Methadone Addiction, Withdrawal, and Treatment
- Methadone Addiction
- Signs & Symptoms of Abusing Methadone
- Methadone Withdrawal & Detox
- Treatment for Methadone Dependency
Methadone is a synthetic opiate primarily used as a medication. Doctors prescribe methadone to assist former opiate users in detoxification from those drugs and as part of maintenance therapy to help patients avoid relapse. Methadone may also be used to treat patients with severe, chronic pain. When used properly, methadone is safe and effective. However, due to the drug’s similarities to the opiates it is used to counteract, the potential for abuse is high.
Methadone is available in pill, liquid, and wafer forms. One dose can relieve pain and withdrawal symptoms for between four and eight hours. As a medication, methadone is taken once a day. In most cases, the drug must be administered under the supervision of a physician through a certified opioid treatment program (OTP). Methadone must be prescribed as part of a comprehensive treatment program. After a patient has exhibited stability in the program, he or she may be approved to take methadone at home between program visits.
Methadone changes how the brain and nervous system respond to pain by mimicking the body’s naturally-occurring opioids and endorphins in order to lessen opiate withdrawal symptoms. The drug also acts an inhibitor and blocks the euphoric “high” produced by opiates like heroin, morphine, codeine, oxycodone, and hydrocodone. Methadone is long-acting and accumulates in the body with repeated doses, allowing it to effectively reduce drug cravings with a single daily dose.
Patients typically utilize methadone for at least 12 months, though some patients may require years of or even lifelong medication assistance in order to avoid relapse. In cases of long-term use, patients can become dependent upon methadone. Therefore, if a patient is ready to stop methadone treatment, it must be done gradually and under the supervision of a physician to prevent withdrawal.
While dependency on methadone can simply be a side effect of long-term maintenance therapy, addiction can also occur when a user takes more than the recommended dosage or for recreational purposes. “Street methadone” is methadone that has been acquired illegally. This occurs most often when a patient in treatment sells his or her “carries,” or the doses he or she has been allowed to take home between visits to the treatment center.
Signs & Symptoms of Abusing Methadone
Since methadone is less potent than other opiates, it can be more difficult to identify when a person is abusing the drug. Common methadone side effects include dizziness, nausea, and increased sweating. The drug also slows breathing. These symptoms usually do not occur after initial use for patients in ongoing treatment programs.
Methadone users who are experiencing severe symptoms such as weak or shallow breathing, blue lips, difficulty waking, or severe constipation should seek medical attention immediately, as they could be experiencing an emergency or overdose.
Methadone may also cause a life-threatening heart rhythm disorder, characterized by a headache, chest pain, severe dizziness, and fast/pounding heartbeats. Low cortisol levels may be present if a patient is experiencing nausea, vomiting, loss of appetite, worsening tiredness, or weakness. Symptoms such as agitation, hallucinations, fever, sweating, shivering, increased heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea could indicate serotonin syndrome.
In addition to the physical symptoms of abuse, methadone users may exhibit behavioral symptoms. Addictive behavior includes loss of self-control and the inability to use the drug as it is prescribed. Users may also focus heavily on obtaining the drug, attempt to purchase it illegally, or try to obtain multiple prescriptions. Finally, an addicted person may stockpile the drug, skipping doses and later combining them to achieve a high from the larger dose.
Methadone Withdrawal & Detox
Within 24 to 36 hours after the last dose of methadone, a patient will begin to experience withdrawal symptoms. Initial symptoms will likely include
- watery eyes, and/or
- runny nose
Patients may also experience severe flu-like symptoms like muscle aches, goosebumps, nausea, vomiting, cramps, and diarrhea. Depression and drug cravings can remain even after other physical symptoms subside.
Detoxification can last anywhere from two weeks to six months, depending on dosage and duration of use. The process should always be supervised by a physician, who will taper the dosage amounts gradually to avoid life-threatening withdrawal symptoms. The doctor can also monitor the patient’s risk of returning to other opiates in order to avoid the discomfort and pain associated with detox, and discuss other options.
Treatment for Methadone Dependency
Treatment for methadone addiction includes short-term detox and long-term management, similar to that recommended for heroin and other opiates. Combination therapy that includes both medication assistance and social support is most effective.
A physician can provide guidance on tapering methadone dosage, as well as medications like buprenorphine, naloxone, and clonidine, to aid in the withdrawal process. These non-opioid drugs help reduce symptoms until the body no longer requires methadone. However, for many opiate users, including those who have abused methadone, long-term methadone use is the best treatment.
Social and emotional support should be provided in the form of individual and group therapy throughout the recovery process. Due to the high risk of relapse, methadone users may need continued support in order to avoid opiate usage even after detoxification has been completed.
- Use of Methadone – National Institutes of Health (NIH)
- Methadone – Substance Abuse and Mental Health Services Administration (SAMHSA)
- Pharmacology and Medical Aspects of Methadone Treatment – National Institutes of Health (NIH)
- How Do I Know if Someone is on Methadone? The Recovery Village
- Going Through Methadone Withdrawal – Healthline.com