Methadone Signs of Use & Side Effects

As a treatment for opioid withdrawal, methadone maintenance treatment (MMT) has saved countless lives and allowed recovering addicts to lead a functional existence. However, there’s a downside to methadone use that leads to dependence, addiction, and a search for other detox methods.

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More About Methadone

Methadone is very effective when taken in low, controlled doses through a licensed drug addiction treatment specialist. The methadone high isn’t the same as that experienced with other opioids even though it affects the same part of the brain as heroin, morphine, and prescription opioid pain relievers. A methadone high produces a mild state of relaxation, euphoria, and drowsiness.

However, the drug is still an opiate, which means the methadone side effects are similar to other drugs in this class, and the potential for dependence and addiction are the same when it’s abused.

What’s different is the path to addiction, the longer half-life or the drug, and the effects of methadone in those with a low opiate tolerance. Since 1999, there has been an increase in methadone-related overdose deaths and rise in those seeking treatment for methadone addiction.

Methadone addiction is mainly seen in those who have been prescribed the drug to manage pain. This results in diversion due to wider availability outside of a clinical treatment setting. Dependence is less of an issue when it’s used in replacement therapy, as recovering addicts are already dependent on opioids; methadone prevents relapse to more dangerous and addictive forms of opiates. Taking it as a pain reliever appears to be the main source of the increase in methadone addiction.

Signs of methadone abuse are easier to determine in someone who has been prescribed the drug for pain relief or who’s taking it illegally as opposed to in a controlled amount for rehabilitation. They include:

  • Increased tolerance; it takes more of the drug to experience the same effects of methadone
  • Flu-like symptoms that are similar to heroin withdrawal; not as severe, but longer-lasting
  • Inability to stop using methadone despite repeated attempts
  • Making methadone use a priority over family or work obligations
  • Continued use despite negative consequences

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Methadone Side Effects

When taken as directed, methadone side effects are mild enough to be almost undetectable, but they last much longer than the effects of heroin or morphine. There may be some dizziness or a light-headed feeling and drowsiness. This is one of the factors that makes abuse hard to detect until it becomes life-threatening. In the short term, side effects also include:

  • Restlessness
  • Nausea and vomiting
  • Depressed respiration
  • Sweating
  • Constipation
  • Sexual dysfunction, in men
  • Disrupted menstrual cycles, in women
  • Lethargy
  • Slowed reaction times

These symptoms are relatively mild and not life threatening unless they persist for a long period of time. What is a concern is the long-term effects of methadone use and severe side effects that indicate an adverse reaction? If any of the following symptoms occur, prompt medical attention is needed:

  • Difficulty breathing or ability to only take shallow breaths
  • Feeling faint, light-headed, or confused
  • Hives or a rash
  • Swelling of the tongue, throat, lips, or face
  • Chest pain
  • Hallucinations

Some patients shouldn’t take methadone under any circumstances. These include those with a low tolerance for opiates, anyone taking depressant medications, even if they’re herbal remedies, and people with the following medical conditions:

  • Heart disease or arrhythmia
  • People with gallbladder problems, pancreatitis, or thyroid problems
  • Those with liver or kidney disease
  • Anyone with a history of head injury, seizures, or stroke
  • Breathing problems or respiratory ailments
  • People with bladder problems or trouble urinating

Long-Term Effects of Methadone

There are some health effects of methadone use in the long run, especially when the drug is abused. The extent depends on the person’s overall health and abuse history, but look out for symptoms like:

  • Ongoing sexual dysfunction
  • Impaired judgment
  • Respiratory distress

Long-term effects of methadone use also include changes in brain chemistry and function that may not be completely reversible. These include difficulty processing information, memory problems, depression, and disinterest in activities that were previously pleasurable. This is the conclusion of a team of researchers in Norway who conducted an experiment on mice, which was published in Science daily. Over the course of this experiment, a group of mice were provided with tasks and rewards, then given methadone for a length of time. Not only did they lose interest when rewards and new objects were introduced, but the disinterest and lack of focus also continued for some time after the methadone doses were withdrawn. Their concentration also continued to be affected after the experiment ended.

How Long Does Methadone Stay in Your System?

The initial methadone effects are felt within 30 minutes after ingesting the drug, and they last for up to 12 hours when taking prescription tablets by mouth as directed. However, it stays in the system for anywhere from two days up until 60 days. The exact length of time it remains in the system is difficult to tell when it’s used for MAT or MMT, as a consistent level of the drug is necessary to combat drug cravings during detox and maintenance.

If someone is being tested for the presence of methadone for employment or legal requirements, the duration for detection varies by the type of drug testing as well as the duration and level of use.

Here are the numbers for different testing methods:

The Hidden Danger of Methadone Abuse

About 5,000 people die from methadone overdose every year. One culprit seems to be mixing the drug with alcohol or tranquilizers, which are also central nervous system depressants. There’s even a danger of methadone interacting with over-the-counter cold medications that contain non-narcotic opioids and herbal remedies that are used to treat depression and anxiety, such as St. John’s Wort.

The drug has a long half-life and effective time, which is among the reasons it’s so useful for suppressing withdrawal symptoms during opiate detox and maintenance. Unfortunately, that’s also another primary cause of methadone overdose and death.