What Is Methadone?
Methadone is a synthetic opiate drug, that works on the opioid receptors in the brain. This produces a feeling of euphoria. It’s most commonly prescribed in chronic pain management, or as a substitute medication for individuals addicted to (e.g.) heroin, during severe withdrawal symptoms.
Methadone is extremely addictive, some users say even more so than heroin itself, and it has a half life of anywhere from 8-60 hours typically.
Methadone is a controlled substance and is usually consumed under pharmacist supervision.
Why Is Methadone So Addictive?
From a biochemistry perspective, Methadone is a full mu opioid receptor site agonist. (1)
This means, the chemical occupies all of the available opiate receptors available, until saturation.
This has the effect of a greater opioid feeling of euphoria associated with the drug, than e.g. Buprenorphine, which is a partial agonist, occupying receptor sites only partially.
Methadone is therefore extremely addictive especially when taken at high levels.
The drug is actually used by medical profession as part of the treatment maintenance plan for opiate addictions.
Unfortunately, it makes it easy for users to trade one addiction for another one.
When taken frequently, e.g. as part of methadone maintenance treatment, tolerance develops quickly. This means users end up requiring more and more of the drug in order to achieve the desired results.
When the Central Nervous System starts becoming reliant upon Methadone, physical dependence has developed.
Those with a dependence will experience substantial withdrawal symptoms when trying to quit Methadone cold turkey.
Methadone withdrawal symptoms occur when the body tries to relearn how to function without the drug in the system.
As the body tries to re-establish normal function, during the medical detox, severe pain may develop.
Habituation: How Methadone Addiction Happens
In non-essential use, i.e. use of methadone where no pain exists, addiction can establish itself quickly.
Receptor areas in the brain quickly become habituated, meaning, it takes increasing amounts of the drug to produce the same euphoric effects.
Repeated use at this level, will usually lead to physical dependence on the drug, with users suffering withdrawal including shaking, breathing difficulties, and heart problems.
Emotional Methadone withdrawal symptoms can include depression, disorientation, night terrors, and continued low mood long after withdrawing from the physical drug.
Methadone – Increasing Prescriptions Over Time
Opioid addiction is very subtle. For individuals starting out on Methadone, they’ll often be prescribed 10-30mls per day by an Addiction Doctor.
With fewer Methadone treatment options in community rehabs, in many cases the prescription for methadone is simply increased over time, e.g. some users moving from 30ml daily to 100ml+, with few other treatment possibilities available.
At this level, in some individuals, motor functions can begin to become impaired, symptoms include slurring of speech, restricted or exaggerated physical gestures, shaking, etc.
Methadone – The Numbers
In Scotland in 2014, nearly half a million prescriptions of methadone (2) were dispensed by pharmacists.
In the US, overdoses on methadone kill around 5,000 people (4) annually, according to the Centers for Disease Control and Prevention (CDC).
Methadone is used as a substitute medication for many opiate addictions, not just heroin or prescription painkillers. This could include, e.g. those who have undergone surgery, received powerful amounts of morphine, and have then become addicted to opiates following discharge.
If the individual becomes physically addicted, opioid addiction will continue, long after the physical injury, or surgery, has healed.
At Abbeycare we’ve helped hundreds of clients with methadone detoxification, including those suffering physical injury from car accidents, surgery problems, unhealed wounds, etc., which have all led to opiate, and ultimately, methadone addiction.
During methadone treatment, most people will experience withdrawal symptoms as the drug is slowly leaving their bodies.
It's important to monitor and adjust detoxification protocols according to individual symptoms experienced.
Overdose is also a common issue with this addiction, and requires a Methadone treatment facility and a medical professional to deal with this.
In opiate withdrawal, the body must re-calibrate, and once again get used to having no methadone in the system, occupying those same receptor sites in the brain, and creating euphoric feelings.
However, removing methadone and other opioid drugs from the system carries risks.
Opioid withdrawal symptoms can be lengthy, and will correlate usually to the amount of intake, and duration over which this has occurred.
They include; a runny nose, anxiety, nausea, and joint pain.
Your treatment provider should have a treatment plan that includes behavioural therapy, medicated assisted treatment, and methadone therapy, among others to treat opioid dependence such as methadone and other opioids.
Detoxing from Methadone alone, without medical supervision, is not recommended.
Symptoms Of Withdrawal
Withdrawal symptoms can escalate into life threatening complications when quitting Methadone, underscoring the importance of professional supervision.
Opioid cravings can seriously disrupt the medication assisted treatment.
