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Methadone Withdrawal & Detox

Methadone withdrawal can be intense and prolonged, often requiring a switch to other medication-assisted treatments like buprenorphine. Symptoms include nausea, vomiting, muscle cramps, and depression. Professional care in a detox facility is recommended to manage withdrawal safely and effectively.

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Methadone withdrawal can be intense after using the drug for a while. Since methadone is often used as part of an addiction treatment program, people may be switched to buprenorphine or another form of medication-assisted treatment (MAT) if they need to detox off methadone.

Without MAT, methadone withdrawal generally lasts a few weeks to a couple months. Withdrawal symptoms include nausea, vomiting, muscle cramps, and depression. If MAT is used, withdrawal symptoms can be largely avoided.

Methadone Use

Methadone is a synthetic pain reliever that works by altering the brain and central nervous system’s response to pain, without producing the euphoric effect that is associated with narcotic pain relievers like oxycodone and morphine. 

The drug has legitimate medical uses. It is most commonly used to treat opioid use disorder (OUD) as part of a (MAT) program as well as severe pain that doesn’t respond to less potent opioids.

Methadone was once only given in hospital settings where it could be controlled. People who take methadone as part of MAT generally visit a clinic to get their daily dose. In some cases, methadone may be prescribed for at-home use, but this is generally only after the person has demonstrated a long history in recovery. 

If people are visiting a clinic for a daily dose of methadone, it’s tough to abuse the medication. Most abuse happens with at-home doses or methadone that is purchased on the street. 

What Is Methadone Withdrawal?

People who take methadone as part of MAT will have a physical dependence on the drug. If they stop use, they will enter withdrawal. The same is true for people who are abusing the drug.

Once use stops, withdrawal symptoms will occur, as the body is thrown into a state of imbalance without the drug.

What Causes Withdrawal From Methadone?

Withdrawal occurs because the body has become dependent on the presence of methadone in order to maintain equilibrium in the central nervous system and specifically within the brain. Other bodily systems, such as the gastrointestinal and cardiovascular systems, are also affected.

The body has to adjust to the new state, without methadone, before withdrawal symptoms will subside. This withdrawal syndrome can be life-threatening, so it’s important to seek medical care before stopping methadone use, whether that use is medically prescribed or recreational.

What Are the Common Symptoms of Methadone Withdrawal?

Symptoms of methadone withdrawal are in line with general symptoms of opioid withdrawal. They include the following:

  • Fever
  • Shakiness and tremors
  • Chills
  • Anxiety
  • Gastrointestinal discomfort
  • Stomach cramps
  • Constipation or diarrhea
  • Nausea
  • Vomiting
  • Heavy perspiration
  • Elevated heartbeat
  • Pain and achiness in the muscles
  • Mood changes and irritability
  • Cravings for more methadone or other opioids
  • Hallucinations and paranoia

What Influences the Intensity of Withdrawal?

Numerous factors can influence the intensity of the withdrawal symptoms you experience if you have discontinued methadone after abusing the medication. Examples include the following:

  • The length of time you have been using: As you consume methadone, traces accumulate in the bloodstream and various bodily tissues. Longer periods of use allow more methadone to accumulate, which can increase the severity of symptoms when you discontinue taking the drug. 
  • The amount you generally used: Similarly, consuming larger doses allows more methadone to accumulate. Symptoms of withdrawal may be more severe once you discontinue use, and the body must once again readapt. 
  • Individual factors: In general, being older or having a medical condition that impacts your metabolism (such as diabetes) or organ functioning (like liver disease) will increase the severity of symptoms you experience once you have discontinued using methadone. 

How Long Does Methadone Withdrawal Last?

Methadone is a long-acting opioid, so it often takes a couple days for symptoms to emerge. While symptoms can appear within 24 hours, it’s more common that it takes about two to three days to feel the first symptoms.

During the initial stage of withdrawal, you may begin to feel shaky and anxious, and cravings for methadone will likely begin. Symptoms will tend to build over the next couple days. You may begin to experience flu-like symptoms at this point, including nausea, vomiting, and achiness. 

While symptoms may begin to decline after reaching their apex, you will still be uncomfortable for the next several days. After the 10-day point, symptoms will become much more bearable, as the majority of the methadone in your system will have been cleared. Your body will have had time to regain a state of homeostasis at this point. 

If you have reached the 10-day milestone, the worst of your symptoms are behind you. However, relapse is still a possibility at this point. Remember that detox is not treatment, so you need therapy to ensure you don’t relapse back to methadone abuse. 

The Need for Professional Care

It is best to detox in a professional facility where you have access to medical care. Since abuse of methadone generally indicates a history of opioid abuse, it’s wise to have more intensive support during detox and beyond. You may be prescribed a safe alternative to methadone, such as Suboxone.

With professional support, you can largely avoid uncomfortable withdrawal symptoms. You’ll also be unlikely to relapse since you simply won’t have access to substances of abuse. If you successfully make it through methadone detox without relapse, you can then focus on the core of addiction recovery in therapy.

Updated May 10, 2024
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  2. Progress in Agonist Therapy for Substance Use Disorders: Lessons Learned From Methadone and Buprenorphine. (November 2019). Neuropharmacology.
  3. Withdrawal Management. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
  4. How Long Does Methadone Withdrawal Last? (June 2023).
  5. Opioid Withdrawal. (April 2023). StatPearls.
  6. Opioid Addiction and Abuse in Primary Care Practice: A Comparison of Methadone and Buprenorphine as Treatment Options. (May 2014). Journal of the National Medical Association.
  7. Pharmacotherapy in the Treatment of Addiction: Methadone. (April 2011). Journal of Addictive Diseases.
  8. “It’s Like ‘Liquid Handcuffs”: The Effects of Take-Home Dosing Policies on Methadone Maintenance Treatment (MMT) Patients’ Lives. (August 2021). Harm Reduction Journal.
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