Methadone Withdrawal: Timeline, Symptoms, Detox

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Methadone is an opioid medication that can be used to treat pain symptoms like other opioids. However, it’s also widely used to treat opioid use disorders. This long-acting opioid can stave off withdrawal symptoms for hours, allowing people to get out of a cycle of active addiction. However, methadone can also be misused as a recreational drug. Whether you are treated with methadone or misuse it, it can cause chemical dependence and uncomfortable withdrawal symptoms. In fact, methadone withdrawal may be more intense than withdrawal that’s caused by other opioids. How do you know if you’re going to experience withdrawal symptoms and what can be done to treat withdrawal?

Learn more about methadone withdrawal and how it can be treated safely.

Will You Experience Methadone Withdrawal Symptoms?

Withdrawal occurs when you stop using certain substances after developing a chemical dependence. Dependence is when your brain and body get used to a drug after a period of high doses or consistent use. Chemical dependence can happen after a period of drug misuse, but it can also come as a side effect of regular prescribed use of a drug. Methadone is unique because it’s often used in patients that are already dependent on an opioid.

Methadone is commonly used in the treatment of opioid dependence and addiction. If you start using the drug as a part of medication-assisted treatment (MAT), it’s likely that you will experience methadone withdrawal symptoms when you quit. Methadone is an opioid that is often used to replace more harmful and difficult to manage opioids. It doesn’t cause intoxication as easily as other options. However, the idea behind MAT is to allow you to avoid going through withdrawal because of an opioid you’re addicted to by staving off symptoms with methadone. 

This can help you go about your life while spending less time in a cycle of active addiction, which involves seeking drugs, getting high, recovering, and doing it all over again. MAT may also allow people to go through the addiction treatment process without having to go through withdrawal and detox right away. Instead, they may go through a process of tapering off the drug after having gone through several months of addiction treatment. However, if you stop taking methadone or cut back, you will likely experience some uncomfortable withdrawal symptoms. 

Methadone can also be misused recreationally. Though it doesn’t cause intoxicating symptoms as easily as heroin and other stronger opioids, it can cause you to experience euphoria similar to other opioids. Methadone misuse can also lead to chemical dependence and withdrawal.

What Are the Methadone Withdrawal Symptoms?

Methadone withdrawal, like other opioids, is often compared to the flu. However, methadone withdrawal may be more intense and last longer than the typical flu or other opioid withdrawal symptoms. Methadone can bind to opioid receptors all over the body. When you stop using after developing a chemical dependence on the drug, you’ll likely experience full-body symptoms. This can include general discomfort, body aches, and increased body temperatures. There are a few opioid withdrawal symptoms that don’t seem to resemble the flu, including excessive yawning and teary eyes. Flu-like symptoms include:

  • Fatigue
  • Fever
  • Sweating
  • Nausea
  • Vomiting
  • Diarrhea
  • Runny nose
  • Body aches
  • Cramps

You may also experience psychological symptoms like anxiety or depression. These are common symptoms to experience as your brain rebalances its chemistry. However, they can sometimes linger long after your other withdrawal symptoms have faded. If you’ve developed a substance use disorder involving methadone, you may experience drug cravings and powerful compulsions to use the drug again. In such cases, you’ll need to pursue recovery in addiction treatment services to learn to cope with cravings and triggers without relapsing. 

When Will Symptoms Show Up?

Methadone can last for many hours with a single dose, but repeated doses can make the duration of action longer. After a period of consistent methadone use, it may take up to 48 hours for you to stop feeling its effects. Withdrawal symptoms may begin after that though it may take a little longer depending on the size of your last dose. Withdrawal symptoms may start out mild and increase until they reach their peak. Peak symptoms can include the worst of your nausea, vomiting, and sweating.  

How Long Does Withdrawal Last?