The withdrawal symptoms usually are flu-like and moderate. The most common are;
- Muscle aches and pains
- Watery eyes
- Rapid heartbeat
- Stomach cramps
Even under controlled circumstances, in an addiction treatment centre setting, withdrawal symptoms must be closely monitored, before administering any detox medication, as applying medication too early can result in precipitated withdrawal, with symptoms markedly worse than normal withdrawal.
Precipitated Methadone withdrawal can induce protracted symptoms, especially those connected to mental health and emotional symptoms of withdrawal such as depression, anxiety, agitation, and the psychological elements of craving.
Following opiate detox some will opt for an opiate antagonist medication, in addition to other aftercare options.
Naltrexone(6) is a drug which works as an antagonist – it occupies the same opiate receptor sites, but does not have the chemical effects of an agonist drug such as Methadone.
By occupying these same places in the brain where Methadone or heroin would usually activate feelings of euphoria, Naltrexone works to dis-associate the euphoric feelings of opiate use, from their intake.
In other words, it works as a deterrent medication – those using heroin or Methadone whilst taking an antagonist medication will usually suffer symptoms such as vomiting, diarrhoea, etc., and certainly won’t experience the feeling of euphoria brought by the opiate drug alone.
Antagonist drugs alone are usually not recommended as the only means of aftercare, or in isolation from appropriate therapeutic intervention during treatment, as below.
Low Dose .vs. High Dose Methadone
Individuals prescribed methadone in the community will typically have their prescriptions increased over time, due to the habituation effects outlined above.
Generally, anything over 30mls is considered within the health care system to be a “high dose” and will require specialist help under withdrawal, or detox, when appropriate.
Abbeycare Scotland are able to provide specialist high dose transfer protocols, subject to approval from our admissions and medical teams.
Methadone Detox & Rehab
Few detox options exist for Methadone in community rehabilitation settings, because the withdrawal process requires close qualified supervision.
Methadone withdrawal can be uncomfortable as well as dangerous, and therefore, seeking private addiction treatment is a positive option.
Many clinics and detox providers use Clonidine, Lofexidine, or other symptom management medications.
Others use Methadone itself to taper Methadone withdrawal very slowly over time.
However, our past clients have found neither of these are particularly effective or comfortable for the individual.
Our specialist Suboxone detox allows a tapered Methadone withdrawal in a safe, supervised, clinic environment, and is fully compatible with a range of aftercare options and therapeutic follow up support.
Many client experience Suboxone as a more comfortable alternative to detoxing from Methadone.
- Effective, comfortable detox from Methadone – even at doses of 30mg daily or greater
- Reduced side effects and cravings following methadone withdrawal
- A custom/specialist program with lower risk of complications, as compared to other programs
- Reducing methadone withdrawal symptoms
- Improving commitment to the detox process
- Increasing detox completion rates
Your detox program is custom prepared, and especially tailored to your personal needs. to minimize the withdrawal effects.
Duration Of Withdrawal
Symptoms typically begin within the first 24 hours since your last dose of Methadone, and it can take more than 60 hours for Methadone to be out of your system. For some, it may take several days before withdrawal starts.
Symptoms of withdrawal from Methadone will last anywhere from three to six weeks, and the process can take even longer for people with severe or chronic addiction.
During detox, the first seven to ten days are usually the worst, and although in most cases this can extend even longer, the Methadone stays in the body for a significant amount of time compared to other medications.
In most cases, the peak withdrawal will not start until seven days elapse. At this point, you will have flu-like symptoms that are distressing such as anxiety. Over the next few weeks, withdrawal symptoms will fade.
Methadone Withdrawal Timeline
Between Day One and Day Two
Symptoms of withdrawal do not usually begin until after 30 hours since the last dose, and may take longer depending on history and extent of intake. Physical symptoms such as fever, muscle aches and rapid heartbeat will start.
Between Day Three and Day Eight
This is the first week and in this time, Methadone cravings are increasing. Patients may face some anxiety, body aches and pains, insomnia and nausea.
Flu-like physical symptoms will persist and due to the long half life of Methadone, and it may take around 8 days for these symptoms to peak.
Additional symptoms at this point include vomiting, cramping and depression.
Between Days Nine and Fifteen
This is after the withdrawal has seriously peaked and therefore the symptoms will now start to subside. However, some will remain such as diarrhoea, irritability, and physical discomfort.
The depression may become severe in some patients and they may also have difficulty feeling pleasure or become motivated.
Day Fifteen and Beyond
Withdrawal symptoms from Methadone such as low energy levels, anxiety, trouble sleeping, and cravings typically persist for 2-3 weeks.
After the 3-6 week detox process is over, many former Methadone users will experience post-acute withdrawal symptoms, or PAWS.
