Methadone Withdrawal Symptoms & Detox

What do individuals in recovery do when the cure becomes the problem? That’s the question facing methadone addiction specialists and patients who rely on the drug for maintenance and detox from opiates. Methadone addiction is a growing problem that has those on both sides of the issue worried about alternative treatment methods for substance use disorders.

More About Methadone

Patients may become dependent on methadone during the maintenance phase of drug rehabilitation, but methadone withdrawal is manageable when the drug is used during methadone maintenance treatment (MMT). In cases of serious addiction from taking the drug for severe or chronic pain, methadone detox is conducted initially like any other form of opiate detox, using drugs like naltrexone to manage withdrawal symptoms.

Methadone treatment will then proceed along the same path as other drug rehabilitation programs. This is best done in a residential treatment center for several reasons:

  • Increased chance of relapse
  • Increased chance of escalation
  • Increased chance of accidental overdose

Much of the debate about addiction and methadone detox or maintenance surrounds the question of whether recovering heroin addicts are simply trading one addiction for another. Evidence shows that the upsurge in methadone overdose and addiction rates correlates to a rise in its use as a relatively mild, inexpensive pain medication with a comparatively low risk of complications.

However, this takes the drug out of a tightly controlled clinical environment and makes it illegally available to active opiate abusers through street purchases and drug diversion. Because the effects are mild and the drug stays in the system longer than more powerful opiates, the chances of accidental overdose and death increase.

Methadone Withdrawal Symptoms

Supervised methadone detox is provided with a partial or antagonist drugs like buprenorphine or clonidine. This helps manage symptoms while blocking opioid receptors. Anyone going through withdrawal from methadone can expect to experience the following symptoms:

  • Agitation and restlessness
  • Anxiety
  • Depression
  • Insomnia
  • Excessive tearing or watery eyes
  • Runny nose
  • Muscle aches and joint pain
  • Sweating
  • Shivering or trembles and goosebumps
  • Frequent yawning
  • Nausea, vomiting, and stomach cramps
  • Diarrhea

The severity depends on individual factors like age, the severity of the addiction, weight, general health, and the presence of other factors like multiple addictions or mental health problems.

How Long Does Methadone Withdrawal Last?

Because the drug can remain in the system for a long time, methadone withdrawal is often drawn-out and painful. Tapering can be tried in less severe cases, but it should still be performed under supervision from a doctor who has experience dealing with methadone abuse and addiction. The most severe symptoms should diminish within two weeks, although cravings can continue for several weeks more.

Signs of Methadone Overdose

One of the dangers of taking this relatively mild, slow-release opiate is the danger of methadone overdose. Approximately 5,000 patients die from methadone-related overdose each year, according to the most currently available statistics. In 2009, the CDC found that it was a contributing factor in one-third of overdose deaths.

The Physical Signs of an Overdose

  • Slow breathing and/or shallow respiration
  • Slow heart rate
  • Severe drowsiness
  • Small pupils
  • Weak muscles and muscle spasms
  • Cold, clammy skin
  • Fainting or losing consciousness
  • Bluish tint to the skin, especially the lips, due to lack of oxygen
  • Facial swelling, especially the lips and tongue
  • Seizures

If any of these signs are present, immediate medical attention is necessary.

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Phases of Methadone Treatment

When methadone is used to mitigate opiate withdrawal symptoms during the initial phase of detox or for long-term MMT, there’s a low risk of abuse and associated problems.

Clinic-based MMT usually follows three stages:

Getting Help for Methadone Addiction

When dependence is mild or of short duration, tapering off until the drug can be discontinued comfortably is still the best way to stop using methadone. However, if the addiction is severe or long-term dependence has developed. the safest route is to go into rehab and detox with a partial or antagonist drug. Both solutions should be undertaken with a doctor or licensed rehabilitation specialist supervising, and in coordination with therapy and ongoing support.

An increase in methadone dependence and addiction problems doesn’t mean that the drug isn’t still an effective form of long-term maintenance for severe opiate addiction. It has changed the lives of countless heroin addicts and saved many from certain death, and it remains one of the safest options for pregnant women struggling with opiate addictions. However, the rise in addiction does point to the need for further development of more effective, alternative pain management treatments, and better communication/education for patients and their doctors.