Methadone is a prescription drug used to treat severe pain. It is also a medication for detox and maintenance treatment of opioid addiction such as heroin. Methadone is itself an opioid and can be addictive. It’s possible for some people to become addicted to methadone as they use it to wean themselves off of another prescription painkiller. Methadone detox and addiction treatment programs can help ensure a safe withdrawal process.
According to the National Center for Biotechnology Information (NCBI) [1], methadone may be prescribed by physicians and dispensed by community pharmacies for analgesia as a Schedule II drug under the regulations of the Controlled Substances Act. However, when used for the treatment of opiate dependence, methadone’s accessibility is restricted to practitioners, clinics, and pharmacies licensed by the Food and Drug Administration (FDA).
In 2017, about 261,000 people age 12 and older reported using methadone for a non-prescribed purpose at least once in their life. This is according to the report from the Substance Abuse and Mental Health Service Administration (SAMHSA) [2]. Once the body becomes reliant on methadone to function normally, dependency on this drug will develop. Those with dependency on methadone will experience withdrawal symptoms if they quit taking the drug.
Withdrawal and dependence on these drugs can be treated with a Methadone detox program in a treatment facility.
Dependence and Tolerance to Methadone
As with other opioids, tolerance and physical dependence may develop upon repeated use, leading to dependency. Therefore, an individual on therapy should be tapered gradually from the drug if it is no longer needed for pain control. In addition, withdrawal symptoms may occur following the sudden discontinuation of Methadone.
According to the US Food and Drugs Administration [3], Methadone is a mu-agonist opioid with an abuse liability similar to morphine. Methadone, like morphine and other opioids used for analgesia, has the potential for being abused and is subject to criminal diversion. Also, a person who uses methadone combined with alcohol may experience respiratory depression, hypotension, profound sedation, or coma
Methadone has an additive effect when used in combination with alcohol, other opioids, or illicit drugs that cause central nervous system depression. Benzodiazepine abuse, drugs such as Xanax, Ativan, Klonopin, and Valium when combined with methadone are often fatal. Methadone addiction is characterized by compulsive use, use for non-medical purposes, and continued use despite harm or risk of harm. Addiction to this drug is a treatable disease and is necessary to find a medically-assisted Methadone detox program.
Methadone Overdose
Abuse of methadone poses a risk of overdose and death. Methadone overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. A methadone overdose can also happen if a person takes methadone with certain painkillers, such as Oxycontin, Hydrocodone (Vicodin), or morphine.
Medicines with these brand names contain methadone:
- Dolophine
- Methadose
- Physeptone
Symptoms of Methadone Overdose
- Tiny pupils
- Constipation
- Nausea and vomiting
- Spasms of the stomach or intestines
- Low blood pressure
- Weak pulse
- Breathing problems
- No breathing
- Coma
- Confusion
- Disorientation
- Dizziness
- Drowsiness
- Fatigue
- Muscle twitches
- Weakness
- Blue fingernails and lips
- Cold, clammy skin
Methadone Withdrawal Symptoms
Methadone withdrawal is said to be one of the worst forms of withdrawal because of how long a person may experience the detox symptoms. That is why the safest way to get off methadone is to work with a Methadone detox healthcare provider on a tapering schedule that gradually lowers the dose of the drug. A taper helps to decrease the severity of withdrawal symptoms and avoid a relapse.
It is important to note that Infants born to mothers physically dependent on opioids, such as methadone, may also be physically dependent and may exhibit respiratory difficulties and withdrawal symptoms, according to FDA [4]
Withdrawal symptoms for Methadone include the following:
- Agitation, restlessness, and anxiety
- Depression
- Insomnia
- Yawning
- Increased tearing or watery eyes
- Runny nose
- Sweating
- Shivering, trembling, or goosebumps
- Muscle aches or joint pain
- Nausea or vomiting
- Abdominal cramps
- Diarrhea
Methadone Withdrawal Timeline
Days 1-2
Symptoms of withdrawal usually don’t start until at least 30 hours after the user’s last dose of methadone, and it may take even longer depending on the amount used. Physical symptoms, such as chills, fever, rapid heartbeat, and muscle aches, will begin during this time of Methadone Detox.
Days 3-8
Over the next week or so, methadone cravings will be strong. Users may face anxiety, body aches and pains, nausea, and insomnia, also, irritability and anxiety. Flu-like physical symptoms will continue. Due to how long methadone stays in the body, it often takes between 3 and 8 days for symptoms to the peak. At this point of Methadone Detox, additional symptoms such as depression, vomiting, and cramps begin to appear.
Days 9-15
After withdrawal peaks, symptoms will begin to subside, although some will remain, such as irritability, diarrhea, and physical discomfort. Users may still feel strong drug cravings, and depression may set in. Depression can become severe, and some patients may have difficulty feeling pleasure or getting motivated.
Days 15+
Withdrawal symptoms from methadone such as low energy levels, anxiety, trouble sleeping, and cravings typically persist for 2-3 weeks. After the 3-6 week detox process is over, many former methadone users will experience post-acute withdrawal symptoms, or PAWS. PAWS may continue for many months, and in some cases, for up to 2 years. PAWS may include irritability, anxiety, depression, the inability to feel pleasure, difficulty sleeping, and poor concentration.
Medical Methadone Detox
While medical detox can help a person safely and comfortably complete withdrawal, it does little to address the underlying issues of substance misuse and addiction. For these reasons, Methadone detox should ideally be followed by comprehensive addiction treatment that involves behavioral therapy and complementary forms of treatment, such as 12-step meetings. In addition, the inpatient treatment approach is aimed at changing behaviors and helping to establish social support systems and better methods of coping with stress.
A person will likely experience many different side effects from their drug use. These side effects may be emotional, physical, or mental. For example, someone in withdrawal will likely experience many uncomfortable feelings and negative thoughts about life during the process of the Methadone detox. Unfortunately for those with dependency, Methadone detox is an unavoidable first step to recovery.
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Sources
SAMHSA – Methadone Detox https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf