Methadone Addiction: Definition, Symptoms, Causes, Effects, and Treatment

Methadone addiction occurs when individuals misuse methadone without a prescription or need for the drug. Methadone is a medication used to treat opioid addiction and its withdrawal symptoms. Long-term and unnecessary use of methadone leads to dependency instead of helping manage withdrawal symptoms.

The main symptoms of methadone addiction include drowsiness, doctor shopping, continuous cravings, increased tolerance, and unsuccessful attempts to quit the drug. Methadone addiction is caused by prolonged use, self-medicating, genetic and environmental factors, or misuse due to underlying mental health issues.

Table Of Contents:

• What is Methadone Addiction?
• How Common is Methadone Addiction?
• What are the Symptoms of Methadone Addiction?
• What are the Causes of Methadone Addiction?
• What are the Effects of Methadone Addiction?
• What are the Treatment Options for Methadone Addiction?
• What are the Withdrawal Symptoms of Methadone Addiction?
• How to Prevent Methadone Addiction Relapse?

The effects of methadone addiction are severe, including respiratory issues, cognitive impairment, heart and liver damage, an increased risk of overdose, and financial problems. The main treatment options for methadone addiction include tapering methadone doses under medical supervision, counseling, behavioral therapies, and medications like buprenorphine to ease withdrawal symptoms.

What is Methadone Addiction?

Methadone addiction is the constant and compulsive use of methadone, an opiate medication prescribed to treat opioid use disorder (OUD) by reducing withdrawal symptoms and cravings. Methadone itself becomes addictive if misused or consumed in higher than prescribed doses, as stated in the 2009 book titled “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings (CHAPTER 6) by the World Health Organizations. Methadone addiction falls under the category of opioid use disorder according to the DSM-5, identified with behaviors such as an inability to control use, cravings, and continued use despite harmful consequences. A fact sheet on methadone by the UMass Chan Medical School states that the risk of methadone is always high, especially when combined with other central nervous system depressants such as benzodiazepines, hypnotics/sedatives, or alcohol.

How Common is Methadone Addiction?

Methadone addiction is common because approximately 261,000 people aged 12 or older in the U.S. (0.1% of the population) reported misusing methadone in 2017, according to the research titled “Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health” by Jonaki Bose and Sarra L. Hedden. It is difficult to tell the exact extent of methadone abuse since most data sources combine it with other narcotics. The number of individuals treated for “other opiates,” including methadone, rose from 28,235 to 36,265 between 2000 and 2001, according to the National Drug Intelligence Center. These individuals were mainly Caucasian, nearly evenly split between males and females, and represented different age groups. The page titled “Drug Overdose Deaths: Facts and Figures” published by the National Institute on Drug Abuse states that opioid-involved deaths, including methadone, rose from 49,860 in 2019 to 81,806 in 2022. Methadone overdose is linked to improper dosing or combining it with other depressants.

What are the Symptoms of Methadone Addiction?

The symptoms of methadone addiction are drowsiness, doctor shopping, continuous cravings, increased tolerance, changes in appetite, isolation, unsuccessful attempts to quit the drug, mood swings, memory issues, and anxiety.

These 10 symptoms of methadone addiction are listed below.