Methadone is a long-lasting opioid, and its withdrawal symptoms may last longer than other opioids. They will gradually increase in intensity until they reach their peak. This could take several days to over a week, but peak symptoms are likely to occur between seven and ten days. In some cases, methadone can last over a month, and it generally lasts between three to six weeks. After 10 days, most of the most intense physical symptoms will be gone. Symptoms like insomnia, sleep disturbances, anxiety, and depression may last the longest. In some cases, you may need to address these issues in treatment to overcome them.

methadone-withdrawal

Is Methadone Withdrawal Dangerous?

Methadone withdrawal is said to be more severe than withdrawal from other opioids. Still, while opioid withdrawal can be extremely uncomfortable, it’s not usually life-threatening. If you are using methadone as a part of medication-assisted treatment, you may go through a tapering period that’s designed to alleviate severe symptoms. If you want to taper off methadone, it’s important to do so with guidance from a medical professional. Tapering requires a dose that’s small enough to be effective but large enough to avoid withdrawal. If you quit cold turkey, you may experience more severe symptoms. 

Either way, methadone withdrawal may be difficult to get through on your own. Uncomfortable symptoms mixed with intense cravings to use the drug again may cause you to relapse. Relapse after a period of sobriety can be dangerous. After a period of abstinence, your tolerance to the drug will be lowered. If you take a high dose, it may cause an overdose even if you’ve taken that amount before. 

Opioids can cause some potentially dangerous consequences if they’re severe enough. Methadone can cause vomiting, sweating, diarrhea, and excessive tearing. These symptoms can cause you to dehydrate quickly if you don’t drink enough fluids. Extreme nausea may make it difficult to keep any liquids down. If this happens during withdrawal, it’s important to speak to a doctor as soon as possible. Fatal cases of dehydration caused by opioid withdrawal have also happened in prisons where prisoners didn’t have enough access to water and care.

How is Methadone Withdrawal Treated?

Whether you’ve used methadone recreationally or as a part of medication-assisted treatment, withdrawal symptoms can be treated. If you’re going through an MAT program, you’ll probably go through a tapering period to help ease you out of chemical dependency. This may make your withdrawal period longer, but you’ll experience much more mild symptoms. If you’re likely to have severe withdrawal symptoms, or if you have other medical concerns that may complicate withdrawal, you may go through a medical detox program. 

Medical detox, or medically managed intensive inpatient services, is the highest level of care in addiction treatment according to ASAM’s Continuum of Care model. At this level of care, you will be treated for severe withdrawal symptoms and other medical complications or conditions. Detox will involve treatment from medical professionals that are experienced in working with addiction and withdrawal.

Detox programs will also have therapists and clinicians that are there to help with the psychological aspects of drug withdrawal and addiction. While in detox, you may begin to address the deeper issues that may contribute to a substance use problem like past traumas, depression, and anxiety. Mental health issues are common alongside addiction, occurring in nearly half of all people that have substance use disorders.

What Happens After Methadone Detox?

After you complete a medical detox program, you may need to move on to another level of care in addiction treatment. If you still have serious medical or clinical needs that would make living independently dangerous or a threat to your sobriety, you may go through an inpatient treatment program. Inpatient and residential treatments involve living in spaces that are run by a treatment center. This may involve a hospital-like setting for people with high-level needs, but it can also mean living in apartments with 24 hours access to care. Once you’re able to live on your own safely, you may start to move on to an intensive outpatient program. This will include nine or more hours of treatment services per week, but it can include as much as 20 hours per week in the case of partial hospitalization. 

As you progress, you may advance to outpatient treatment with fewer than nine hours of treatment services each week. This level of care can be important in transitioning from formal addiction treatment to complete independence. Through each level of care, you may go through many different therapies. Your treatment plan should be unique to your specific needs, and it should address medical, psychological, and social issues. 

Sources

ASAM. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about

Darke, S., Larney, S., & Farrell, M. (2016, August 11). Yes, people can die from opiate withdrawal. from https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512

National Institute on Drug Abuse. (2019, November). 8: Definition of dependence. from https://www.drugabuse.gov/publications/teaching-packets/neurobiology-drug-addiction/section-iii-action-heroin-morphine/8-definition-dependence

National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids

National Institute on Drug Abuse. (2018, January). Types of Treatment Programs. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

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