How To Stop Taking Methadone?
READING SUMMARY: The best way to stop taking methadone is by consulting a medical professional. Methadone withdrawal can be painful and psychologically challenging. Whatever discontinuation method you decide to use make sure to discuss the risks and benefits with your doctor. S/He can help you decide whether a long-term taper or abrupt discontinuation is right for you.
TABLE OF CONTENTS
Why Quit Methadone?
There are a few reasons you may want to quit taking methadone.
- Treatment completion. If you have achieved therapeutic stabilization and are ready to live without methadone, congratulations! According to this study published in 2009, methadone is the most successful treatment for stronger opiate addiction, although with fairly substantial financial and personal costs. If you’re ready for a change and have the support…go for it! See the chart below from the 1999 NIDA Notes on methadone treatment success.
2. Drug interactions. Other medications may interact with methadone and can cause heart conditions. Take a look at this WHO chart of methadone drug interactions for a full list of potential side effects.
3. You’re addicted to it. According to SAMHSA, methadone is addictive. After all, it’s still a psychoactive drug…and can cause euphoria especially when you’re not taking it a prescribed. If you get high on methadone, it may be time to look into treatment options for getting off methadone for good.
What Happens When You Quit?
Quitting methadone throws your body out of balance. Most users have developed physical dependence on the substitution drug. So, when you come off of methadone, the lack of it causes stress to the system.
According to the World Health Organization’s (WHO) Clinical Guidelines for Withdrawal Management, it can take between 3 and 10 days for the amount of methadone in in your system to stabilize. So, after taking methadone for a this period of time physical dependence on the medication is expected. This means that your brain and body begin to function normally in the presence of methadone.
When you remove methadone, it takes about 7-10 days to get back to normal. So, if you have developed dependence on methadone and you stop using it, you will experience typical methadone withdrawal symptoms.
Think of withdrawal like this: the body adapts to the depressant effects of methadone by “speeding up” some processes. Take away the methadone, and it takes time for these processes to slow down again.
Withdrawal is a group of predictable symptoms that arise in the body when you lower or cut off your usual doses of methadone. Withdrawal symptoms occur as the effects of methadone wear off and the medication starts to leave the system. These unpleasant side effects are always accompanied by symptoms of discomfort which may increase your need for this drug.
The duration of these unpleasant withdrawal symptoms is around several days to one week. The withdrawal symptoms tend to manifest three days after dose reduction, and last 7-10 days. However, some protracted withdrawal symptoms such as depression, anxiety, or sleeping problems can last for several months after dose cessation.
When you stop taking methadone you can expect to experience some flu like symptoms. Muscle aches and pain occur as methadone is eliminated from your body. As withdrawal symptoms progress you will likely feel nausea, cramps, sweats, and you may experience vomiting and diarrhea. Click here for an Addiction Blog list of methadone symptoms and timeline.
You may also experience other uncomfortable symptoms during the withdrawal stage, such as:
- concentration problems
- mood swings
In order to overcome these difficulties it is best to stop using methadone under medical guidance.
Doctors never recommend quitting methadone cold turkey.
Going cold turkey off methadone can bring you serious difficulties and may have dangerous consequences. One of the biggest risks during the detoxification period is relapse. People who quit cold turkey usually start with high motivation and determination, but once withdrawal sets in, they’ll go to any length to get more of the drug…or will relapse to a stronger opiate, like heroin.
“Tapering” is a procedure that involves a gradual reduction of methadone doses during an extended period of time. Methadone dose reduction schedules range from 2–3 weeks to as long as 180 days, with longer time periods generally associated with better outcomes. Studies have indicated that the more rapid the reduction, the more likely a drug relapse (especially to heroin). Still, this method of discontinuation is considered less aggressive and more safe than abrupt cessation.
Medical professionals recommend to gradually taper off methadone according to individualized tapering schedule created by your doctor. The main goal of tapering is to ensure that the withdrawal process is completed with safety and comfort. Methadone doses are usually reduced in the following rates:
- 20-50% from your current dose per day until you reach 30 mg/day.
- 5 mg per day every three to five days until you reach 10 mg/day.
- 2.5 mg per day every three to five days.
The Australian Department of Health states that the recommend methadone dose reduction should be from 10mg/week to a level of 40mg/day, then 5mg/week. Rates of reduction should be discussed with your doctor and dose changes should occur no more frequently than once a week.
Tapering won’t make withdrawal symptoms disappear. In fact, it can be unpleasant, but it can also lower the intensity and duration of symptoms. When tapering is used to manage withdrawals from heroin or methadone, withdrawal signs and symptoms will begin to manifest as you cut down your daily doses below 20mg. Symptoms reach their peak usually between the second and the third day after cessation According to The Department of Health methadone withdrawal symptoms subside after 10 to 20 days following cessation. Nevertheless, medical practice has confirmed that people tend to tolerate withdrawal symptoms better when they gradually reduce their dosage.
NOTE HERE: You should not attempt to reduce methadone doses by yourself. Dose reductions should be made in consultation with a doctor. When you make an agreement on a tapering schedule, your doctor and addiction counselor or therapist. will be able to follow your progress.
Several medications are used during detox and addiction treatment programs for helping people who are addicted to methadone.
- Buprenorphine may be prescribed to people because of its similar effects to methadone. Buprenorphine is effective in easing withdrawal symptoms.
- Clonidine eases some of the physical withdrawal symptoms associated with methadone detox.
- Naltrexone prevents methadone from binding to opioid receptors in the brain.
When medications are used as an integral part of a medically guided treatment program, mood-stabilizing medications, such as antidepressants or anti-anxiety medications can also help.
NOTE: Whether you decide to taper your methadone doses, or decide to go cold turkey, the most important point is that you first ask for support from medical professionals.
When you decide to stop taking methadone, a professional point of contact can be your doctor, addiction treatment program, or methadone clinic. Or, you can call us directly. Our hotline number on this page will direct you to an addiction recovery specialist. Here’s what you can expect when you seek help:
Medical professionals first determine whether you are physically dependent or addicted to methadone. They assess dependence levels, take your psychological profile, and interview you. You may be asked to submit a urine or blood sample for drug testing.
2. Medical detox.
After your methadone dependency level is determined, you are going to work out the safest alternative to quitting with methadone. One possibility is that you will need to visit a detox clinic. The medical detox clinic will provide you with round the clock care and a safe, drug free environment.
If necessary, you may be referred to longer term inpatient or outpatient rehab.
4. Therapy and counseling.
The goal of quitting methadone for good is learning to deal with psychological issues. Mental and behavioral therapies along with family support are usually combined to help you lead a sober life.
Your Questions Are Welcomed
Got a question?
If you or a loved one are considering quitting methadone, don’t hesitate to consult your doctor or treatment provider. Or, feel free to ask your questions in the comments section below. Additionally, if you have any tips or experiences you’d like to share, please do! We’ll do our best to answer all legitimate inquiries personally and promptly.
Reference sources: Medline Plus: Methadone
CSAT Tip 43: Medication Assisted Treatment for Opioid Addiction
DOJ: Methadone Fast Facts
NCBI: Methadone at tapered doses for the management of opioid withdrawal
The Department of Health: Cessation of methadone maintenance treatment
Photo credit: Robert Ellsworth Tyler