• Drowsiness: Drowsiness is a constant feeling of sleepiness or fatigue, even when the person is fully rested. Methadone’s sedative effects slow brain activity and cause users to feel lethargic or sluggish throughout the day, according to the 2008 research titled “Subjective Daytime Sleepiness and Daytime Function in Patients on Stable Methadone Maintenance Treatment: Possible Mechanisms” by Harry Teichtahl and Cathy Goodman.
• Doctor Shopping: Doctor shopping means visiting multiple healthcare providers to get methadone prescriptions. Individuals with methadone addiction lie about their symptoms or pain to get more medication.
• Continuous Cravings: Continuous cravings are an uncontrollable desire experienced by methadone addicts to consume methadone despite already taking heavy dosages, according to the research titled “Craving despite extremely high methadone dosage” by Jan W. de Vos and Jan G.R. Ufkes. These cravings lead users to prioritize drug use over essential activities like work, family, or self-care.
• Increased Tolerance: Increased tolerance occurs when methadone-addicted individuals crave higher doses of the drug to experience the same effects or trip. The body adapts to the drug with time and pushes users to increase their intake, which raises the risk of overdose.
• Changes in Appetite: Changes in appetite refer to the fluctuations in eating patterns, either reduced or increased food intake. Methadone suppresses appetite and causes weight loss, according to the study titled “Knowledge about nutrition, eating habits, and weight reduction intervention among methadone maintenance treatment patients” by Anat Sason and Miriam Adelson.
• Isolation: Isolation means the withdrawal from social activities, family, and friends. Methadone addiction leads to feelings of shame or guilt and leads individuals to distance themselves from loved ones to hide their drug use.
• Unsuccessful Attempts to Quit the Drug: Unsuccessful attempts to quit the drug refer to the repeated efforts to stop using methadone that result in relapse. Methadone users find it hard to overcome the addiction despite recognizing its harmful effects like heart problems, kidney damage, and gastrointestinal issues.
• Mood Swings: Mood swings are sudden and unpredictable changes in a person’s mood or emotions, such as moving from happiness to anger or irritability. Methadone addiction changes the brain chemistry and causes this instability in emotions and mood.
• Memory Issues: Memory issues associated with methadone addiction involve difficulties with concentration and recall. Methadone impairs cognitive functions, including memory, and makes it hard to focus on tasks or retain information, according to the research titled “Chronic exposure to methadone impairs memory, induces microgliosis, astrogliosis, and neuroinflammation in the hippocampus of adult male rats” by Fatemeh Navaei and Fatemeh Fadaei Fathabadi.
• Anxiety: Anxiety is a significant psychological sign of methadone addiction. Users feel constant sadness, hopelessness, or fear, specifically during the withdrawal phase of methadone.

What are the Causes of Methadone Addiction?

The causes of methadone addiction include chronic pain management, prolonged use, misuse of methadone prescriptions, genetic factors, psychological factors, and environmental influences.

These 6 causes of methadone addiction are explained below.

• Chronic Pain Management: Chronic pain management refers to the use of methadone to treat persistent pain conditions that don’t respond well to other treatments. Dependence on methadone to manage pain leads to addiction, especially if dosages are increased to maintain relief.
• Prolonged Use: Prolonged use refers to extended use of methadone even after the intended treatment period. Methadone is used for long-term opioid replacement therapy, and continuous exposure increases the risk of developing physical and psychological dependence, even when used as prescribed, according to the study titled “Use of methadone” by Ilene B Anderson and Thomas E Kearney.
• Misuse of Methadone Prescriptions: Misuse of methadone prescriptions involves taking higher doses than prescribed or using it without a medical need. Some individuals misuse methadone to enjoy its euphoric effects and mild sedation, but that increases the chances of addiction and overdose.
• Genetic Factors: Genetic factors are inherited traits that influence the risk of substance addiction addictions, including methadone. Individuals with a family history of opioid use disorders are more likely to develop methadone addiction due to genetic factors affecting brain chemistry, according to the research titled “Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review” by Shao-Cheng Wang and Yuan-Chuan Chen published by the International Journal of Molecular Sciences.
• Psychological Factors: Psychological factors such as anxiety, depression, or trauma contribute to methadone addiction as people with underlying mental health issues use the drug for emotional relief. This cycle of dependency worsens their condition over time.
• Environmental Influences: Environmental influences include factors like peer pressure, socioeconomic stress, and exposure to drug use in surroundings. Individuals in environments where methadone or substance abuse is common are more vulnerable to developing methadone addiction.

What are the Effects of Methadone Addiction?

The causes of methadone addiction include respiratory depression, cognitive impairment, heart and liver damage, hormonal imbalances, chronic fatigue and drowsiness, mental health decline, increased risk of overdose, financial problems, neglect of responsibilities, legal issues, and withdrawal symptoms.

These 11 effects of methadone addiction are listed below.

