Methadone Withdrawal Symptoms | Timeline & Treatment

Methadone, a long-acting synthetic opioid sold under the brand names Dolophine, Methadose, and others, is a controlled substance with two key medical uses:

• treating severe chronic pain
• treating opioid addiction through methadone maintenance treatment

However, methadone can itself be addictive and habit-forming, resulting in methadone withdrawal symptoms when a person discontinues methadone use.

Symptoms Of Methadone Withdrawal

Withdrawal syndrome, also known as discontinuation syndrome, occurs when a person who has developed methadone dependence ends their substance use or drops their dosage.

As with other opioid medications, methadone withdrawal symptoms are often compared to the flu and are rarely life-threatening with proper medical supervision.

Symptoms of methadone withdrawal can include: 

• anxiety
• chills
• cravings
• depression
• diarrhea
• fever
• hallucinations
• inability to feel pleasure
• insomnia
• irritability
• muscle aches
• nausea
• paranoia
• rapid heartbeat
• runny nose
• stomach cramps
• sweating
• vomiting

Depending on your history of opioid use, and the general severity of your opiate withdrawal symptoms, how long you experience withdrawal symptoms will likely vary.

Methadone Withdrawal Timeline

While in many ways methadone works much like other opioid or opiate drugs like oxycodone or heroin, it is exceptionally long-acting with a half-life of between 12 and 18 hours at the first dose.

This half-life extends to between 13 and 47 hours with ongoing dosing (compared to around 4 hours for oxycodone and less for heroin).

Unfortunately, this means that methadone withdrawal syndrome, while similar to other forms of opioid withdrawal, may take even longer to complete, especially in severe cases.

A general timeline of common methadone withdrawal symptoms is as follows:

• 1-3 days after the last dose of methadone: the drug is eliminated from the body and withdrawal symptoms begin
• 1-2 days after withdrawal symptoms begin: individuals experience acute physical symptoms including chills, fever, rapid heartbeat, and muscle aches
• 3-8 days: individuals experience strong methadone cravings as well as other physical and mental withdrawal symptoms including irritability, anxiety, and mood changes
• 9-15 days: withdrawal peaks and acute symptoms subside, though cravings and feelings of depression and low motivation may remain
• 16+ days: symptoms continue to improve as the body rebalances, with withdrawal and detoxification ending between three and six weeks after a person’s last dose

Post-Acute Withdrawal Syndrome

PAWS, or post-acute withdrawal syndrome, is common after a period of methadone withdrawal and can cause certain individuals to continue experiencing some lingering withdrawal effects like anhedonia (inability to feel pleasure), difficulty sleeping, or concentration issues for months after acute withdrawal is finished.

Treatment For Methadone Withdrawal

While opioid dependence and withdrawal is rarely directly life-threatening, there are serious dangers associated with this process, including:

• malnutrition and dehydration, which can potentially become life-threatening in the absence of medical care
• overdose deaths, which may occur as those in recovery relapse and take opioid drugs to alleviate their withdrawal symptoms, accidently overestimating their current level of tolerance

Because of this, those attempting methadone withdrawal are likely given two recommendations:

• medical detox program, which offers medical support and guidance for those moving through the withdrawal process
• tapering, or slowly reducing methadone dosage over time, as quitting cold turkey will increase the severity of the withdrawal process

Tapering services are provided through medical detox centers and other healthcare professionals.

Treating Methadone Addiction

While drug addiction treatment is difficult, there are a variety of interventions and addiction treatment options available to help individuals work through the recovery process after methadone detox is concluded.

Inpatient Treatment

Inpatient treatment programs, also known as residential treatment programs, are the most effective and recommended treatment format for those with moderate to severe methadone addiction.

Inpatient treatment provides participants with around-the-clock medical treatment and a wide-range of different therapy programs, education, and alternative treatments.

These treatment options may include:

• medication-assisted treatment (MAT) using buprenorphine or naltrexone
• cognitive behavioral therapy (CBT)
• motivational enhancement therapy (MET)
• individual and group counseling
• peer support groups

Outpatient Treatment

Outpatient treatment is also an option for those with a milder degree of methadone addiction, as well as for those who are unable to participate in inpatient treatment or who have already completed inpatient treatment.

Outpatient treatment programs vary in intensity and offer different levels of treatment ranging from counseling to intensive, inpatient-like interventions.

If you or a loved one lives with methadone addiction, you aren’t alone. Contact Northeast Addictions Treatment Center to learn more today.