Methadone withdrawal is associated with uncomfortable physical and psychological symptoms. While these symptoms generally subside over time, extreme cases of methadone withdrawal can be fatal. Methadone is somewhat unique among opioids because of its long half-life (up to 55 hours), so acute withdrawal symptoms can last longer than other opioids.
Physical Withdrawal Symptoms
Physical withdrawal symptoms that are often associated with methadone include:
- Increased pain sensitivity
- Nausea or vomiting
- Diarrhea
- Itchy skin
- Muscle aches
- Headache or lightheadedness
- Sweating
- Chills
- Hypertension
- Seizure or stroke, in extreme cases
Many people report that physical methadone withdrawal feels like a very bad flu.
Psychological Withdrawal Symptoms
Psychological withdrawal symptoms that are often associated with methadone include:
- Drowsiness
- Restlessness
- Anxiety
- Lack of pleasure
- Insomnia
- Depression
- Changes in sex drive
- Paranoia
- Suicidal ideation
- In extreme cases, visual or auditory hallucinations, delirium and psychosis
Symptoms of Post-Acute Withdrawal Syndrome (PAWS)
Post-acute withdrawal syndrome (PAWS) can be a frustrating component of methadone rehab. Many people expect that once acute withdrawal symptoms have passed, they should be free of physical and psychological symptoms associated with withdrawal. Unfortunately, methadone causes substantial, long-lasting changes in the brain that persist even in the absence of methadone. These symptoms are often experienced for months or years after cessation.
The symptoms are typically similar to those experienced during acute withdrawal. The degree and duration of PAWS symptoms may fluctuate, but they subside over time. It is important to recognize that experiencing PAWS or cravings long after you’ve quit does not mean that your recovery has failed.
Protracted Withdrawal Symptoms
Protracted withdrawal is a synonym of PAWS. The Substance Abuse and Mental Health Services Administration defines protracted withdrawal as “the presence of substance-specific signs and symptoms common to acute withdrawal but persisting beyond the generally expected acute withdrawal timeframes.”
Helping Methadone Withdrawal
A first-line approach to help ease the methadone withdrawal process is to taper the dose. By gradually weaning off of methadone, people can stave off debilitating withdrawal symptoms and cravings. Moderate to severe methadone withdrawal management may call for medication. The most common medications associated with methadone withdrawal are clonidine and buprenorphine (Suboxone). These drugs each help reduce the severity of methadone withdrawal symptoms.