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Methadone Withdrawal Symptoms, Timeline, and Treatment

Methadone Withdrawal Symptoms, Timeline, and Treatment

Methadone is a prescription opioid and it is also used in opioid addiction treatment to help people detox from opioids

Methadone is a prescription opioid used to treat severe pain that does not respond to alternative methods of pain management. It is also sometimes used in opioid addiction treatment to help people detox from opioids and stay committed to recovery. While methadone does have legitimate medical uses, it has the potential to be addictive. In some cases, a person may need support to help them come off of the medication and cope with methadone withdrawal symptoms. One option for managing methadone withdrawal is taking a medication called Suboxone. Learn about this option, as well as what to expect when coming off methadone, below. 

Methadone Overview 

Methadone is a prescription medication belonging to the opioid class of drugs. It is long-acting, meaning that its effects do not wear off quickly as is the case with some shorter acting drugs. Below are the details of methadone and its uses. 

Uses 

Methadone is FDA-approved for two uses: treating chronic pain that does not improve with non-narcotic drugs, and treating opioid use disorder as a part of the detox or medication-assisted treatment process. While not FDA-approved for this purpose, methadone is also used to treat neonatal abstinence syndrome, which occurs when newborns experience withdrawal symptoms after being exposed to opioids during the prenatal period. 

Prescription 

 Patients must have a prescription to take methadone. Because it is a Schedule II Controlled Substance, its use and prescription is highly regulated. Historically, patients have had to report regularly to a treatment center to receive dosages of methadone, but restrictions were reduced as a result of the COVID-19 pandemic. 

As a result of pandemic-related flexibilities, stable patients, defined as those who have been on methadone for at least 60 days and who have provided negative drug screens for illicit drugs, can take home a 28-day supply of methadone, rather than returning to a clinic regularly to receive more medication. Those who have been in methadone treatment for 30 days and who have demonstrated at least partial compliance with their treatment plan can receive 14 days of medication to take home.

The government has decided to extend these flexibilities for one year following the end of the COVID-19 Public Health Emergency and is exploring options to make the flexibilities permanent. 

Administration 

Methadone is available in a number of formulations, including oral tablets, as well as IV, intramuscular, and liquid solutions. The most common routes of administration for methadone are an oral tablet or a concentrated syrup.

Dosages

A person’s methadone dose will vary based upon the reason they are taking the medication. For patients taking methadone for pain management, a beginning dosage is typically 2.5 mg taken by mouth once every 8 hours. The dose may be increased if needed. For patients who are already tolerant of opioids, a beginning dose for pain management will be higher, depending upon the patient’s needs. 

For patients in MAT treatment for opioid use, methadone doses begin at 30 to 40 mg per day and then increase by 10 to 20 mg a week until a patient stabilizes on a dose of 80 to 150 mg a day. 

Keep in mind that these dosages are just general guidelines. A person’s exact dose will vary based upon their needs and health history. It is important to consult with a doctor regarding the appropriate methadone dose if you are taking or planning to take this medication. 

Side Effects 

As with any medication, methadone can have side effects. Some common side effects that patients experience when taking methadone include sedation, nausea, constipation, dry mouth, flushing, lethargy, itching, and breathing problems. In rare cases, methadone can cause cardiac problems and hypoglycemia. Consult with your doctor about any side effects you experience with methadone.  

Methadone Withdrawal Timeline

One common question pertaining to methadone withdrawal is, “How long does it take to withdraw from methadone?” The methadone withdrawal timeline is about 7 to 14 days, but some patients may find that methadone withdrawal symptoms linger for several weeks. This is because methadone is a long-acting opioid, compared to drugs like heroin, which is a short-acting opioid. While heroin withdrawal symptoms tend to pass within 4 to 5 days, methadone withdrawal symptoms are longer lasting because of the longer lasting effects of methadone. 

Since methadone is a longer-acting opioid, withdrawal symptoms may not appear until 12-48 hours after the last use of the drug. This means that you may not notice signs of methadone withdrawal until a day or two after you stop using the drug. 

Methadone Withdrawal Symptoms 

The symptoms of methadone withdrawals can make it difficult to stop using this drug without professional intervention. Some common withdrawal symptoms from methadone are as follows

  • Gastrointestinal symptoms like nausea or vomiting 
  • Anxiety
  • Sleep disturbances
  • Hot flashes
  • Sweating
  • Runny nose
  • Diarrhea
  • Watery eyes and nose 

Methadone Withdrawal Treatments 

If you’re looking to learn how to detox methadone, it’s important to speak with your doctor and/or an addiction treatment facility. 

Typically, you can detox from methadone in one of two ways. If you’ve been taking prescription methadone for pain or as a part of MAT treatment for opioid use, you can taper off of your medication in consultation with your doctor. While your tapering regimen may vary based upon your unique needs, a typical dose reduction schedule is to reduce the daily dose by 10 mg per week until reaching a daily dose of 40 mg. After that, methadone is tapered by 5 mg per week until a dose of 0 mg is reached. 

Another option for coming off methadone is to take Suboxone to help alleviate withdrawal symptoms and cravings. Research has shown that transitioning from methadone to Suboxone is possible, but it is important to keep in mind that you cannot simply stop taking methadone and then immediately begin taking Suboxone. If you have not yet begun to experience methadone withdrawal symptoms, taking Suboxone can throw you into methadone withdrawal. You must work with a doctor or detox facility to determine how to best transition from methadone to Suboxone. 

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Methadone Withdrawal FAQs

If you’re looking for information on methadone withdrawal, the answers to the following questions will be helpful. 

Does Methadone Have Side Effects?

As with any medication, methadone can have side effects. Common adverse effects include sedation, nausea, constipation, dry mouth, flushing, lethargy, itching, and breathing problems. In rare cases, methadone can cause cardiac problems and hypoglycemia.

What Helps With Methadone Withdrawal?

Tapering off methadone by following a doctor-approved tapering schedule can help to reduce the severity of methadone withdrawals. It can also be beneficial to work with a doctor to transition from methadone to Suboxone to make methadone withdrawal less severe. 

How Long Does It Take To Withdraw From Methadone?

The length of time it takes to undergo methadone withdrawal depends upon the dose of methadone you have been taking. Consult with your doctor or treatment facility to determine how long it will take you to withdraw from methadone. In general, methadone withdrawal lasts 7-14 days, but some people may experience symptoms for several weeks. 

Consult With Confidant’s Online Doctors for Opioid Withdrawal Treatment 

If you’re looking for help with methadone withdrawal, you can access online MAT treatment for opioid use through Confidant Health. Download our app today on either the Apple Store or Google Play Store to access our online medication assisted treatment (MAT) clinic. 

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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