Methadone is a synthetic opioid drug that is used primarily in opioid replacement therapy. It is also commonly used as an analgesic drug due to its pain-relieving properties. For individuals with chronic pain, taking Methadone may provide effective pain relief. This is a drug that acts on the same opioid receptors in the brain as both morphine and heroin – which leads people to experience similar effects from this drug.
Many individuals that have serious addictions will go on Methadone as an alternative to a more powerful drug like heroin. In other words, a person will stop using heroin and instead start taking Methadone. The idea behind using this medication is to serve as a safer replacement for an illicit drug like heroin. A person will take this drug over a period of time and a doctor will eventually help that person gradually reduce their dose – thus helping them defeat their opiate addiction.
A common problem associated with Methadone is that many people find it to be just as addicting (in some cases more addicting) than illicit opiates like heroin. People end up taking this drug and ironically become addicted to the drug that was supposed to help them kick the other addiction. However, research does support the idea that this is a less powerful substance than illicit opioids and in some cases, this is the most effective option for hardcore addicts.
Factors that influence Methadone withdrawal include:
When withdrawing from a drug like Methadone, there are going to be a number of different factors that affect the severity of your withdrawal experience. Various important factors include things like: time span over which you took the drug, dosage, individual factors, and how gradually you tapered off of it.
1. Time Span
How long have you been taking Methadone? Some people have been on it for years as a means to provide pain relief. Others have been on it years to help them cope with opioid dependence. If you have been on Methadone for a shorter duration, the withdrawal should be easier than someone who has been on this drug for an extended period of time (i.e. years). Whenever you take a drug like this for a long period of time, it changes your nervous system and you become physically and psychologically dependent on this drug for daily functioning.
2. Dosage (15 mg to 120 mg)
For opioid replacement therapy, usually a dose between 20 mg and 120 mg is prescribed to be taken daily. For people taking Methadone for pain relief, a dose between 2.5 mg and 10 mg is usually taken every 12 hours. Generally, the greater the dose of Methadone you are taking, the greater the difficulty of withdrawal. Higher dosages require longer tapering periods and when you have built up a tolerance or dependency to high amounts of this drug, it will take your body much longer to adjust to functioning without it.
3. Individual Physiology
Many individual factors play a role in determining how you respond to withdrawal. Some people may not experience nearly as many symptoms or as intense of symptoms as others. With that said, most people experience a pretty profound withdrawal when they have been taking Methadone for an extended period of time.
A lot depends on individual factors including, physiology, nervous system, genetics, environment, habits, etc. These factors are part of the reason that withdrawal is a unique experience for everyone.
4. Cold Turkey vs. Tapering
It is never recommended to quit a drug like Methadone cold turkey, but there have been people that have successfully done it. Some people swear by withdrawing from opiates cold turkey because the symptoms are intense for a shorter duration of time. However, most people have a seriously difficult time with “cold turkey” withdrawal – additionally the symptoms that you could experience from quitting cold turkey may be dangerous.
It is professionally recommended to gradually taper off of Methadone – some suggest reducing your dosage by 10% every 2 weeks. Although tapering is going to be unpleasant as well, it is going to make for a much less intense, less severe withdrawal than if you were to quit cold turkey. People tend to tolerate withdrawal symptoms better when they gradually reduce their dosage.
Methadone Withdrawal Symptoms: List of Possibilities
Included below are some common symptoms that people experience when they withdraw from Methadone. Keep in mind that everyone is affected differently and that you may not experience all of the symptoms on the list below. I already wrote a post detailing “Opiate Withdrawal Symptoms” that you can also reference for further information.
- Anxiety: For some individuals, Methadone helps keep them calm and anxiety at bay. When the person withdraws, they may experience severe and/or intense feelings of anxiety and panic. The panic is likely a result of the person feeling and experiencing all of these withdrawal effects.
- Body aches: It is common to feel aches throughout the body when you withdraw. These aches may be mild or intense. Just know that the achiness should gradually improve and become less intense after you have been off of the drug for awhile.
- Chills: You may feel chills throughout your body when you stop taking Methadone. This is a common experience that will usually last a couple of weeks.
- Concentration problems: Not only will you likely have an array of physical symptoms to deal with, your focus and concentration will plummet. This is because your brain is trying to function without stimulation from the drug. Your focus should gradually start to return after a few weeks.
- Confusion: Many people report feeling intense confusion when they quit this drug. This is a result of them experiencing so many effects both physically and psychologically upon withdrawal. The cognition of the individual that withdraws is likely to be significantly reduced.
- Cramps: You may get cramps throughout your entire body when you stop taking this drug. Most people report severe “abdominal cramps” when they quit. These cramps can be painful in their own right – so do your best to fight through this pain.
- Cravings: If you were addicted to opioids, it is extremely common to experience drug cravings. Not only can a certain level of psychological addiction be created, but physical addiction occurs as well. During withdrawal, you may have intense cravings for this drug and/or other opioids. Do your best to fight through the addiction and avoid going back on the drug at all costs.
- Depersonalization: You may feel depersonalized when you quit taking this drug. This means you may feel unlike your natural self and feel as if you have transformed into a zombie or alien. This is a result of neurochemistry changes and physical changes that your body is enduring. This feeling will go away following an extended detoxification period.
