Methadone is a synthetic opioid used in medication-assisted treatment to help people quit the use of heroin or other opiates. It should be used as part of a comprehensive treatment program that also includes counseling and participation in social support programs.
When used as directed, methadone can relieve the symptoms of opioid withdrawal and decrease opioid cravings. Less commonly, methadone may be prescribed for pain management to those who have been unable to find relief with other opioids.
Although methadone can help a person overcome addictions to drugs like heroin, it also has the potential for abuse and addiction. Detractors of methadone use contend that it is essentially like trading one drug for another. However, the truth is that methadone is effective at reducing the harm done from more powerful opioids, as long as it is used correctly.
Becoming dependent is common with long term methadone use. If a person with a dependency stops using it, they will encounter unpleasant withdrawal symptoms. The best way to manage withdrawal is through a gradual reduction in dosage or professional detox treatment.
Methadone Withdrawal at Home
When a person abruptly stops using opiates, the withdrawal process isn’t usually life-threatening. However, if a person uses methadone in large amounts or over a prolonged period, stopping the use of this drug can result in severe symptoms. These include depression and suicidal thoughts, which are most safely managed in a clinical setting.
Attempting to withdraw from methadone at-home is not only uncomfortable but potentially dangerous. Detoxing from methadone abruptly or “cold turkey” is not recommended, especially if the person is a chronic and/or excessive user. Medical supervision can ease withdrawal symptoms, prevent relapse, and reduce the risk of suicidal thoughts.
Methadone Withdrawal Symptoms
Methadone withdrawal symptoms can onset within 30 hours of the last use. Withdrawal from methadone is slow and may last for a few weeks or longer.
Symptoms associated with methadone withdrawal include the following:
- Anxiety or depression
- Fatigue
- Restlessness
- Irritability
- Accelerated heart rate
- Sweating
- Teary eyes or a runny nose
- Chills
- Excessive yawning
- Insomnia
- Muscle aches and pains
- Nausea and vomiting
- Cramps
- Diarrhea
- Drug cravings
The first signs of methadone withdrawal are frequently described as flu-like symptoms.
Methadone Withdrawal Timeline
Within about 36 hours following the last dose of methadone, many people begin to encounter withdrawal symptoms. This process can take days to weeks. The first few days of the withdrawal are referred to as the acute phase.
Early symptoms of withdrawal likely to onset include rapid heartbeat, chills, and cold sweats. Shortly thereafter, some of the most unpleasant withdrawal symptoms may also occur. These may consist of physical symptoms such as nausea, vomiting, body aches and pain, and increased anxiety. Most of the worst physical symptoms of withdrawal, such as nausea and vomiting, will have subsided after 7-10 days.
The stage after acute withdrawal is called post-acute withdrawal. Many of these symptoms are emotional and may include depression, anxiety, and irritability. Difficulty concentrating and fatigue are also effects likely to persist, as well as drug cravings.
Tapering
If a tapering process is used, a person who has used methadone for a long period will need a slower, more gradual weaning process. Shorter, less severe addictions may not need an extensive tapering process. Tapering is a method used to gradually reduce drug dosages to promote a more comfortable and safer withdrawal.
While withdrawal will depend on individual factors, there is a standard process for weaning off methadone. It is not recommended to reduce dosages faster than 5 mg of methadone per week. Many methadone taper program will use a dose reduction of 10% every two weeks.
How Long Does Methadone Withdrawal Last?
The length of withdrawal from methadone depends on several factors. These include the length of time used, size of the dosage, and the preferred method of consumption.
A person who uses methadone as directed for three months will likely encounter a relatively short withdrawal process. Conversely, a person who has been abusing methadone for a year or more will be more likely to experience a more intense, extended withdrawal period.
Medication-Assisted Treatment
Fortunately, there are several medications available that can ease the methadone withdrawal process.
Suboxone is a synthetic drug like methadone. Its use can decrease methadone withdrawal symptoms and reduce the length of the withdrawal process. It is designed to increase the comfort of patients during withdrawal, which in turn can decrease the risk of relapse.
Clonidine is another medication often used to reduce emotional symptoms that may occur during detox. Clonidine is approved for the treatment of high blood pressure, but it can also mitigate anxiety and agitation. It may also be helpful for physical symptoms like body aches and runny nose.
During the withdrawal process, Zofran is sometimes also used to treat physical symptoms such as nausea and vomiting. Managing these symptoms helps to avoid dehydration that could otherwise result from excessive vomiting.
Baclofen is a muscle relaxer that can be used to relieve muscle aches, pains, and spasms to make the patient more comfortable. By minimizing these symptoms, the patient is then more free to focus on the emotional aspects of detox and recovery.
Following detox, naltrexone may be prescribed to help patients continue with recovery. This medication reduces cravings and blocks the pleasurable effects of opioids.
Methadone Overdose Symptoms
Those who are abusing methadone in high amounts face the potential for overdose. By some estimates, 5,000 overdose deaths occur each year as a result of methadone misuse. In 2014, methadone accounted for nearly one-fourth (23%) of all opioid-related deaths.
Methadone overdose often occurs because the drug stays in the body for a very long period. For this reason, those in treatment programs are only given a few doses per day. Accumulation of successive doses can have lethal consequences.
Signs of a methadone overdose include the following:
- Low blood pressure
- Very weak pulse
- Cold, clammy skin
- Blue lips and fingernails
- Constricted/pinpoint pupils
- Dizziness or sloppy behavior
- Body spasms at irregular intervals
- Absence of breathing or consciousness
A methadone overdose can result in profound central nervous system depression and death. If you witness someone overdosing on methadone, seek emergency medical help immediately.
Treatment for Methadone Addiction
Supervised withdrawal at a medical detox facility is the best way to ensure that the patient is supported and comfortable. By withdrawing from methadone in a clinical environment, people avoid the worst of the symptoms.
Often, other medications such as Suboxone can be used to treat opioid dependency. Addiction specialists can prescribe buprenorphine for people as they transition away from a methadone dependence. Buprenorphine is a partial opioid with much less potential for abuse.
Detox should be immediately followed by addiction treatment that features therapies essential for recovery, including the following:
- Psychotherapy
- Individual/family counseling
- Peer group support
- Health and wellness education
- Aftercare planning
- Dual diagnosis treatment for co-occurring mental health conditions
Midwood Addiction Treatment offers comprehensive programs that provide clients with the tools and support they need to overcome addiction and prevent relapse. We believe that every person is entitled to receive the most effective treatment currently available.
If you or someone you love is struggling with the use of methadone, other drugs, or alcohol, contact us today! Discover how we help people who need it most break free from the cycle of addiction for good!