Methadone Abuse: Withdrawal and Treatment

Methadone belongs to the class of opiate (narcotic) analgesics. It functions as a pain reliever by altering how the brain and nervous system respond to pain.

Methadone, which was first developed by German doctors during WWII for severe pain, is now commonly used in the treatment of opioid addiction. Medical experts prescribe methadone to prevent withdrawal symptoms in individuals who have quit taking opiates. Methadone differs from other opioid drugs in that it is processed more slowly in the body and counteracts the negative effects of other opioids. It is also far easier to wean off of than other opioid drugs. As such, it is extremely useful as part of a larger treatment plan for heroin addicts.

Methadone, like most drugs, has many advantages, particularly for people in recovery from opioid use disorder. Nevertheless, these advantages are accompanied by various risks. In addition, methadone is a Schedule II substance. This means that it is highly addictive and can cause a person to become physically dependent on it.

Methadone therapy can lead to abuse and addiction if not medically supervised or closely monitored. Like other drugs, long-term methadone use prescribed for chronic pain can result in tolerance, a condition in which high doses are required to provide the same effect. Once tolerance develops, the individual may attempt to take higher or more frequent doses. This type of behavior can lead to the onset of addiction.

Methadone abuse can also develop if the drug is used illegally, which means obtaining it without a prescription, or if it is taken incorrectly, such as by mixing it with other illicit drugs.

When a person uses methadone, they experience side effects, such as dry mouth, drowsiness, lightheadedness, gastrointestinal distress, urinary retention, and sexual impotence.

In addition to the physical side effects of methadone, psychological side effects may also manifest, including hallucinations, depression, anxiety, paranoia, insomnia, impaired concentration, delusion, and suicidal ideations

According to CDC data, methadone accounted for about 1% of all opioids prescribed for pain and around 23% of all prescription opioid-related deaths in 2014. 

The mortality rate from methadone overdose increased by 600% from 784 individuals (per 100,000) in 1999 to 5,406 persons in 2006 and stabilized at 5,518 in 2007. In 2014, it dropped by 39% with 3,400 persons.

Methadone also carries its own risks of drug abuse. Like alcohol and most drugs, methadone, while less intense than morphine or heroin, can cause mental and physical dependence. Methadone is rarely abused when used as prescribed and under controlled medical supervision. However, it tends to be less tightly supervised when prescribed for pain relief rather than addiction treatment. It can also be purchased and abused illegally without a prescription. These latter two cases can very quickly lead to drug abuse. Despite being a lifesaver for many individuals struggling with addiction, methadone is linked to thousands of deadly overdoses yearly.

When methadone is not taken as prescribed and people take higher doses in search of a “high,” a pattern of abuse and addiction can develop. The effects of methadone can be extremely damaging to mental health and can pose life-threatening risks to the physical health of the individual.

Methadone overdose is the most dangerous risk. A person who has overdosed is usually limp, breathing very slowly or not at all (respiratory depression), and has blue lips or fingernails. Sometimes they are vomiting or lightly gurgling and have high blood pressure. In some cases, people who have overdosed are completely unresponsive. Naloxone, which reverses the effects of opioid overdose, is the best treatment for an overdose, but it must be administered as soon as possible. If you suspect a loved one is abusing methadone, it is a good idea to keep a supply of naloxone at hand.

The following are the overdose symptoms of methadone:

• Nausea and vomiting
• Constricted pupils
• Hypertension
• Discoloration in the nails and fingertips
• Clammy or bluish skin
• Slow, shallow breathing, known as respiratory depression
• Dizziness
• Loss of consciousness
• Convulsions
• Coma
• Death

To ensure the safe use of medication, individuals should disclose their complete medical history to their healthcare providers. Other drugs, including herbal remedies, opioid painkillers, or illicit drugs, may interact with methadone and have adverse health effects, such as unintentional overdose. If you suspect someone is having an unintentional overdose, dial 911 immediately or seek immediate medical care.

• Runny nose
• Watery eyes
• Anxiety
• Tiredness
• Restlessness
• Sweating
• Yawning
• Trouble sleeping

• Muscle aches and pains
• Severe nausea
• Vomiting
• Cramps
• Diarrhea
• Goosebumps
• Depression
• Drug cravings

Because methadone stays in your body for a longer period than other opiates, the symptoms of withdrawal that you experience when you stop using don’t start as soon or as intensely as with other opiates. If you have any symptoms during the first 30 hours of abstinence from methadone, it is quite likely that you are going through withdrawal. The first symptoms will usually become visible between 24 and 36 hours after the last dose. 

In general, withdrawal from methadone can last between two weeks to six months. The withdrawal process needs to be monitored by a qualified medical practitioner for any symptoms and complications. This way, the doctor can help manage the individual’s painful symptoms and maintain treatment.

The half-life of methadone can range from 8 hours to 59 hours or more. However, this varies greatly from person to person, depending on several factors, such as age, metabolism, liver function, weight, methadone dosage, and other health conditions. Due to the fact that it takes five half-lives for the system to eliminate a medication completely, methadone can remain in the bloodstream for a longer period. 

A half-life of 8 to 59 hours equates to 1.83 to 13.52 days when measured in terms of days. In other words, the amount of time that methadone stays in a person’s body can range anywhere from 1.83 days to 13.52 days. With extended use, methadone remains in the body for much longer.

There are numerous options available for treating methadone addiction. If your doctor prescribed methadone as part of addiction treatment, it is often a good idea to consult the physician who prescribed it. They are likely familiar with your situation and can recommend a treatment program that provides the care you need.

Many addicts have found relief through 12-step programs. There are hundreds of 12-step programs in existence today, and each one focuses on specific drug use. Narcotics Anonymous is commonly used in the treatment of opioid addiction. Attending 12-step meetings allows one to build the tools necessary for recovery from addiction and abuse. It is also an opportunity to meet other people struggling in similar situations. These meetings are open to absolutely anyone and are run on a voluntary basis without any fees.

For those with the means to do so, attending sober living is often the best and most effective course of action to recover from opioid addiction. Many different options for recovery are available, including halfway houses, rehab centers, and sober living homes. They are highly effective for recovering from substance abuse and achieving positive outcomes after re-entering the world. One study on sober living houses by researcher Korcha R. Bond found that simply living in a sober environment was enough to improve recovering addicts’ measures of success.

Different options exist for people in different situations when it comes to seeking help and finding a sober living home. Nonprofits such as Shatterproof are available to help provide information. For low-income individuals, government insurance like Medicaid can often pay for rehab and other inpatient treatment programs to help with opioid addiction.

Of course, private facilities are also plentiful. Many offer more dedicated, structured care — and for longer periods. However, while private facilities do indeed cost more, many offer reasonable payment plans. Whatever your financial situation, investing in recovery is likely to sound economic and health advice.