- Depression: Some individuals have claimed that Methadone works to treat depression. Clinical evidence has found that drugs like this one have been used with success at treating refractory depression (i.e. Suboxone for depression). Since most people receive feelings of pleasure and/or an antidepressant effect from taking this drug, it is no wonder that they experience depression when they withdraw. The depression may become very severe because not only are neurotransmitters in a state of chaos, endorphin levels are likely to be lower than average.
- Diarrhea: It is almost guaranteed that you are going to have pretty intense diarrhea during your withdrawal. This diarrhea may strike early within the first few days and may be pretty severe. The best way to cope with this is to go get some Imodium (available over-the-counter). While on Methadone, you may have easily become constipated – during withdrawal, the opposite happens.
- Dilated pupils: While taking any opiate drug, your pupils will contract. When you stop taking it, your pupils will naturally become dilated.
- Dizziness: The dizziness you experience may be incredible and tough to deal with. It may feel as if you have no balance and/or your motor skills are affected by withdrawal.
- Fatigue: Do you feel excessively tired after you quit Methadone? If you feel tired, lethargic, fatigued, etc. – this is because your body is trying to heal itself. It recognizes that it is no longer receiving the drug and is resting in order to restore natural functioning.
- Headaches: A side effect that most people experience during drug withdrawal is that of headaches. If you are experiencing headaches, just know that this is part of the withdrawal process. Working to rest, relax, and stay properly hydrated can go a long way in helping manage these.
- Insomnia: Some people report intense sleepiness, but insomnia is also very common. You may have both sleepiness at times, and insomnia at others. If you are unable to fall asleep at night, this may also have something to do with the anxiety and symptoms you are experiencing. Your best bet is to fight through these symptoms and focus on relaxation if your insomnia is caused by anxiety.
- Irritability: The irritability that is experienced during withdrawal is pretty difficult to tame. When you are being irritable, recognize it as being a withdrawal symptom and try to not let it get the best of your character. It is a result of the depression that you experience when withdrawing.
- Lightheadedness: Another reported symptom is that of feeling lightheaded. This goes hand in hand with feeling dizzy. You may get surges of extreme lightheadedness that prompt you to lie down and rest.
- Mood swings: The moods that you experience when coming off of Methadone may feel totally out of your control. One minute you may feel extremely depressed and like crying, the next you may feel angry and irritable. Eventually you will see the light at the end of the tunnel and your mood will begin to improve and stabilize.
- Muscle pains: If you were taking this drug for pain management, you can expect a lot of the pain to return. In some cases the pain you experience will be even worse than before you started. This is because your body’s natural painkillers (i.e. endorphins) have been depleted by the consistent use of this drug. It will take awhile for your body to re-establish proper endorphin functioning.
- Nausea: If you feel nauseated you are certainly not alone. Many people feel extremely nauseous when they first quit Methadone. The nausea may be intense enough to cause vomiting. Realize that this is your body’s response to coming off of a powerful drug – it will fade.
- Restless legs: It is common to experience restless legs during withdrawal. In other words, your legs may constantly shake or appear restless. This is a symptom that may take a couple of weeks before it starts to subside.
- Runny nose: Another common symptom to experience is that of a runny nose. Although this will eventually dry up, your nose run like a faucet. You can prepare for this by keeping extra tissues around.
- Shakes: Your body may shake in an almost uncontrollable manner and this may be uncomfortable. Although this is going to be uncomfortable and the shakes are difficult to cope with, they will eventually subside. Give your body time to work out these withdrawal effects and it will eventually begin to function without shaking.
- Sleepiness: Most people report feelings of excessive tiredness and sleepiness. During this time your body is trying to recharge itself and re-establish drug-free functioning. This sleepiness may be intense during the initial couple weeks of withdrawal. Over a period of time, your energy levels should return to normal.
- Suicidal thoughts: Both the physical and mental depression can become so severe during withdrawal that you may become suicidal. If you are having constant suicidal thoughts, be sure to seek help or talk to someone about it. Realize that these thoughts are not normal and will not last forever – they are merely a result of withdrawal.
- Sweating: Many people report profuse sweating throughout the day and while they sleep (i.e. night sweats). If you are sweating, just know that this is a very common symptom and it’s your body’s natural way of detoxifying itself.
- Vomiting: Some people report intense vomiting when they stop taking this drug. The vomiting is a result of the person feeling nauseous and sick because their body doesn’t know how to cope without the drug. If you are vomiting and feel sick, these symptoms should go away within a week or two.
Methadone Withdrawal Duration: How long does it last?
The withdrawal process affects everyone differently, but can take a long time. Methadone has a half life ranging from 8 to 59 hours. So at the longest half life, Methadone stays in your system for up to 2 weeks after you’ve discontinued. The first week might be difficult, but the bulk of the withdrawal symptoms will likely become most severe once the drug has fully left the body (this could take several weeks). Expecting to feel fully recovered after a few weeks of withdrawal is typically not realistic.
Long after the drug has been cleared from your body, you can experience what is called a “post-acute withdrawal syndrome” or PAWS. In the event that you experience PAWS, it is likely that it will take an even longer period of time for you to fully recover. My rule of thumb is to give the withdrawal process 90 days before you judge whether you are really starting to feel “back to normal.”