• Respiratory Depression: Respiratory depression is the slowing or weakening of breathing due to methadone’s sedative effects. Respiratory depression is life-threatening, as it reduces oxygen levels in the body, potentially leading to unconsciousness or death, especially when methadone is combined with other depressants, as stated in the research titled “Methadone Deaths: Risk Factors in Pain and Addicted Populations” by Vania Modesto-Lowe, Donna Brooks, and Nancy Petry.
• Cognitive Impairment: Cognitive impairment refers to difficulties in thinking, memory, and decision-making. Methadone affects brain function and causes confusion, poor concentration, and slower reaction times, which can interfere with work, learning, and daily tasks, according to the study titled “Assessment of Cognitive Functions in Methadone Maintenance Patients” by Shahrzad Mazhari and Zeinab Keshvari.
• Heart and Liver Damage: Heart and liver damage occur with long-term methadone use. Methadone strains the cardiovascular system, increasing the risk of arrhythmias, according to the study titled “A systematic review of the cardiotoxicity of methadone: by Samira Alinejad and Toba Kazemi. Similarly, prolonged use causes liver toxicity, especially if combined with other substances, as stated in the research titled “Effects of Methadone on Liver Enzymes in Patients Undergoing Methadone Maintenance Treatment” by Mahin Eslami-Shahrbabaki.
• Hormonal Imbalances: Hormonal imbalances happen when methadone affects the normal production of hormones like testosterone or cortisol. Hormonal imbalance leads to symptoms such as reduced libido, fatigue, and weight gain.
• Chronic Fatigue and Drowsiness: Chronic fatigue and drowsiness are persistent feelings of exhaustion and sleepiness. The sedative properties of methadone make users feel constantly tired, which affects productivity and increases the risk of accidents.
• Mental Health Decline: Mental health decline includes increased anxiety, depression, and emotional instability. Methadone addiction has the potential to exaggerate existing mental health issues and increase feelings of hopelessness and isolation, as proved in the study titled “The effect of methadone on depression among addicts: a systematic review and meta-analysis” by Masoud Mohammadi and Mohsen Kazeminia.
• Increased Risk of Overdose: The increased risk of overdose occurs when methadone is taken in high doses or combined with other substances. Methadone ranks as the third most commonly seized analgesic by U.S. law enforcement agencies. Methadone-related deaths surged by 390% between 1999 and 2004, largely due to increased use in pain clinics. Overdose deaths frequently occur in methadone maintenance therapy (MMT), particularly among polysubstance users, according to the study titled “Methadone Deaths: Risk Factors in Pain and Addicted Populations” by Donna Brooks and Nancy Petry.
• Financial Problems: Financial problems arise as people prioritize their methadone over financial responsibilities. Individuals spend excessive amounts on purchasing methadone, leading to debt, job loss, or financial instability.
• Neglect of Personal Responsibilities: Neglect of personal responsibilities includes failing to fulfill tasks at work, school, or home. Methadone addiction shifts focus entirely to obtaining and using methadone, resulting in missed deadlines, poor job performance, or neglected family duties.
• Legal Issues: Legal issues occur due to engaging in illegal activities to buy methadone or impaired judgment leading to criminal behavior. Addicted individuals experience arrests for possession or theft, further complicating a user’s life.
• Withdrawal Symptoms After Stopping: Withdrawal symptoms after stopping methadone include nausea, sweating, muscle pain, and anxiety. Withdrawal symptoms are severe and require medical assistance to successfully quit the addiction.

What are the Treatment Options for Methadone Addiction?

The treatment options for methadone addiction are medical detoxification, medication-assisted treatment (MAT), counseling and therapies, support groups, and rehabilitation programs.

These 5 treatment options are listed below.

• Medical Detoxification: Medical detoxification is the supervised process of clearing methadone from the body while managing withdrawal symptoms. Medical detoxification ensures safety by 24/7 monitoring and providing medications to ease discomfort, reducing the risk of severe withdrawal complications like dehydration or seizures.
• Medication-Assisted Treatment (MAT): Medication-assisted treatment (MAT) involves using alternative medications, such as buprenorphine or naltrexone, to stabilize brain chemistry and reduce cravings. Buprenorphine and naltrexone are less likely to cause dependence and are combined with therapy to support long-term recovery.
• Counseling and Therapies: Counseling and therapies include cognitive-behavioral therapy (CBT) and motivational interviewing (MI) to address and treat the psychological problems related to addiction. Therapies help individuals identify triggers, develop healthier coping mechanisms, and rebuild confidence in their ability to stay drug-free.
• Support Groups: Support groups are a community of people who are struggling with methadone addiction and the challenges associated with it. Sharing experiences and hardships helps individuals feel less isolated and stay on track in their recovery journey.
• Rehabilitation Programs: Rehabilitation programs offer structured inpatient or outpatient care where individuals focus on recovery in a closed environment. Rehab programs involve and combine medical care, therapy, and life-skills training to help individuals get back into society after recovering from their addiction.

What are the Withdrawal Symptoms of Methadone Addiction?

The withdrawal symptoms of methadone addiction are anxiety, body aches, irritability, nausea and vomiting, insomnia, sweating, chills and shivering, cravings for methadone, depression, diarrhea, restlessness, and rapid heart rate.

These 12 withdrawal symptoms of methadone addiction are listed below.

