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Does methadone help with opiate withdrawal


ARTICLE OVERVIEW: Yes, methadone helps with withdrawal. Methadone is used for drug detoxification and treatment programs to lessen the symptoms of withdrawal and to block the effects of opiate drugs. Used successfully for more than 40 years, methadone has been shown to eliminate withdrawal symptoms and relieve drug cravings from heroin and prescription opiate medications. Methadone helps people recover from addiction and to reclaim active and meaningful lives.


TABLE OF CONTENTS


Why Withdrawal Happens

Opiate drugs can help relieve pain and trigger extreme euphoria. This is why people use them. In fact, illicit and prescription pain killers have caused what is being called an “Opioid Epidemic” in the U.S. Drugs like:

  • Codeine
  • Fentanyl
  • Heroin
  • Hydrocodone
  • Morphine
  • Oxycodone
  • Tramadol

…all of these drug can become habit forming. But after heavy and prolonged use of opiate drugs, the central nervous system becomes habituated to their chemical presence and adjusts itself. This is called “drug dependence.”

If you develop dependence on opiates, what is actually happening is that the brain and central nervous system are trying to achieve balance to continue functioning. Otherwise, the brain would just shut down. So, in order to counter the depressant effects of opiates, the brain “speeds up” certain systems. Once you stop or dramatically reduce drug doses the “sped up” present in the central nervous system. These are the hallmark signs and symptoms of opiate withdrawal, often including nausea, vomiting, shaking, and muscle pain.

Main Withdrawal Symptoms

When a person stops taking narcotic, painkiller drugs, the body needs time to recover and withdrawal symptoms result. Withdrawal from opiates can occur any time long-term use is stopped or cut back.

Early symptoms of opiate and opioid withdrawal include:

  • Agitation.
  • Anxiety.
  • Muscle aches.
  • Increased tearing.
  • Insomnia.
  • Runny nose.
  • Sweating.
  • Yawning.

Late symptoms of opioids withdrawal include:

  • Abdominal cramping.
  • Diarrhea.
  • Dilated pupils.
  • Goose bumps.
  • Nausea.
  • Vomiting.

These symptoms are very uncomfortable, but are not life-threatening, and usually start within 12 hours of last drug dose. Still, withdrawal from these drugs on your own can be very hard and may be risky and very dangerous. Not only can the symptoms trigger relapse, but you can also fear the worst. In fact, most symptoms can be treated as they occur and are best addressed in a medical setting.

Medical Detox

Withdrawal can take place in a number of settings:

  1. At-home, using medicines and a strong support system. This method is difficult, and withdrawal may be best when managed with a taper.
  2. In medical facilities set up to help people with detoxification (detox).
  3. In a regular hospital, if symptoms are severe.

Treatment in a medical detox setting involves medicines, counseling, and support. So, you don’t need to go through the process alone. Additionally, medications can be used to assist with the treatment of opioid dependence throughout different stages of recovery, as determined by the attending doctor. You and your health care provider will discuss your care and treatment goals to determine what can work best for you.

Main medicines used in medical detox clinics include:

  • Buprenorphine (Suboxone or Subutex)
  • Methadone
  • Extended release naltrexone (Vivitrol)

These medications have demonstrated effectiveness in their ability to reduce the unwanted effects of opiate withdrawal while increasing comfort. Still, medicines are not all that you need. The National Institute on Drug Abuse recommends that medicines should be combined with behavioral counseling for a “whole patient” approach, known as Medication Assisted Treatment.

How Can Methadone Help?

Methadone is the most effective known treatment for narcotic addiction. It is also the preferred drug in the treatment of opiate withdrawal, if an opiate agonist is to be used. In fact, methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. How does it work?

Methadone is a long-acting opioid drug. It activates the same opioid receptors as stronger drugs, effectively eliminating withdrawal symptoms. In this way, it also blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. So, providing the correct dose of methadone prevents opioid withdrawal symptoms and eases drug craving but it does not provide the euphoria.

Specifically, methadone:

  • Blocks the euphoric effects of opiates.
  • Blocks the sedative effects of opiates.
  • Does not cause euphoric high.
  • Relieves drug craving.
  • Suppresses opiate withdrawal.

