Methadone was once an opioid that was used to treat pain but is now a drug that has been delegated to medication-assisted treatment (MAT). The sole purpose of methadone is to alleviate withdrawal symptoms and wean people off of severe opioid dependence. It is used in conjunction with therapy to help an individual live a life outside of active opioid addiction. With more than 130 people dying a day from the opioid crisis, all solutions are acceptable when attempting to treat this epidemic. Studies show that nearly 80 percent of those who become addicted to heroin started abusing prescription medication, and many of those who attend treatment will be given the option of using methadone.
Methadone works by blocking the brain receptor sites that heroin and other opiates affect. Methadone works by blocking the euphoria these drugs provide as well as withdrawal symptoms. Methadone is a full opioid agonist like heroin and other opiates, meaning it can produce euphoric effects when binding to the brain’s opioid receptors; however, it is much milder than the opioids it is intended to treat.
Medication-assisted treatment has been a significant difference-maker for those who take part, but there are still dangers associated with the use of methadone. While the drug may be less potent than other opioid drugs such as heroin or fentanyl, in which it is meant to treat, it can become like trading one addiction for another.
If someone has become addicted to prescription opioids such as OxyContin, heroin, or fentanyl, and turned to methadone for relief but became addicted, treatment is available with the help of medical detoxification.
What Are the Methadone Withdrawal Symptoms?
Although methadone is milder in nature when compared to other opioids, it still falls under the same class of drugs. Methadone withdrawal symptoms are going to be similar to what you’d expect from other opiate drugs. Some of these withdrawal symptoms include:
- Nausea and vomiting
- Flu-like symptoms (runny nose, fever, chills, etc.)
- Muscle cramps
Since methadone is used to transition someone off of other more potent substances, one may wonder if there are drugs that can taper off of methadone. Buprenorphine works in a way similar to methadone and blocks the brain’s opioid receptor sites and cancels the effects of methadone as well as other withdrawal symptoms.
Methadone is a full opioid agonist, whereas buprenorphine is only a partial agonist. What this means is that euphoric effects are not likely to be produced due to buprenorphine use. Because of the lack of effects, it makes buprenorphine a safer option for long-term tapering use in addiction treatment. Unfortunately, though, buprenorphine may not be sufficient enough to help curb the cravings or withdrawal symptoms in the event of a severe opioid dependence on substances like fentanyl. It can, however, be instrumental when weaning someone off of methadone.
What Are the Stages of Methadone Withdrawal Treatment?
Methadone withdrawal is not nearly the intense experience as someone coming off more potent opioids; however, it is a much more prolonged experience that can span from two weeks to several months. Unfortunately, even the acute withdrawal period can require several stages before it is completed. The timeline of a methadone withdrawal looks like this:
- Physical symptoms will begin to arrive around 24 hours of the last use, but this can vary for methadone. In some cases, it can take methadone 15 to 60 hours to entirely leave the body, and symptoms may not appear for several days.
- Over the course of the next ten days, the psychological symptoms will come to fruition. The physical symptoms will also begin to appear and be their most active and intolerable.
- After this period, the majority of physical symptoms will have peaked and begin to dissipate, but psychological symptoms such as depression can persist and become stronger. The phase often lasts around ten more days.
- Once three weeks of methadone abstinence has been achieved, if any symptoms do persist, they should be very mild. Bouts of depression are to be expected in the weeks and months to come as the body continues to adjust to the lack of methadone that it became dependent on using.
The timeline listed above is a very general look at what methadone withdrawal symptoms can be, but there are a host of other factors that may contribute to the length of someone’s symptoms and deviate from it. These can include:
- How much methadone was being consumed
- The length of time methadone was being used
- How often they were taking methadone
- If they were taking it in the prescribed tablet form, injecting, or snorting it
- The severity of the addiction, if their mind is just as dependent on methadone as their body
- How they choose to stop taking methadone (tapering the dosage, substituting a medication like buprenorphine, or stopping cold turkey).
Should I Detox?
Methadone is not necessarily dangerous when compared to alcohol or benzodiazepines, but quitting methadone without tapering off the dosage will make the withdrawal symptoms much more intense and prolong the process. Recurring cravings and bouts of depression can persist months after you abstain from methadone use, significantly increasing your risk of relapse.
You should never quit methadone cold turkey because it can make the withdrawal process much more uncomfortable and lengthy. Also, opioid or methadone withdrawal is not something to try and manage at home.
Overdosing is possible as your sensitivity to the drug’s effects will increase, and your tolerance to the effects will decrease. If you are serious about treating a methadone addiction, it is in your best interest to commit yourself to medical detoxification to avoid any serious health risks.
The safest decision to make is to begin the continuum of care in a supervised detox where the staff can plan accordingly in case of anything out of the ordinary is to occur. The process will take anywhere from three to seven days but can last longer at the discretion of the staff.
When entering into detox, clinicians will devise a plan that determines your next level of care. A thorough assessment will be made that acts as a suggestion for what level of care will be best suited for your needs.
What Is the Next Treatment Step?
Once methadone detox has been completed, it’s imperative to move forward with ongoing addiction treatment. While detox is essential for ridding methadone from your system, it will not get to the root of what caused your addiction, especially if you become dependent on methadone while undergoing treatment for a stronger opioid. If the psychological aspect of addiction is not discussed at length, the chance of relapse remains high.
Whether the assessment in detox placed you in a residential or outpatient treatment facility, ongoing treatment will help you understand the underlying factors that caused addiction. The program will also equip you with the tools necessary to manage the addiction and maintain sobriety long-term. If you or someone you love is struggling with a dependence on methadone, it is imperative that they reach out for help immediately.