Methadone Withdrawal: Symptoms and Treatment

Last Updated: July 6, 2021

Authored by Olivier George, Ph.D.

Reviewed by Michael Espelin APRN

Methadone, sold under the brand name Dolophine, is a prescription drug and works as an opioid agonist. It is prescribed as a potent analgesic for patients with chronic pain and opioid addiction treatment. Although it is very safe and effective when used under a doctor’s supervision, just as other opioids, it has the downside of causing addiction. Once a dose lower than the prescription is taken or stopped altogether without the dosage being weaned off gradually, the symptoms of withdrawal start showing up in phases. This process can be challenging, and there are chances of relapse during this period. But with the help of a trained doctor and the correct procedure for detox from Methadone, it can be easily dealt with. The proper withdrawal methods for this medicine include tapering and detox. Other medications can also be used as a substitute or for dealing with the symptoms. Patients should have information about withdrawal symptoms and the proper procedures to be followed for the medicine to seek help immediately if needed.

What Is Withdrawal from Methadone?

This medicine is typically started as a solution to another addiction—usually to opiates. The medication is usually provided at Methadone clinics, which focus on opioid addiction treatment.  While the drug blocks opiates, this doesn’t mean that the medication is without its problems. One of the biggest is Methadone addiction.

While the medication is highly successful in getting opioid addicts to stop using, it often results in the user trading one addiction for another. Many users are on the medication long term as part of their addiction management strategy, and as a result, their bodies become dependent upon its presence. As a result, when it is stopped, or the dosage is reduced, Methadone withdrawal begins.

Sad woman experiencing methadone withdrawal at home.

Quitting this medicine is not easy. First, the withdrawal process varies between patients based on their bodies and how much they were taking. Second, the patient must be carefully weaned off of the drug under the supervision of a doctor enabling easy detox from Methadone. Without the supervision of a doctor, the patient can go cold turkey, leading to severe complications like heart and blood pressure difficulties and even lead to overdose and death.

Causes of Withdrawal

This drug is a potent opioid agonist which acts on the opioid receptors. Once the body stops getting a supply of opioids, it starts displaying unpleasant Methadone withdrawal symptoms. Usually, this medication is weaned off before stopping. It cannot be prescribed as an “as needed” pain medication, even for severe pain.

Once the body reaches the point of addiction, coming off this drug will result in some degree of withdrawal symptoms. Warnings for this medicine emphasize how difficult this period can be. In addition to the symptoms themselves being potentially dangerous, recovering addicts will also feel significant temptation to begin using their original drug of abuse to stop the adverse effects of Methadone.

Methadone Withdrawal Symptoms

Methadone withdrawal symptoms are unpleasant at best and dangerous at worst. Symptoms of Methadone withdrawal are similar to those caused by opioids, so many people addicted to the drug will be familiar with the sensations from their previous substance abuse.

Methadone Withdrawal Symptoms Include:

  • Muscle aches
  • Irritability
  • Watery eyes
  • Extreme sweating
  • Struggles with sleep
  • Diarrhea
  • Abdominal cramping
  • Nausea
  • Vomiting
  • Fever
  • Rapid pulse
  • High blood pressure
  • Cravings
  • Paranoia
  • Depression
  • Hallucinations

In most cases, these symptoms are uncomfortable but not life-threatening. However, that is not always the case. People can and do die from opiate withdrawal, and that includes this drug. Those with a more profound addiction are more likely to experience withdrawal symptoms to a significant degree and have them become dangerous. Users can mitigate their risk by seeking medical help with managing the side effects of Methadone withdrawal.

Quitting Methadone Cold Turkey

One option people consider is how to get off this medication is quitting cold turkey. This means suddenly stopping the use of the drug without medical supervision. Users might utilize home remedies for Methadone withdrawal at the same time, but this does not qualify as medical management. Ultimately, going cold turkey is dangerous.

Close up of methadone tablet in hands.

When someone goes through Methadone withdrawal cold turkey, they don’t have a medical expert checking their vital signs or monitoring their symptoms. It is easy for the high blood pressure and increased heart rate caused by withdrawal to become dire without the user having a clue that something is wrong.

