Methadone Withdrawal Symptoms, Timeline, and Detox Treatment

These groups can be a powerful support network for those who find that they aren’t able to quit using opioids despite their best efforts. Talking with your religious or spiritual advisor may help too. Your healthcare professional may recommend that you have naloxone available to lower your risk of an overdose. Naloxone reverses the effects of opioids during an emergency if you stop breathing.

• Withdrawal can take place at home, in a detox center, or a hospital.
• Provide symptomatic treatment (see Table 3) and supportive care as required.
• The U.S. Drug Enforcement Administration (DEA) publishes that nearly 2.5 million Americans reported abusing methadone at least once in their lifetime as of a 2012 national survey.
• Most doctors can prescribe it within or outside a dedicated drug addiction program.
• While 38 of the 51 (75%) of patients reached zero dosage, only 31% were not using heroin or methadone at the one-month follow-up.

Long-Term Treatment for Opioid Addiction

• Regardless of the setting, medications may be used to relieve withdrawal symptoms, to taper off opioid drugs, or both.
• This medicine may cause a life-threatening heart rhythm disorder.
• However, people on methadone have to stop taking it for several days before starting buprenorphine or they will experience precipitated withdrawal.
• ” Peter used to be in the habit of drinking all his methadone on the day he got it.

The WHO acknowledges that this is only a general recommendation and that the taper schedule should be tailored to each individual’s needs. So, dose reductions can occur once a week, once every two weeks, or less often. John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).

Misconception: “If I tried harder I could get off opioid medications”:

Buprenorphine is another medicine used as a substitute for heroin in the treatment of opioid dependence. However, these guidelines will focus on methadone as it is the most widely used substitute medicine. Patients who are made to cease MMT should be placed on the same dose reduction schedule as described for patients voluntarily ceasing treatment.

Timing of Withdrawal Symptoms

The half-life is the length of time that it takes for half of the dose to leave the body. Methadone’s half-life ranges from 8–60 hours, compared with just 3–5 hours for oxycodone. Addiction treatment can methadone withdrawal start anyone battling substance misuse on the path to a happier and healthier life. Rehab centers are located throughout the U.S., and many offer specialized treatment that can cater to individual needs.

Patients withdrawing from stimulants should be monitored regularly. Because the mainstay of treatment for stimulant withdrawal is symptomatic medication and supportive care, no withdrawal scale has been included. Generally, benzodiazepine withdrawal symptoms fluctuate; the intensity of the symptoms does not decrease in a steady fashion as is the case with most other drug withdrawal syndromes. It is not recommended to increase the dose when symptoms worsen; instead, persist with the current dose until symptoms abate, then continue with the dose reduction schedule. Allow the patient to stabilise on this dose of diazepam for 4-7 days.

As for management of mild alcohol withdrawal, but patients in severe alcohol withdrawal also require diazepam sedation. This may involve very large amounts of diazepam, many times greater than would be prescribed for patients in moderate alcohol withdrawal. Patients should be monitored 3-4 times daily for symptoms and complications. The Alcohol Withdrawal Scale (AWS, p.49) should be administered every four hours for at least three days, or longer if withdrawal symptoms persist.

• Methadone doses should never be withheld as punishment to patients.
• Outpatient treatment is also generally recommended for those who have completed an inpatient program but are still new to sobriety.
• As of December 2022, the MAT Act has eliminated the DATA-Waiver (X-Waiver) program.
• Assessing the use of methadone in various clinical scenarios demands specialized knowledge concerning its pharmacological characteristics and legal limitations.
• If you’re pregnant and have a heroin or pain pill addiction, it’s especially important to get treatment to keep yourself and your baby safe.

A 2009 research review explains the mu receptor appears to be specifically related to the body’s reward process. Methadone, like other opioids, is labeled a Schedule II drug by the Drug Enforcement Administration (DEA), meaning it has a high chance of leading to drug dependency. Like all opioids, methadone’s origins can be traced back to opium, a product of the poppy plant. Most methadone clinics offer some sort of counseling, so that’s a good place to start.

Buprenorphine/naloxone:

Methadone overdose can induce severe respiratory depression, potentially resulting in fatalities. Signs of overdose include extreme lethargy, somnolence, stupor, coma, miosis, bradycardia, hypotension, respiratory sedation, and cardiac arrest. The concurrent use of opioids with other drugs that affect serotonergic neurotransmission has resulted in serotonin syndrome. Experts say people who take methadone to treat an addiction should use it for at least a year while they work on recovery. When it’s time to stop, your doctor will help you do so slowly to prevent withdrawal.

Psychological Symptoms

These symptoms may complicate the patient’s involvement in treatment and should be taken into account when planning treatment. Codeine phosphate alleviates opioid withdrawal symptoms and reduces cravings. To avoid the risk of overdose in the first days of treatment methadone can be given in divided doses, for example, give 30mg in two doses of 15mg morning and evening. Symptomatic treatment (see Table 3) and supportive care are usually sufficient for management of mild opioid withdrawal. Withdrawal symptoms vary according to the drug of dependence and severity of dependence, but often include nausea, vomiting, diarrhoea, anxiety and insomnia. Table 3 provides guidance on medications for alleviating common withdrawal symptoms.