Over time, the dose can be slowly tapered off, freeing the person from physical dependence without withdrawal symptoms. However, some people can stay on methadone for months to years after withdrawal.  According to the National Institute on Drug Abuse publication Principles of Drug Addiction Treatment: A Research-Based Guide – 2012, the length of methadone treatment for cases of addiction should be a minimum of 12 months. So, even if you think you are ready to stop methadone treatment, it must be stopped gradually to prevent withdrawal. Such a decision should be supervised by a doctor.

In addition, long term methadone maintenance has been shown to reduce illicit heroin use, decrease the incidence of infectious disease (such as HIV and hepatitis) commonly contracted through needle sharing, reduce criminal activity, improve social outcome, and reduce mortality.

Dosing

Methadone used for the detox and the maintenance of opiate addiction treatment is available by prescription as oral solutions (1-2 mg/mL strength), tablets (5-10 mg), dispersible tablets (40 mg), or injectable solutions (10 mg/mL).

The dosage of methadone in maintenance therapy remains controversial. It is usually started at 10 to 20 mg and increased in 10-mg increments until the withdrawal symptoms are controlled. Most patients can be maintained at 40 mg a day to control withdrawal symptoms but not eliminate drug craving. Evidence supports the need to administer higher doses of methadone for effectiveness. In the past, it was common to administer the lowest dose possible to curb opiate withdrawal symptoms.

When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives. For optimal results, people should also participate in a comprehensive medication-assisted treatment program that includes counseling and social support.

Getting a Prescription

By law, methadone can only be dispensed through an opioid treatment program certified by SAMHSA. Also, regulatory restrictions concerning the use of methadone for the maintenance or detoxification of opiate addiction require that practitioners be registered with the DEA as a Narcotic Treatment Program.

People taking methadone must receive the medication under the supervision of a physician. After a period of stability (based on progress and proven, consistent compliance with the medication dosage), they may be allowed to take methadone at home between program visits. You can find a methadone providing opioid treatment program here: SAMSHA Medication Assisted Treatment.

For the above, if you have been addicted to an opiate (narcotic drug such as heroin), and you are taking methadone to help you stop taking or continue not taking the drug, you must enroll in a treatment program. The treatment program must be approved by the state and federal governments and must treat patients according to specific federal laws. You may have to take your medication at the treatment program facility under the supervision of the program staff. Ask your doctor or the treatment program staff if you have any questions about enrolling in the program or taking or getting off your medication.

Side Effects

Side effects of methadone should be taken seriously, as some of them may indicate an emergency. You should stop taking methadone and contact a doctor or emergency services right away if you:

  • Experience a fast or pounding heartbeat.
  • Experience difficulty breathing or shallow breathing.
  • Experience hallucinations or confusion.
  • Experience hives or a rash; swelling of the face, lips, tongue, or throat.
  • Feel chest pain.
  • Feel lightheaded or faint.

Who CAN Use Methadone

Generally, methadone is indicated for patients who are dependent on opioids or have a history of opioid dependence. In the U.S., there were 11.8 million past year opioid misusers aged 12 or older, according to the 2016 National Survey of Drug Use and Health. Worldwide, the 2011 Word Drug Report estimated between 24-35 million adults age 15-64 years used an illicit opiate in 2010. In sum, any of these folks who want to quit using can benefit from methadone.

You must be able to give informed consent for methadone maintenance treatment, and the side effects discussed above should be considered for the selection of people who can take this med during opioid withdrawal. So, methadone is not right for everyone.
2016 Statistics on Opioid Misuse I the U.S.

Who SHOULD NOT Use Methadone

Patients diagnosed with severe liver disease should not be prescribed methadone maintenance treatment because methadone can trigger hepatic encephalopathy.

When taken as prescribed, methadone is safe and effective. But all medicines have risks. The physical effects of methadone must be managed in order to get the maximum benefits of the medication. Therefore, people who are intolerant of methadone or ingredients in methadone formulations should not be prescribed methadone. And because methadone is habit-forming, it’s not always the best choice for someone who wants to quit drugs altogether.

Furthermore, drinking alcohol, taking prescription or non-prescription medications that contain alcohol, using street drugs, or overusing prescription medications such as benzodiazepines during your treatment with methadone increases the risk that you will experience serious, life-threatening side effects. Talk to your doctor about the risks of drinking alcohol or using street drugs during your treatment.

Methadone may harm or cause death to other people who take your medication, especially children. Store methadone in a safe place so that no one else can take it accidentally or on purpose. Be especially careful to keep methadone out of the reach of children.