PAWS may continue for many months, and in some cases for up to 2 years. PAWS symptoms include irritability, anxiety, depression, the inability to feel pleasure, difficulty sleeping, and poor concentration.
Methadone Withdrawal Treatment
Detoxing from Methadone is the safest and most efficient when completed in a drug treatment facility or hospital.
Methadone users should always detox under the supervision of a doctor to ensure the patient completes detox safely and comfortably and improves their chances of a successful recovery.
Most medical detoxes provide a tapering off of the drug, or reducing the user’s dosage over a period of weeks.
This method reduces the severity of withdrawal symptoms and is usually recommended over quitting “cold turkey.”
However, tapering off the drug takes longer.
Treatment for Methadone Addiction
Drug treatment centres such as Abbeycare utilise the expertise of physicians and therapists to develop a personalised addiction treatment plan for each patient.
In almost all cases, an inpatient treatment program will give moderate to severe methadone addicts their best chance at a successful recovery.
Inpatient programmes, also sometimes referred to as residential, provide the patient with around-the-clock medical treatment, a variety of therapy programs, and valuable life skills training.
Although each specific treatment programme varies tremendously, there are thousands of options available, meaning there is a good match for every patient.
Outpatient treatment is also an option for those whose Methadone addictions have been diagnosed as minor by a substance abuse professional.
Outpatient addiction treatment is also generally recommended for those who have completed an inpatient programme but are still new to sobriety.
There are a number of levels of outpatient care, including Partial Hospitalization Programs (PHPs), Intensive Outpatient Programs (IOPs), and Standard Outpatient Programs (OPs), so it is important that each patient gets professional assistance in determining what is the proper level of care.
Our methadone protocol is usually administered in oral tablet form.
Much like standard prescriptive detox, methadone detoxing is prescribed in a tapered dose, personalised specifically to your needs.
Any final doses of methadone before detox begins are managed carefully by our doctor to ensure maximum safety and comfort during the process.
Therapeutic Work & Aftercare
There are significant safety issues for those detoxing from Methadone, especially higher doses, in a short period of time.
Those who are newly detoxed from any opiate misuse, run greater risks of overdosing, should they unexpectedly relapse when returning to the community.
For this reason, it is essential that those undertaking detox from Methadone are committed to undertaking the appropriate therapeutic work and aftercare plan required, to maintain abstinence in the long term. aftercare.
This means, matching your needs, regarding all aspects of your life currently, to appropriate supports that you’ll have, after detox treatment.
This ensures, that no matter what stressor arises in your life, you have support to deal with it.
For some, detoxing and subsequent rehab for Methadone, will result in a changed social circle, renewed values in life, a change in living situation, support groups, employment, or other life corner-stone.
However, this fundamental life-work is required, to overcome Methadone addiction for good.
Clinic Treatment For Methadone
During your stay, after detox has begun, you’ll be expected to take part in the day to day agenda in the clinic, in every aspect.
This includes attending therapy sessions, goal setting, motivational work, 12 step work, physical fitness, holistic care, and support groups.
Can this process be used to detoxify from heroin use?
This method may be suitable for some as a detox from heroin, or other opioid medication misuse, depending on your personal circumstances. Every client is assessed individually to ascertain the most appropriate detox method.
I’m on high dose Methadone, is this suitable for me?
Yes. This method of detox is suitable even for those on a higher dose of Methadone greater than 30mg/daily.
Is this a quick fix?
No. This detox protocol allows detoxification from high doses of methadone, however this is not a quick fix and does not address the underlying drivers of addiction, unless you actively participate in our therapeutic program and engage in ongoing aftercare work and relapse prevention actions.
Can you detox me from Methadone at home?
No. Due to the safety issues and medical supervision required, only a residential stay in our clinic is appropriate.
How long will detox take?
The duration of detox from Methadone varies greatly, and depends on multiple factors, including the severity and duration of Methadone usage, your physical and emotional health, and other circumstances.
As a general guide, you should expect this form of detox to last at least 14 days or more.
As above, we recommend a stay duration of 28 days to allow ample time to undertake the therapeutic program elements necessary for long term abstinence. For those with extensive history of Methadone usage, timescales may be much longer.
Upon admission our doctor carries out a full assessment:
- Physical health examination and history checks
- Mental health and wellbeing
- Your usage history, current levels of intoxication, duration and dosages used historically
…to provide a personalised detoxification fitted to your needs precisely.
Get the Detox Treatment Started
To begin detox from Methadone get in touch with Abbeycare now:
Need help for Methadone? : 01603 513 091