Severe vomiting and diarrhea are also likely to occur, and without the proper response, the user could become dehydrated, even dying as a result.

Methadone withdrawal cold turkey increases the chances of death with an overdose. This is because users may opt to go back to the medication and take more than they should to fight the unpleasant withdrawal symptoms.

Methadone Withdrawal Timeline

Methadone half-life ranges from 8 to 55 hours. After 24 to 30 hours of stopping the use of this medicine, the withdrawal symptoms begin to show, and they can last from 2 weeks to 6 months. The time varies from person to person. This time can be affected by the duration and dosage of drug use and interactions with other drugs. Individual factors such as age, metabolic rate, and others can also contribute to this time.

Below Is What Users Should Expect When Stopping This Drug:

  • Day 1 and 2: The process starts around 30 hours after the last dose. Early symptoms include chills, elevated heartbeat, fever, and muscle aches which are not as painful but very annoying.
  • Days 3 to 8: A stronger craving for the drug begins, and patients become susceptible to relapse. Along with this, they can experience irritability, anxiety, insomnia, nausea, and body aches. Flu-like symptoms will start appearing. During this time, the withdrawal symptoms will peak at one point depending upon the duration and dosage used. The peak is usually accompanied by additional symptoms, which include depression, vomiting, and cramps.
  • Day 9 to 15: As the peak subsides, the most severe symptoms start fading, but some symptoms such as physical discomfort, irritability, and diarrhea continue. At this point, drug cravings remain strong, and depression becomes severe.

The quitting process of this drug, like most opioid withdrawals, can be divided into two phases. The first includes acute withdrawal symptoms, which are listed above. These are primarily physical symptoms and can be very painful and difficult to manage. The second phase is post-acute withdrawal symptoms, which start after the acute phase and are mainly psychological. The use of opioids can stimulate the reward center of the brain and cause the release of dopamine. Over a period after using the same substance, the body will stop the natural production of dopamine. Once the use of the drug is discontinued, the body takes time to go back to its original state. This duration is psychologically tricky as the person can experience severe depression, anxiety, sleep, and memory problems, thinking impairment, etc.

What Methadone Detox Is

When looking at drug detox, many people use the term interchangeably with tapering and even suddenly stopping drug use. However, each of these is something slightly different. Methadone detox refers to the comprehensive plan for stopping the drug safely and as comfortably as possible.

Methadone detox includes medical supervision, supplements, drug therapies, and a tailored plan for stopping drug use. Generally speaking, this plan for Methadone detox will involve tapering, not stopping the drug all at once.

Doctor consulting a patient about methadone detox.

A Methadone taper plan will have the user steadily taking less and less of the drug over a set period. However, even in the best circumstances, this is not always successful. It is not uncommon for the user to switch to another medication first, then step down from there.

Medications Used in Detox

During the Methadone taper, users may be prescribed other drugs and supplements to keep them comfortable and healthy. Which medications are used during Methadone taper will vary between patients and the symptoms being managed. For example, if the patient is dealing with muscle aches and pains, pain relievers may be used. If they are becoming dehydrated, intravenous fluids may be part of treatment. If the doctor feels the user is at significant risk of relapse, they might opt to prescribe a similar medication, such as switching from Dolophine to suboxone. However, patients should not go into the Methadone detox process expecting to switch to another maintenance medication.

Importance of Rehab for Addiction

Rehabilitation is vital for recovery from this addiction. Without rehab treatment, there is a risk of making this addiction worse by taking the drug for long. Due to this medicine being an opioid drug, it is incredibly addictive, and without supervision, many users will struggle to quit at all. The controlled conditions individuals undergo while rehabilitating allow the person a much higher chance of effectively getting off this medication.

There are some different recovery programs to aid in recovery from addiction. Each program differs slightly, so there is always something to suit each person. For example, someone who needs to maintain a daily routine can choose outpatient care and still get essential support in a home environment. A person should aim to select the best program. They can contact their local drug and alcohol rehabilitation facilities for detailed information on the programs. It will aid in recovery and help an individual to improve their health by getting off the drug for good.

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Page Sources

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Published on: March 15th, 2017

Updated on: July 6th, 2021

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.