Methadone medication is specifically tailored for the individual person (as doses are often adjusted and readjusted) and is never to be shared with or given to others.


Methadone Safety

Methadone safety is well established and research goes back to the 70’s to back this up. Still, methadone can be addictive and even lethal when misused, so it must be used exactly as prescribed. Taking more methadone than prescribed can cause unintentional overdose, for example. And mixing methadone with alcohol can cause respiratory depression. This is particularly important for persons who are allowed to take methadone at home and are not required to take medication under supervision at an opioid treatment program.

Tell your doctor if you are pregnant or plan to become pregnant. If you take methadone regularly during your pregnancy, you’ll need special medical attention. This is because withdrawal can provoke miscarriage or premature birth. Even so, your baby may experience withdrawal symptoms after birth….but methadone maintenance can help stabilize you during pregnancy.

Other medications may interact with methadone and cause heart conditions. Even after the effects of methadone wear off, the medication’s active ingredients remain in the body for much longer.

The following tips can help achieve the best treatment results:

  • Be careful driving or operating machinery on methadone.
  • Dispose of unused methadone by flushing it down the toilet.
  • Do not consume alcohol while taking methadone.
  • Never use more than the amount prescribed, and always take at the times prescribed. If a dose is missed, or if it feels like it’s not working, do not take an extra dose of methadone.
  • Store methadone at room temperature and away from light.
  • Take steps to prevent children from accidentally taking methadone.

Need Methadone Help?

Are you considering methadone for an opioid problem? Are you scared, nervous, or confused? Leave your questions or concerns in the comment section below, and we will get back to you as soon as we can. Or, give us a phone call on the number listed above. You are also welcomed to leave a comment with advice and experiences of your own.

Reference Sources: WHO: Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
State of Wisconsin: A Dose of Reality
NCBI: Maintenance Medication for Opiate Addiction: The Foundation of Recovery
CDC: Methadone maintenance treatment
DEA: FAQs prescriptions
MedlinePlus: Opiate withdrawal
MedlinePlus: Methadone
NCBI: Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings
NCBI: Use of methadone
SAMHSA: Follow directions, methadone brochure
TOXNET: Methadone

Leave a Reply

35 Responses to “Does methadone help with opiate withdrawal
R Johnson
8:55 pm August 27th, 2015

This is good information for people to consider who are battling with an addiction to heroin and/or prescription pain medication. Individualized methadone treatment plans, combined with comprehensive medical and psychological care can be very effective in helping a person achieve a healthier and more productive lifestyle.

Susan
6:21 am September 21st, 2015

I had a problem many years ago with pain medication. After 5 yrs a doctor suggested I go into a methodone program. Well it was the best thing I stayed on it for about 5 yrs. I met my husband and wanted to stop. I always did what they told me and I asked for a blind detox. They loved me and told me I was a great example of how much it can change your life if you never took anything else and always had clean urine. I went to a doctor 6yrs later and he prescribed tramadol for bad neck pain that turned into 31/2 yrs of taking 20 pills a day at 50 mg. I want the help of methadone again because I can not tapper myself. It would be way to hard for me I am 57 but very healthy. Can you tell me if methadone for this tramadol addiction will help me? Thank you and be well Susan

3:55 pm September 23rd, 2015

Hi Susan. Methadone is used to help people come off of tramadol in some very extreme cases when slow and gradual tapering of doses is impossible. Consult your doctor and ask him/her to help you construct a tapering schedule that will help you wean off without experiencing adverse withdrawal symptoms.

Dan
12:40 am December 20th, 2015

I want to know i usually split an 8mg suboxone between two days and im fine it alleviates withdraw symptoms completely i was was wondering if i did that with a methadone 10mg if it would work the same way with withdraw symptoms from heroin

Suzanne
1:50 am December 24th, 2015

I’m scared. Panic stricken. Taking 35mgs methadone for opiate withdrawal. Withdrawal unbearable. I would rather die than go drink medicine for maintenance. What is the minimum small dose required to quell withdrawal symptoms?

Lydia @ Addiction Blog
10:34 am December 24th, 2015

Hello, Suzanne. I’d suggest you consult a doctor to help you plan an individualized tapering schedule just for you.