• Anxiety: Anxiety is a state of constant worry, fear, and nervousness associated with methadone withdrawal.
• Body Aches: Body aches are muscle and joint pain caused by the absence of methadone’s sedative effects.
• Irritability: Irritability refers to heightened sensitivity to minor frustrations. Those withdrawing from methadone experience mood swings and short tempers as the body’s chemistry struggles to rebalance.
• Nausea and Vomiting: Nausea is a queasy feeling in the stomach that leads to vomiting. Nausea and vomiting occur during methadone withdrawal as the digestive system reacts to the sudden absence of the drug.
• Insomnia: Insomnia is the inability to fall or stay asleep during withdrawal. Insomnia worsens other symptoms, such as anxiety, irritability, and mood swings.
• Sweating: Sweating is the body’s way of eliminating toxins during methadone withdrawal. Excessive sweating leads to dehydration if fluids are not replenished.
• Chills and Shivering: Chills are sudden cold sensations with shivering as the body struggles to regulate its temperature during methadone withdrawal.
• Cravings for Methadone: Cravings for methadone are intense during withdrawal and become overwhelming.
• Depression: Depression is a prolonged feeling of sadness, hopelessness, and fatigue, triggered by methadone withdrawal.
• Diarrhea: Diarrhea, or frequent loose bowel movements, is a withdrawal symptom as the digestive system is getting used to the absence of methadone.
• Restlessness: Restlessness is the inability to sit still or relax. Individuals constantly move or feel an uncontrollable urge to fidget during methadone withdrawal.
• Rapid Heart Rate (Tachycardia): Rapid heart rate or tachycardia refers to an abnormally fast heart rate experienced during methadone withdrawal. Tachycardia causes palpitations and contributes to feelings of anxiety and panic.

How to Prevent Methadone Addiction Relapse?

To prevent methadone addiction relapse, it’s essential to have regular medical supervision to manage cravings and adjust treatment plans. Educating yourself about triggers such as stress, certain environments, or unhealthy routines helps avoid situations that lead to relapse. Opt for non-addictive pain management options like physical therapy or non-opioid medications to reduce dependency. Joining support groups or seeking counseling helps share struggles and gain support.

What is Methadone?

Methadone is a synthetic opioid used in the treatment of opioid addiction and chronic pain. Methadone activates the same receptors in the brain as drugs like heroin but without producing the same euphoric high. The main role of the drug is to ease withdrawal symptoms and reduce cravings for opioids, making methadone an essential component of Medication-Assisted Treatment (MAT) for opioid use disorders. Methadone is addictive despite being effective in managing pain, especially with prolonged or improper use.

Why is methadone addictive?

Methadone is addictive because it interacts with opioid receptors in the brain and gives a sense of calm and relief from pain. The body becomes dependent on the drug with time to feel normal. Methadone builds tolerance, requiring users to take higher doses, which increases the risk of addiction.

How is methadone consumed?

Methadone is consumed in various forms, including tablets, liquid solutions, and injections. Oral consumption is the most prevalent method in treatment settings, where methadone is taken as a liquid or pill under medical supervision. Methadone injections are used by drug addicts who are trying to consume the drug illicitly.

How does methadone make you feel?

Methadone makes you feel relaxed and calm, as it relieves physical pain and reduces anxiety associated with opioid withdrawal. Methadone does not produce intense euphoria like other opioids when taken as prescribed. Users feel drowsy or experience a mild buzz in some cases, especially if tolerance has not developed yet.

How long does methadone stay in your system?

Methadone stays in the system for 8 to 59 hours depending on factors like metabolism and dosage. Methadone is detected in urine for up to 7 to 10 days after the last dose, in blood for about 24 hours, and in hair for up to 90 days. Methadone’s prolonged presence helps in managing withdrawal but poses a risk of overdose if misused.

What is more addictive, methadone or suboxone?

Methadone is more addictive than Suboxone due to its full activation of opioid receptors, leading to a higher potential for dependence. Suboxone contains buprenorphine and naloxone, and partially activates these receptors, resulting in lower euphoric effects and reduced addiction potential. Suboxone is preferred for its safer profile in outpatient treatment settings.

Can you take methadone the same day you use heroin?

No, you can not take methadone the same day you use heroin. Combining methadone and heroin increases the risk of respiratory depression and overdose. Methadone remains in the system for a long time (8 to 59 hours), and adding heroin or other opioids can overwhelm the body’s ability to regulate breathing.

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