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Methadone Withdrawal

Methadone is an opioid that is used to treat pain. It is primarily known as a medication used in maintenance therapy to ease withdrawal symptoms and most commonly to help with weaning people off of opioid dependence. 

Methadone works by blocking the brain receptor sites affected by heroin and other opiates, preventing the “high” those drugs provide. It also helps reduce drug cravings and, by extension, withdrawal symptoms. Since methadone is a full opioid agonist like heroin and other opiates, it can produce euphoric effects when it binds to the brain’s opioid receptors.  But it is much milder than the opioids it is being used to treat.

When it comes to treating addiction in the midst of the opioid crisis, methadone is an incredibly useful tool.  As such, it was listed on the World Health Organization’s List of Essential Medicines, which is a running list of the most necessary and safe medicines that are needed for an effective health system.

However, while one cannot argue with the fact that the use of methadone in medication-assisted treatment is saving lives, there are still dangers associated with its use. Methadone may be less potent than the opioids it helps to treat, but unless its usage is tightly restricted, it can become all-too-easy to end up swapping out one addiction for another.

As the prescription opioid epidemic blossomed, so did methadone abuse, with deaths from methadone overdose increasing 460 percent from 1999 to 2005. As of 2012, nearly 2.5 million people reported abusing methadone, and it continues to account for almost one in four prescription opioid-related overdose deaths.

If a heroin or Oxycontin addiction has turned into a methadone addiction, it is possible to stop using with the help of medical detoxification.

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What Are the Methadone Withdrawal Symptoms?

While methadone is a milder opioid, it is still an opioid. As such, methadone withdrawal symptoms will typically be similar, if not identical, to the symptoms one experiences during opioid withdrawal, including:

  • Hallucinations
  • Paranoia
  • Nausea and vomiting
  • Flu-like symptoms (runny nose, fever, chills, etc.)
  • Insomnia
  • Depression
  • Muscle cramps
  • Diarrhea
  • Anxiety
  • Tremors
  • Restlessness

One might wonder if methadone is used to help wean someone off of stronger substances like heroin, what can be used to taper off the use of methadone? The answer is buprenorphine. Buprenorphine works in much the same way methadone does, blocking the brain’s opioid receptor sites and mitigating the effects of methadone as well as some of the withdrawal symptoms. 

While methadone is a full opioid agonist, buprenorphine is only a partial agonist. This means any euphoric effect it produces is mild at best, which makes it the safer option for tapering use in addiction treatment. Buprenorphine alone may not be effective enough in helping curb cravings and withdrawal symptoms of severe opioid dependence on substances like heroin. However, it is extremely beneficial for weaning patients off of methadone.

What are the Stages of the Methadone Withdrawal Timeline?

Methadone withdrawal is usually not nearly as intense a process as it is with other opioids, but it is much more prolonged, spanning anywhere from two weeks to several months. Even the acute withdrawal period can take several stages to complete:

  • Physical symptoms usually begin to show within 24 hours of the last use. This can vary as it takes methadone anywhere from 15 to 60 hours to leave the body. Sometimes,symptoms might not appear for several days.
  • Over the course of roughly the next ten days, the psychological symptoms will join the physical ones and be at their most active and intolerable.
  • After this period, the majority of the physical symptoms will have peaked and begun to fade, but psychological symptoms such as depression will persist and sometimes become stronger. This phase usually lasts about another ten days.
  • After three weeks, if there are any remaining symptoms, they should be very mild. Intermittent bouts of depression are to be expected in the weeks and sometimes months to come as the body continues to readjust to the lack of methadone.

While this is what the general timeline of a methadone withdrawal looks like, there are a wealth of different factors that can cause the length of a person’s withdrawal symptoms to deviate from it, including:

  • The length of time someone was using methadone
  • How much of it they were taking
  • How often they were taking it
  • Taking it in tablet form, injecting, or snorting it
  • The severity of the addiction. If their mind is dependent on the it as their body.
  • Method chosen to stop taking methadone, such as dosage tapering, using buprenorphine instead, or stopping completely.

Why Should I Detox?

While not fatally dangerous, quitting methadone without tapering off the dosage will make the withdrawal symptoms more intense and prolong the entire process to an even greater degree. Recurring cravings and periods of depression can continue even months after you stop using methadone, significantly increasing your risk of relapsing. 

If you still want to quit methadone “cold turkey,” it should never be attempted without direct supervision from medical professionals to avoid any serious health risks. 

The safest and most effective decision is to undergo a full detox at a professional treatment center. Here, you can get expert medical and emotional support as you make your way through the withdrawal process.

What is the Next Treatment Step?

Once you have completed your methadone detox, it’s always recommended to move forward with ongoing addiction treatment. Detoxification helps to purge your body of methadone and mitigates damage caused by prolonged abuse.

However, it doesn’t get to the root of what created the addiction in the first place, especially If you became dependent on methadone while undergoing detox from a stronger opioid.

If the psychological component of your dependency is not addressed, the chances of relapse are high. 

Whether you choose an inpatient or outpatient program, ongoing rehabilitation treatment will help you understand the underlying causes of your addiction.

Woman with her head on her knees holding a pill and a glass of water

The program can also teach you the tools needed to help manage your addiction and successfully maintain sobriety long after you have completed your recovery treatment program.

Sources

Methadone Prescribing and Overdose and the Association with Medicaid Preferred Drug List Policies – United States, 2007–2014 | MMWR. (0AD). Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6612a2.htm

Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. (0AD). Retrieved from https://medlineplus.gov/ency/article/000949.htm

Whelan, P. J., & Remski, K. (2012, January). Buprenorphine vs methadone treatment: A review of evidence in both developed and developing worlds. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271614/

National Institute on Drug Abuse. (0AD). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

National Institute on Drug Abuse. (0AD). Drug Misuse and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

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