Jack
4:15 pm January 19th, 2016

It was interesting to learn that, “Opiate drugs cause physical dependence, which means that a person relies on the drug to prevent symptoms of withdrawal.” No wonder it’s important to seek treatment and rehabilitation if you’ve ever used this kind of drug. It’s good that there are so many treatment programs willing to help people recover. Thanks for sharing this.

QueenB
6:09 am February 15th, 2016

I am considering getting on Methadone. I have a daughter and I don’t want to lose her. If I tried getting on this program will I be at risk of losing her? Does the county or my doctor or her doctor need to know or be contacted? Please let me know! Thank you!

4:22 pm February 25th, 2016

Hi QueenB. You should consult your doctor and obtain a prescription for methadone. A lot of factors go into safe methadone use, so you should be monitored at first, and your doctor should also determine whether you need any kind of additional support. Actually, you can only get methadone legally through a doctor’s prescription.

CJ
12:10 am March 18th, 2016

Will taking methadone, short term, alleviate the withdrawal symptoms from Oxycodone? Don’t want to stay on methadone maintenance, just want to use methadone for a week or two, and cease usage. Was addicted to oxycodone for 2-3years, stopped cold turkey for 2 weeks, then relapsed for 5 months and now ready to stop for good. I have methadone tablets to help but am I just prolonging the process? Or will I be detoxing from oxy while taking the methadone, and since the methadone is so short termed, I won’t detox from the methadone? And also, will withdrawal be as bad this time around since I quit cold turkey for 2 weeks and picked up the habit again? Or am I detoxing from the 5 months I’ve been using after I stopped for 2 weeks? Sorry for long message, just want some opinions. Thank you, CJ.

Suzanne
8:52 pm June 9th, 2016

I’m still going through the tapering down process. It’s like a never-ending story.

Mike.
1:33 am June 19th, 2016

I’ve been on 6 200mg morphine sulfate s.r, 6 50 mg ir.fast acting morphine sulfate,3 30 mg oxcontine a day.2 60 mg temazapam I to sleep, I have access to 10 mg methadone to try withdrawal I cannot use my Dr or get another my G.P says I have to be on these the rest of my life..I have severe chronic pain syndrome a lot of permanent injuries multiple operations. I’m so dann tired of being in a depressive fog for 15 years now..I need advice on the dosages needed to come of all these meds..

Shannon
1:23 pm August 30th, 2016

I’m using 40$a day of heroin if I take 15 mg a day of methadone than ten than 5 for two wks can I get off it

Lydia @ Addiction Blog
4:21 pm September 5th, 2016

Hi Shannon. If you are looking for addiction treatment, call our trusted treatment hotline, our providers can help you make the best decision for you.

Rexrider
12:55 pm October 6th, 2016

Unfortunately i was prescribed methadone for a back injury resulting in surgery. So at the same time i was also prescribed Norco, & Soma. I don’tdon’t like downers. So i shit canned the Soma, seriously 20 + years later i want to settle my claim with comp. That would mean 20+ years of opiate use now stops. I am starting into my 5th week of withdrawal sickness, no sleep, no energy, shits, pukes, shakes, hot cold flashes, fighting the depression part. The worst i think is, i have major anxiety, and nerve aches in my spine. This is absolutely the Devils brew , .. METHADONE….. now why would a person want to use methadone to get off hydro or vicadin, or any fucking Opiate ? Methadone is the strongest of that group, you will become addicted to the methadone surely ! So you think you needed help getting off hydrocodone, you’ll beg for any sort of relief of the Methadone sickness… i hope i make it ! ! ! I am forcing myself to be a little productive, very hard to cope with anything. Cold Turkey for me, i quit a 13 year smoking habit, CT…then after 18years no smokes i needed to stop a 29 year heavy drinking habit, cold turkey. But the day i gave up alcohol, is started smoking again. The smoking lasted 15 years this time, Made a promise quit smoking ‘CT’ again 2 years ago. The odds are definately not with me ! But if you say i can’t do it alone CT like that ! That just makes me want it more have more …. will power baby. Hang tough, exercise, force feed, be positive your gonna win.
Best of luck, good wishes : REXRIDER

Pam
3:45 am October 7th, 2016

Hi I wod really love some help. I am an opiate addict. I am currently on one of my relapses. I have been using for 3 months. Hydrocodone 50-60 mg. a day. I need to detox and have about 5 10 mg. methadone pills. I was goi g to use 10 mg of if a day for 3-4 days and then taper to 5 mg. I thought I should only use the methadone for 4 days and then stop. I was hoping not to go through heavy withdrawals. Will this work? Thank You

Lydia @ Addiction Blog
3:33 pm October 28th, 2016

HI Pam. I suggest that you speak with your doctor to help you plan an individualized tapering schedule. Also, consult with a local pharmacist to recommend some teas, remedies, and over-the-counter aid to ease withdrawal symptoms.

