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Methadone is a long-acting opioid medication that was introduced in the 1970s to help those struggling with addiction to wean off heroin.
This drug is still used in this fashion under strict medical supervision, and it can be very effective in easing withdrawal symptoms in people who have struggled with opioid addiction for years. In some instances, methadone may be prescribed for pain control. However, because methadone is a strong drug, it can lead to addiction in some instances.
Per the National Survey on Drug Use and Health, in 2012, about 2.46 million people reported using methadone for a non-prescribed purpose at least once in their life.
Many individuals have become addicted to methadone after being prescribed this drug to treat pain. Because it is being prescribed as a painkiller rather than only as an addiction treatment, more people are able to acquire this drug illegally, by purchasing it off a person with a prescription or stealing it.
Methadone was responsible for one in three opioid overdose deaths in 2009, according to the Centers for Disease Control. The risk of overdose is high in individuals who do not have built-up opioid tolerance due to ongoing drug abuse, and 40 mg may be a fatal dose for many. Methadone stays in the body for a long time, typically at least one day.
In cases where individuals are prescribed methadone to assist with withdrawal from other opioids, individuals may be prescribed 10-20 mg for the first few days of detox. Then, the dose will gradually be lowered until the individual is taking 2 mg per day. This helps lessen many of the strongest withdrawal symptoms, such as opioid cravings, nausea, muscle aches, and anxiety. After the individual is on a very low dose of methadone, the prescribing doctor may switch the person to another detox medication, such as naltrexone. Often, methadone is taken in conjunction with naltrexone to ease the person off opioid dependence.
However, if a person has become addicted to methadone, a weaning or tapering approach should still occur, but a doctor may prescribe naltrexone in addition to buprenorphine or anti-anxiety medications. Weaning or tapering should only occur under the supervision of a medical professional who can help the individual regulate doses.
A doctor may prescribe other medications to help wean the individual off methadone, including buprenorphine or clonidine. These medications can ease withdrawal symptoms while preventing methadone or other opioids from binding to the same receptor sites, so methadone will not have an effect. Most medical professionals will help the individual taper the methadone dose over time, at an individual pace, to ease psychological symptoms. Overall, methadone is considered safe to use when supervised by doctors who can regulate the dose and ensure compliance with the treatment plan.
Although methadone is used to ease withdrawal symptoms in people who have become addicted to heroin or prescription painkillers, methadone can cause its own withdrawal symptoms. This is because it is a synthetic opioid and can be addictive due to its strength. Methadone withdrawal may not be as severe as withdrawal from other opiates, but it can last longer. For most opioids, withdrawal symptoms are most intense for two weeks, but methadone withdrawal can last longer than that.Withdrawal symptoms for methadone include:
- Agitation, restlessness, and anxiety
- Increased tearing or watery eyes
- Runny nose
- Muscle aches or joint pain
- Nausea or vomiting
- Abdominal cramps
- Shivering, trembling, or goosebumps
Quitting Methadone Cold Turkey
If a person decides to quit methadone without tapering the dose, withdrawal symptoms will be more intense. This should never be attempted without direct supervision from medical professionals. In medical detox, professionals can prescribe other medications to elevate mood or ease anxiety, allowing clients to safely move through the withdrawal process.
When quitting cold turkey, withdrawal symptoms are most intense during the first week. However, methadone stays in the body for up to two weeks, so it can take longer a few weeks longer than that for the body to stop feeling withdrawal symptoms, such as a runny nose, trembling, anxiety, depression, and cravings. As with any addiction, cravings can recur months or even years after getting clean.
How Medical Detox Helps People Get off Methadone
Medical detox is offered by some inpatient rehabilitation facilities as part of a larger program to help people suffering from opioid addiction, including addiction to methadone. Medications can address specific withdrawal symptoms, such as antidepressants to address sadness and anti-anxiety medications to ease nervousness.
While medical detox can guide a person through withdrawal, it does not adequately address abuse and addiction issues. Detox should be followed by comprehensive addiction treatment that involves talk therapy and complementary therapies. These therapies address the issues that led to methadone addiction, and help to establish social support systems and better methods of coping with stress.
Medications Used in Medical DetoxDepending on whether or not the individual decides to taper the methadone dose or try other forms of detox, there are several medications a doctor may use while working with a person who is addicted to methadone. These include:
- Buprenorphine, a drug similar to methadone that is sometimes used during detox to ease withdrawal symptoms
- Suboxone, a partial opioid agonist that temporarily prevents opiates from binding to opioid receptors in the brain
- Naltrexone, an opioid agonist that stops opiates from binding to receptors in the brain
- Clonidine, which is sometimes used off-label to ease some of the physical withdrawal symptoms associated with opiate detox
- Mood-stabilizing medications, such as antidepressants or anti-anxiety medications
Whether people decide to taper their use of methadone until they are weaned off it, or decide to go cold turkey, the most important point is that these individuals need support from medical professionals, and family and friends. A comprehensive addiction treatment program can help individuals find a firm footing in recovery so they are able to move forward without returning to substance abuse.