Methadone is an opioid drug that has been used for decades in the management of pain and in the treatment for opioid addictions.
In the case of someone with a heroin or prescription painkiller dependency, recommendations may involve medication-assisted treatment (MAT), with methadone being part of the plan to minimize withdrawal symptoms and cravings for either heroin or the prescription opioid in question. A controlled dose of methadone is effective in this role because it provides relatively long-acting opioid receptor stimulation, eliminating the intense highs and lows and effectively minimizing the withdrawal effects that would otherwise occur in conjunction with heroin or painkiller use and subsequent cessation of use.
Abuse of methadone can amplify the effects of the drug in a way that approximate the rush of heroin.
Despite its utility in addiction treatment, as an opioid drug, methadone itself may be addictive—especially if misused or abused. Abuse of methadone can amplify the effects of the drug in a way that approximate the rush of heroin. These intensified effects can be brought out by:
- Using the drug in ways other than directed such as injecting.
- Saving up and then using multiple doses at once.
- Mixing it with other intoxicating substances.
Methadone has been linked to increasing numbers of overdose deaths. The risk of ill effects from overdose is compounded when methadone is combined with other depressant substances such as alcohol and benzodiazepines.
If you are suffering from an addiction to methadone, professional detox programs are available to help you navigate the process of withdrawal so you can resume your recovery.
Effects and Symptoms of Methadone Detox
Someone who has become dependent on methadone will feel like they are not functioning normally when they are not using and will experience withdrawal symptoms. Methadone has a slower onset of action than many opioids, as well as a longer half-life—meaning that it sticks around in the body for relatively longer periods of time. In the case of quicker acting drugs like heroin, withdrawal symptoms will begin within 12 hours of last use. Methadone withdrawal symptoms, however, may not begin for 30 hours after last use and will usually peak within the first week of cessation.
Symptoms of methadone withdrawal can be very uncomfortable but not usually life-threatening. Withdrawal symptoms may include:
- Muscle pain.
- Poor appetite.
- Sleeping problems.
- Nausea, vomiting, and diarrhea.
During the withdrawal process, some users experience intense psychological developments, including anxiety, panic, and irritability.
The extent of withdrawal symptoms will vary widely based on a number of factors including:
- The dose of methadone.
- How long methadone has been used.
- Whether the methadone was combined with other drugs.
- Pre-existing or co-occurring mental health issues.
The pain and discomfort might lead some to continue using the drug due to fear or lack of information on how to detox from methadone appropriately. This is one of the reasons that a structured detox program – with a regimented detox and tapering protocol, as well as comforting, supportive care throughout the process – may increase the chances of successful methadone recovery.
Methadone Detox Timeline and Protocol
When you enter a detoxification program for methadone, you will be evaluated to determine an appropriate treatment for your specific needs. The extent of your methadone use (as well as that of any other substances) will factor heavily into how your detoxification program is structured, so it’s important to be honest about your use of this and any other substance. Your pre-existing medical history can also affect your treatment, so be sure to disclose any medical conditions you may have.
Methadone detoxification programs usually involve a gradual taper, during which the amount of methadone you’re given is slowly lowered until your body is completely free from the drug.
Types of Medications Used
Medications that may be used to mitigate the unpleasant signs of opioid withdrawal, and thereby facilitate the methadone taper include:
- Clonidine – This blood pressure medication is a common drug used in opioid tapers. Clonidine is helpful in reducing withdrawal effects and can be given every 4 to 6 hours. Clonidine will help manage symptoms like anxiety, sweating, aches, and cramps.
- Buprenorphine (Subutex) – This partial opioid agonist can shorten the timeline for opioid detox and can be taken long-term as part of medication-assisted treatment (MAT).
Some programs offer “rapid” or “ultra rapid” methadone detox. This method claims to make the process of withdrawal easier, because the patient is given a sedating anesthetic while an opioid blocking agent like naltrexone is used to initiate withdrawal symptoms. However, this method is controversial, and the National Institute on Drug Abuse has found no evidence that this process actually eases withdrawal more than other methods and may be less safe – especially in cases where the patient did not reveal medical conditions prior to being anesthetized.
After detox completion, you may be referred for ongoing addiction treatment, such as that offered through either an inpatient or outpatient substance abuse recovery program. This will help you discover reasons behind your substance abuse, manage any ongoing contributing issues, like mental health disorders, and learn the skills to maintain a prolonged period of recovery.
How Does Supervised Detox Help?
While it is possible, albeit uncomfortable, to detox without help, professional treatment holds many advantages. Supervised detox can:
- Accurately assess your individual needs to create a unique treatment plan with the best chances for success.
- Recommend, prescribe, and administer medications to ease the discomfort associated with symptoms of methadone withdrawal.
- Create a safe environment free from temptations to relapse.
- Refer you to ongoing substance use or mental health counseling programs as many suffer from long-term depression and anxiety when beginning the recovery process.
You can often find an inpatient rehab program that incorporates formal detox, or you may enter a standalone program that concentrates focus on the detox process only, and then transition home or to a residential program.
NOTE: Successful completion of a detox program does not constitute thorough addiction treatment. Patients are encouraged to continue with ongoing recovery efforts, such as those offered by professional outpatient or inpatient/residential addiction rehabilitation programs.
Do I Need Supervised Detox?
You might need medical detox if you meet the criteria for an opioid use disorder, which include (but are not limited to):
- Craving methadone.
- Spending an excessive amount of time in using or obtaining methadone.
- Previous unsuccessful attempts to quit on your own.
- Continued use despite negative consequences.
- Giving up previously enjoyed habits or activities in favor of methadone use.
- Development of tolerance (needing more or larger amounts).
- Experiencing withdrawal symptoms when not using.
When you’re assessing whether you need methadone detox, consider the toll that withdrawal from methadone can take. Many people continue using, despite their best intentions, to avoid the discomfort of withdrawal. A formal program can help you go through the process with the least amount of pain possible to increase your chances of getting and staying sober.
Entering a professional detox program can be particularly beneficial because qualified staff can monitor you and ensure your safety. Should complications arise, or your resolve falter, you will be given the appropriate attention, encouragement, and any needed medical care.
Finding a Treatment Program
Choosing the best treatment program for methadone is an important decision. Not all programs will employ the same protocol. Make sure to thoroughly explore the right option for you. Aspects to consider include:
- Treatment location (far away or close to home).
- The facility type (inpatient, residential, outpatient).
- Medications used as part of the program.
- The total time commitment.
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