How Long Does Methadone Stay in Your System?

Methadone Basics

As a long-acting opioid agonist, orally administered methadone is approved by the Food and Drug Administration (FDA) for pain management and the treatment of opioid use disorders. Methadone offers a gradual onset of effects, which minimizes rewards associated with other faster routes of use while preventing withdrawal symptoms from shorter-acting opioids such as heroin. Given various regulations governing its distribution, methadone is only available via specially licensed outpatient treatment programs, where it’s dispensed daily.^1,2

Methadone is most commonly prescribed as a tablet or solution that is taken by mouth. In some cases, doctors can administer doses of the drug through an injection.

The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that when methadone is taken as prescribed, it’s a safe and effective method to help individuals achieve and sustain recovery. However, the substance is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies.²

Common side effects of methadone use include:²

How Long Does Methadone Take to Work?

Dosage and administration of methadone is different from many opioid agonists. Its pharmacokinetic properties along with high interpatient variability in its pain-relieving potency, absorption, and metabolism mean physicians must be cautious and provide highly individualized prescriptions.³

Although methadone’s duration for pain-relieving action is typically between 4 and 8 hours, the half-life is longer than some other opioid pain relievers. In fact its peak respiratory depressant effects can persist longer than its pain-relieving effects. Bottom line: The length of time it takes for methadone to work varies dramatically by individual.³ Contact your prescribing physician for additional insights about how long methadone will take to work for you.

How Long Does Methadone Stay in Your System?

Many factors influence how long methadone stays in your system. Individual health factors, such as age, weight, metabolism, liver function, and additional ailments—as well as the duration of methadone use, frequency of use, dosage amount, and concurrent use of any other substances—all impact how quickly methadone gets processed through your body. Additionally, even after much of the drug leaves a person’s system, traces of it can show up for much longer, depending on the type of drug test used.

Thus, it’s irresponsible to offer broad guidelines as to how long methadone stays in your system. Contact your prescribing physician to learn more about your unique situation and how long methadone may be detectable.

Broad comparisons of Suboxone and methadone show that methadone usually takes longer to clear from a person’s system than Suboxone. Meanwhile, heroin—a highly addictive illicit drug derived from morphine—has a much shorter half-life than both methadone and Suboxone. As such, it typically clears out of the body much quicker.

While standard drug tests often test for opioids, such as heroin and morphine, they don’t always include methadone detection unless specifically requested or added. Because of this, specific and more costly tests must be used if the drug test is screening for methadone use. Urine, saliva, hair, and blood tests have all been developed to test for the presence of methadone in the system.

• Urine tests: Urine tests are the most common form of drug testing. Because urine tests are noninvasive, easy to administer, relatively inexpensive, and have a long detection period, they are usually the preferred mode of methadone testing.
• Saliva tests: Saliva tests offer a convenient and noninvasive way to test for substance use.
• Hair test: Hair tests are helpful for testing for long-term methadone use, as traces of the drug will remain in the hair for many months after last use.
• Blood test: While blood tests for methadone are highly accurate, they are expensive, invasive, and have a relatively short detection window, so they are not commonly used to test for methadone.

Risks of Methadone Misuse

As a schedule II substance, methadone has the potential for misuse.⁴ However, when taken as prescribed, it’s a safe and effective treatment for opioid use disorder.²

When used improperly, methadone overdose can occur. Symptoms of an opioid overdose include:⁶

• Small, constricted pinpoint pupils.
• Falling asleep or loss of consciousness.
• Slow, shallow breathing.
• Choking or gurgling sounds.
• Limp body.
• Pale, blue, or cold skin.

Methadone Withdrawal Symptoms

If someone stops taking methadone abruptly, withdrawal symptoms such as the following may occur:⁵

Detox and Treatment Options

If methadone is used improperly, a methadone addiction is possible. Should this occur, detox and treatment options are available.

Following the detox process, addiction treatment can begin. Many treatment programs are available that start by helping clients through the detox process and take them all the way through planning appropriate aftercare. Long-term and short-term residential/inpatient programs, outpatient treatment, ongoing counseling, and community support programs are all effective treatment options. Individual circumstances and goals will help determine which treatment option is the best for you.

Inpatient treatment programs provide highly structured 24-hour care and monitoring. Outpatient programs offer more flexibility and, depending upon the intensity of treatment, opportunities to continue participating in work and family responsibilities. Both inpatient and outpatient programs aim to include a comprehensive treatment plan, including individual counseling, group counseling, health and drug education, occupational assistance, and establishment of a strong care plan following treatment. Ongoing individual therapy and/or participation in community support programs are often components of an aftercare plan.

Best Practices for Methadone Use

With a nearly 50-year track record of opioid use disorder treatment, methadone is associated with significantly higher rates of treatment retention and lower rates of illicit opioid use. However, it’s highly regulated and only available through specially licensed outpatient treatment programs. In addition, there is wide individual variability in methadone pharmacokinetics, and dosage must begin low and slowly progress with daily monitoring.⁷ Thus, best practices for methadone use should only be addressed by medical professionals with the appropriate licensures to prescribe methadone.