Methadone is a synthetic opioid that is prescribed to treat severe pain or to help people manage withdrawal symptoms associated with addiction to other opioids, including heroin, fentanyl, oxycodone or morphine. In spite of its success as a long-term treatment method for opioid use disorders, regularly using methadone is not without risk.
Methadone is powerfully addictive and although it is generally considered to have a lower risk for addiction than heroin and many other opioids, regular methadone abuse quickly leads to profound physical and psychological dependence that can be very difficult to overcome. For many people, professional rehab is the safest and most effective way to beat a methadone use disorder.
How Long Does Methadone Stay in Your System?
The half-life of methadone is quite variable, depending on whether someone regularly uses it or other opioids. In an opioid-tolerant person, the half-life is approximately 24 hours. In someone who does not use opioids, the half-life is approximately 55 hours.
A drug’s half-life indicates the amount of time it takes for half of the amount of drug to be metabolized. As a general rule of thumb, it takes five half-lives for a drug to be nearly completely eliminated from someone’s system. Thus, an opioid-tolerant person will have methadone in their system for approximately five days, while an opioid-naive person may take more than 11 days to completely clear methadone from their system
Methadone Withdrawal Symptoms
Methadone withdrawal includes a myriad of uncomfortable physical and psychological symptoms. Many people describe opioid withdrawal as the worst flu of their life.
Physical withdrawal symptoms include:
- Physical Withdrawal Symptoms
Increased pain sensitivity
Sweating or chills
Psychological withdrawal symptoms include:
- Psychological Withdrawal Symptoms
Drowsiness and/or restlessness
Dysphoria (a general sense of unease and dissatisfaction)
Anhedonia (an inability to experience pleasure)
Methadone Withdrawal Timeline
The timeline of methadone withdrawal can be somewhat variable, depending on the degree of dependence that someone has developed, but the long half-life of methadone leads to prolonged withdrawal symptoms. What makes methadone withdrawal different from other opioids is the long-half life, which substantially increases how long withdrawal symptoms will be felt.
In some cases, methadone withdrawal symptoms can set in as early as 12 hours after the last dose, but symptom onset usually occurs between 30-48 hours after the last dose. Symptoms of acute withdrawal can persist for up to 20 days.
Persistent, fluctuating withdrawal symptoms may be present for weeks or months after symptoms were expected to resolve. This is called post-acute withdrawal syndrome (PAWS). Although PAWS is incredibly frustrating, it is important for people in recovery to understand that their symptoms will subside as time goes on.
The timeline of methadone detox and acute withdrawal will be different for each person, but a general overview of a typical methadone withdrawal timeline is as follows:
- 12 Hours - 2 Days
Onset of withdrawal symptoms
- 2 - 4 Days
Peak of symptom severity
- 4 - 20 Days
Symptom severity will gradually subside
In some cases, fluctuating symptoms may persist for several weeks or months
Factors Impacting Methadone Withdrawal
The key determinant in how long methadone withdrawal will last is the degree of dependence that someone has developed. Additional factors that affect the methadone withdrawal timeline include:
- Methadone Withdrawal Factors
Frequency of use
Duration of use
Polysubstance abuse (abuse of other drugs or alcohol simultaneously or concurrently)
The presence of a support system (friends, loved ones, rehab professionals)
How to Cope with Methadone Withdrawal
Methadone withdrawal can seem unbearable, especially for people who are attempting to quit without professional help and support. Unfortunately, there are no effective home remedies for methadone detox, but people who elect to undergo professional medical detox will have access to around-the-clock care and, when appropriate, medications that will mitigate the severity of withdrawal symptoms.
Tapering off methadone is the safest and most effective way to quit. After a professional evaluation, a tapering schedule can be designed that will help reduce withdrawal symptom severity. In mild cases, partial hospitalization or intensive outpatient programs may be sufficient, but for severe dependence, people are encouraged to enroll in a medical detox program that transitions into residential rehab.
Having a healthy diet and drinking plenty of water can help reduce the severity and duration of withdrawal symptoms. Regular methadone use may deplete vitamin stores, particularly B-vitamins and magnesium, so supplements may be beneficial.
The Dangers of Withdrawing from Methadone Alone
Methadone withdrawal is usually not dangerous for people with mild to moderate dependence. However, people with severe chronic dependence may have an increased risk of seizures if they quit methadone abruptly.
People who suddenly choose to stop taking methadone often face extremely uncomfortable, even debilitating symptoms. Relapse rates are high among people who quit cold turkey, and there is an increased risk of overdose if people enduring withdrawal give in to the desire to take more methadone.
If you are planning on quitting methadone without professional assistance, make sure you enlist a trusted friend or family member who can support you and check on you regularly. Before you quit, discuss your plans with them, including why you want to quit and define specific short and long term goals. As detox and withdrawal progress, they can remind you of why quitting is important to you.
When to Find Help: Methadone Rehab in Florida
If you are concerned that you need methadone addiction treatment, make an appointment with an addiction specialist who is experienced with helping people overcome methadone use disorders. They can provide you with treatment recommendations and referrals as well as give you an understanding of what to expect during detox and early recovery.
For most people, the safest and most effective way to overcome a methadone use disorder will be through professional rehab. The best treatment outcomes are typically associated with comprehensive programs that are equipped to manage every stage of recovery. Rehab facilities that provide multidisciplinary care can evaluate whether a dual diagnosis is appropriate (that is, whether substance use is related to a mental health disorder), which can be incredibly valuable.
If you are facing methadone withdrawal, help is available. The Recovery Village Palm Beach offers evidence-based treatment plans that are proven to help people achieve success in recovery. Contact us today to learn more.
Grissinger, Matthew. “Keeping patients safe from methadone overdoses.” Pharmacy and Therapeutics, August 2011. Accessed September 21, 2019.
Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. “Chapter 4: Withdrawal Management.” World Health Organization, 2009. Accessed September 21, 2019.
Kral, Lee A. “Opioid Tapering.” Pain Treatment Topics, March 2006. Accessed September 21, 2019.