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Methadone is a synthetic opioid used as a replacement therapy and or for pain management. Barbiturates are sedatives that are for the most part no longer prescribed. Because barbiturates increases (potentiate) CYP 3A4 liver enzymes (the primary enzyme that metabolizes methadone), the combination of the two can result in rapid metabolism of methadone and put an individual who is on a stable methadone dose into withdrawal.

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