What Is Methadone Withdrawal?
Methadone can be extremely physically addictive, especially when taken in high doses. The drug is commonly used to treat opiate addictions, leading some users to trade one addiction for another. If taken frequently, tolerance to methadone can develop quickly, which means the user will require more of the drug to achieve the desired effects.
Once the body becomes reliant on methadone to function normally, a dependence has developed. Those with a dependence on methadone will experience withdrawal symptoms if they quit taking the drug.
Withdrawal happens because the body has to relearn how to function without methadone in its system. While the body tries to reestablish normal functions, uncomfortable withdrawal symptoms occur, which can make recovery difficult.
Because the withdrawal process can cause adverse symptoms, methadone users are advised to detox in a medical environment. Most inpatient and outpatient treatment programs offer medical detox, which can help reduce the severity of methadone withdrawal symptoms.
The withdrawal process is different for everyone. The symptoms and duration of withdrawal will vary depending on the severity and length of the user’s addiction. A user’s body chemistry and tolerance will also affect their symptoms and how long the withdrawal process takes.
Symptoms Of Withdrawal
Symptoms of withdrawal from methadone are similar to those of other opiates, such as heroin and morphine. Many users especially struggle with methadone withdrawal because the medication stays in the body longer. Methadone withdrawal symptoms are usually moderate and flu-like.
Common and severe symptoms include:
- Muscle aches and pains
- Nausea or vomiting
- Rapid heartbeat
- Stomach cramps
Those with more severe methadone addictions will likely experience more serious withdrawal symptoms. If the user is addicted to multiple substances, the withdrawal process may be longer and more intense.
Quitting “cold turkey” will cause more severe withdrawal symptoms. Doctors usually recommend tapering off use of methadone to make the withdrawal process more bearable.
I was withdrawing cold turkey, by choice, from methadone on my parents’ couch in Daytona Beach, 250 miles away from my clinic and conspiring ways to teleport the pink syrup, realizing what happened to me. I used to be a heroin addict, then I was a methadone addict. I sank my sweaty, twitching body into the cushions. Seventy two hours for the stuff to get out of my body, and a lifetime of convincing myself the grass isn’t greener on the methadone side.
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Duration Of Withdrawal
Symptoms typically present within 24 hours of the user’s last dose. However, it can take anywhere between 15 and 60 hours for methadone to be out of a user’s system. For some people, it may take several days for withdrawal to begin.
Symptoms of withdrawal from methadone usually last three to six weeks, but the process can take longer for those with severe addictions.
The first seven to 10 days are often the worst, although in some cases, this extends for longer. Methadone stays in the body for significantly longer than other medications, and in some cases peak withdrawal will not start until 7 days. At this point flu-like physical symptoms and distressing psychological symptoms such as anxiety often appear. Over the next several weeks, withdrawal symptoms will fade.
Methadone Withdrawal Timeline
|Days 1-2||Symptoms of withdrawal usually don’t begin until at least 30 hours after 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.|
|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, as well as irritability and anxiety. Flu-like physical symptoms will persist. Due to how long methadone stays in the body, it often takes between 3 and 8 days for symptoms to peak. At this point, 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.|
Methadone detox is safest and most efficient when completed in a drug treatment facility or hospital.
Methadone users should always detox under the supervision of a doctor to ensure the patient completes detox safely and comfortably and improves their chances of a successful recovery.
Most medical detoxes provide a tapering off of the drug, or reducing the user’s dosage over a period of weeks. This method reduces the severity of withdrawal symptoms and is usually recommended over quitting “cold turkey.” However, tapering off the drug takes longer.
Treatment for Methadone Addiction
Drug treatment centers utilize the expertise of physicians and therapists to develop a personalized treatment plan for each patient. In almost all cases, an inpatient treatment program will give moderate to severe methadone addicts their best chance at a successful recovery. Inpatient programs, also sometimes referred to as residential, provide the patient with around-the-clock medical treatment, a variety of therapy programs, and valuable life skills training. Although each specific treatment program varies tremendously, there are thousands of options available, meaning there is a good match for every patient.
Outpatient treatment is also an option for those whose methadone addictions have been diagnosed as minor by a substance abuse professional. Outpatient treatment is also generally recommended for those who have completed an inpatient program but are still new to sobriety. There are a number of levels of outpatient care, including partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and standard outpatient programs (OPs), so it is important that each patient gets professional assistance in determining what is the proper level of care.