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Methadone Withdrawal

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Methadone is a common but controversial approach to treating opioid withdrawal. As a long-acting opioid, a dose of methadone is able to stave off opioid withdrawal symptoms for a day without causing significant opioid intoxication. 

However, the drug also causes chemical dependence and withdrawal that can be even worse than other opioids. Methadone can also be abused to achieve a euphoric high, which can lead to addiction and overdose. 

If you or someone you know has been using methadone, it’s important to recognize the signs of withdrawal and how it can be treated. 

What Are Methadone Withdrawal Symptoms?

Methadone withdrawal causes symptoms that are similar to other opioid withdrawal symptoms. It’s often described as a particularly bad case of the flu. Opioids are sometimes grouped in with central nervous system depressants because they can cause sedation that’s similar to depressants. 

However, they work in the brain differently, and they cause different symptoms during withdrawal. Methadone withdrawal symptoms aren’t life-threatening like depressant withdrawal symptoms can be. They can cause extreme discomfort and powerful drug cravings.

Opioid withdrawal symptoms can include:

  • Agitation
  • Irritability
  • Anxiety
  • Depression
  • Nausea
  • Vomiting
  • Diarrhea
  • Lightheadedness
  • Runny nose
  • Sweating
  • Body aches
  • High body temperature
  • Hyperventilation
  • Fever
  • Yawning

Though they aren’t deadly, opioid withdrawal symptoms do represent a significant barrier to sobriety for many people. Some people attempt to stop using opioids, only to encounter awful physical and psychological withdrawal symptoms. Medical detox and addiction treatment can make the withdrawal period and additional recovery efforts more manageable. 

The Stages of the Methadone Withdrawal Timeline

There are several factors that can influence the timeline in which you experience methadone withdrawal. 

The amount of time you were dependent on opioids, the dose of methadone you’re used to taking, and the size of your last dose can all influence your withdrawal timeline. 

Because methadone is such a unique drug, whether or not you’ve used other opioids alongside methadone is a serious consideration. Methadone is a long-acting drug with an extremely long half like. Because of that, it takes longer for your body to process the chemicals, causing methadone withdrawal to last longer than other opioids. 

Though your timeline can be influenced by several factors, it’s likely to follow a rough timeline.

  • 3 days. You will likely experience your first withdrawal symptoms within the first three days after your last dose. If you were used to a high dose or if your last dose was smaller than usual, you might experience your first symptoms in as little as 15 hours. Early symptoms may include irritability, body aches, and runny nose.
  • Two weeks. Between your first and second weeks, you’ll likely experience peak symptoms, which is when your withdrawal phase is at its most intense. Symptoms can include fever, nausea, vomiting, and muscle weakness. You’ll also experience some of the most intense methadone cravings during this time. 
  • Three weeks. By the third week, you will start to feel some of your symptoms start to fade as your overall condition begins to improve. Luckily, the most intense physical symptoms are usually the first to subside. However, you might experience psychological symptoms like anxiety, irritability, and depression for longer. Insomnia is also fairly common.
  • A month or more. Cravings and psychological symptoms can last longer than your initial withdrawal period and may need treatment to address effectively. 

Why Should I Detox?

Like other opioids, methadone isn’t known to cause deadly withdrawal symptoms, but anyone who’s gone through methadone withdrawal might tell you that it’s everything but deadly. 

Methadone is said to cause extremely unpleasant withdrawal symptoms even when compared to other opioids. Methadone causes flu-like withdrawal symptoms that are often compared to the worst case of the flu. Even if it doesn’t lead to potentially fatal consequences, it’s so unpleasant, it’s tough to get through, especially if you don’t have medical help. 

Methadone detox isn’t without its risks, however. Symptoms like vomiting, diarrhea, and heavy sweating can cause you to lose water quickly. If you don’t hydrate with plenty of fluids, you could become dangerously dehydrated. Dehydration is a common problem with a simple remedy, but if you don’t have access to water or if you aren’t able to get it for yourself, you could expense fatal consequences. 

Opioid withdrawal fatalities are typically associated with the neglect of prisoners that are going through withdrawal. Still, it’s vital to consider your water intake during withdrawal. 

Even if you aren’t likely to experience fatal withdrawal symptoms during methadone withdrawal, you are likely to experience a relapse if you go through it without help. Substance use disorders have relapse rates that are similar to other chronic diseases, and they can be as high as 60 percent. Those rates may be even higher for people who are trying to go through withdrawal alone. Relapse can be dangerous and often leads to a fatal overdose. 

What Is the Next Treatment Step?

After you complete medical detox, you may continue on to the next best level of care for your needs. If you still have high-level medical needs after detox, you may continue treatment in an inpatient or residential program. 

At this level of care, you’ll continue to have 24-hour care as you begin to address the underlying issues that may be contributing to your addiction. 

Once you’re able to live on your own, you may continue on to intensive outpatient treatment (IOP). At this level of care, you will attend at least nine hours of care each week. You may also participate in as much as 20 hours of treatment per week in a partial hospitalization program. When you advance in treatment, you may move on to an outpatient program that includes fewer than nine hours of treatment services each week. 

Why Seek Methadone Addiction Treatment?

Opioid addiction is notorious for how difficult it is to overcome. Addiction is a chronic disease. It affects the brain by changing the way your reward system perceives drug use. It can cause intense compulsions to use that are difficult to ignore, even despite serious consequences. 

If you or a loved one is struggling with a substance use disorder that’s related to opioids, it’s critical to address the issue as soon as possible. Substance use problems typically get worse before they get better, especially if you try to go through it on your own. 

Sources

Darke, S., Larney, S., & Farrell, M. (2016, August 11). Yes, people can die from opiate withdrawal. from https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512

U.S. National Library of Medicine. (2019, September 3). Opioid addiction – Genetics Home Reference – NIH. from https://ghr.nlm.nih.gov/condition/opioid-addiction

U.S. National Library of Medicine. (2019, August 22). Methadone: MedlinePlus Drug Information. from https://medlineplus.gov/druginfo/meds/a682134.html

National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

National Institute on Drug Abuse. (2018, January). How effective is drug addiction treatment? from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment

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