opioid Dependence
The key signs of opioid dependence are tolerance and opioid withdrawal symptoms.
Here’s how they manifest:
- Tolerance. If you take opioids for a prolonged time, your brain will start producing more opioid receptors, leading to tolerance. Simply put, this means that your body will become so accustomed to the drug that your usual dose will no longer be effective. If this happens, do not increase your dosage without consulting your doctor, as this is where the vicious cycle of opioid abuse often starts.
- Withdrawal symptoms. Opioid-dependent people experience flu-like symptoms, cravings, sleep disturbances, nausea, and other physical and psychological withdrawal symptoms upon drug discontinuation. These symptoms can seem virtually impossible to bear, prompting people to keep taking opioids just to feel normal.
If this sounds like you, know that it is not your fault; anyone can develop opioid dependence. Seeking professional treatment is key to returning to an opioid-free life.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is a cutting-edge treatment that eradicates opioid dependence by re-regulating the endorphin-receptor system.
ANR eliminates opioid dependence together with cravings and other withdrawal symptoms by re-regulating the endorphin-receptor imbalance caused by prolonged opioid use. The treatment is performed under sedation, allowing you to avoid the discomfort associated with opioid withdrawal.
Since it addresses the root of opioid dependence, ANR treatment allows you to leave the fear of relapse in the past. It also doesn’t involve methadone or other opioid-replacement drugs.
Furthermore, ANR is very safe, even for those with underlying medical conditions, such as heart or liver disease.
It is performed by a team of highly experienced board-certified healthcare professionals, including anesthesiologists, in an ICU setting of fully accredited hospitals. Patients are discharged from the hospital craving- and dependence-free after a short, approximately 36-hour stay.
To learn more about ANR, contact us today for a free, 100% confidential consultation.
Key Takeaways
Before you leave, let’s summarize the key points we covered today:
- Methadone is a synthetic opioid used in pain and OUD treatment that may lead to abuse and addiction.
- Heroin is an illicit semi-synthetic opioid that acts on the same receptors as methadone but produces faster effects and has a shorter duration of action.
- If you’re struggling with methadone or heroin dependence, ANR is the only treatment you need to overcome it once and for all; it negates the risk of relapse by modulating the endorphin system.
Methadone vs. Heroin FAQ
Methadone is different from other opioid drugs in that it is long-acting. While it binds to the same receptors as other opioids, it has a long duration of action—it exerts effects for up to 36 hours. Therefore, it is often used to replace short-acting opioids, such as fentanyl, heroin, or oxycodone.
Methadone is not the same as morphine. Like codeine, morphine is an opiate; it is an alkaloid that naturally occurs in the opium poppy plant. Meanwhile, methadone is a synthetic opioid most commonly used in OUD treatment. While both methadone and morphine can be prescribed for pain relief, the effects of methadone last much longer, as it is a long-acting opioid.
The main advantage of methadone over heroin is the reduced risk of opioid overdose. Heroin is an illicit drug, which means you never know exactly what you’re buying. By contrast, you can obtain methadone legally, which in and of itself makes it a safer alternative. However, neither methadone nor heroin is safe; both can lead to addiction, overdose, and other adverse effects.
