Patients often ask difficult questions about addiction which we are unable to answer. There is certainly no affect on the skeleton from methadone use. Many patients have poor dental hygiene while using street drugs, and bad caries may be first recognised when starting methadone. There is a tendency to dry mouth on high doses of methadone which usually comes in the form of a sweet syrup. Although both of these can theoretically lead to dental caries, many patients on methadone have perfectly normal teeth.
Calcium metabolism appears to be normal.
Overdoses from methadone can occur in the first week of treatment if excessive doses are given. This should be a rare event by using an initial dose of 30mg and by close daily supervision in early treatment. Those new to treatment are inherently unstable. They come from a life of uncontrolled use of various street drugs. When on regular doses of methadone, patients describe having no euphoria from the drug.