SVB
6:03 am February 16th, 2017

I want to quit Oxycodone. I have a month supply of Methadone.My questions is this. If I quit the Oxycodone cold turkey tomorrow and start taking the methadone….. will it take away the opiate withdrawals and in 2 weeks when the physical Opiate withdrawals are all gone can I stop taking the methadone and be withdrawal free or is methadone an opiate in itself? Meaning when I stop the methadone will I get withdrawals the same as if I never took it in the first place to quit the oxycodone cold turkey?

Cherie
11:29 pm February 21st, 2017

I was on codeine phosphate for 2 years for medical reasons went into hospital with a bowel obstruction and codeine was stopped been off it for 2 weeks suffering withdrawal symptoms starting taking some oxynorm liquid which helped with withdrawal but doctor wants me to stop it but I am having withdrawal symptoms still and feel awful I can’t function. Is there a substitute that I can be put on to help and then wean me off that?? Would really appreciate your feedback as I don’t know what to do. Thank you

Ed
10:25 pm May 17th, 2017

Hi I have been using heroin and pain pills for many years almost 20 with only brief periods of being clean ( one year at most) I’ve tried so many times to quit detox then counciling 12 step groups all with limited success I am thinking of methadone maintenance program since all other attempts have failed I just want out some kind of normal life too many people around me have od and died I still don’t stop I don’t mind getting up at 4 am each day to line up at clinic to get meds Id do it for dope so if it will help I am in also at only 20$ a day for meds its a lot less than my habit anyone got a comment maby your exp with this any comments are welcome thank you for your support

Lydia @ Addiction Blog
4:39 pm June 1st, 2017

Hi Ed. Call the number you see on the website to speak with a trusted treatment consultant who can help you find the best rehab for you. The helpline is free, confidential, and available 24/7.

Melissa
2:23 am June 24th, 2017

My son had recently started treatment at a methadone clinic for addiction to heroin. He says He doesn’t feel effects and said that he still has craving and actually took heroin. This Is day 5 of treatment and today they increased dosage to 75 mg. I am concerned about mixing the drugs. How long does it usually take to help?

Syd
9:46 pm June 25th, 2017

I am trying to detox from Ativan and I already take methadone.—Will my methadone help me with my Ativan withdrawals or ease the withdrawals a bit

Lydia @ Addiction Blog
6:03 pm June 28th, 2017

Hi Syd. Methadone is used to treat opioid addiction. The best way to quit Ativan is by lowering the daily dosage gradually. I suggest that you speak with your doctor to help you plan an individualized tapering schedule. Also, take a look into the Ashton Manual:
http://www.benzo.org.uk/manual/

Carrie
3:14 am June 26th, 2017

I have taken i cuisine for ten years. Never had a script no insurance and it’s just been a nightmare. I do not take it to get high I have several co ditikns causing me pain. It’s impossible to get a dr with no insurance to prescribe. I’ve come to the point in my life where I cannot stand the game the chase the worry of being sick the cost. I can get as many methadine pills 10mg as I want. If I do not take them long enough to become addicted can these truly get me free from the. Us ? I e tried cold turkey the anxiety almost killed me I truly do not want these pills in my life anymore. I mean that with all my heart and without insurance or even any primary dr if I get the methadines about how many days is safe to take them how much and will it actually work. Thanks so much

Elizabeth
8:49 am July 4th, 2017

Will methadone help immediately as soon as you start getting sick off Heroin ??

Lydia @ Addiction Blog
12:41 pm July 4th, 2017

Hi Elizabeth. You may want to consult with an addiction professional first. Getting off heroin can be hard and uncomfortable, so the safest way to do it is under medical supervision. Call a toll-free Heroin Helpline on 1-888-988-7934 to get in touch with trusted and confidential helpline professionals available 24/7.

maxie
11:34 am July 7th, 2017

Hi if I been taking Norco for like 3years at 3times a day 10mil . How long does it take to detox off of the pain pills?

Lydia @ Addiction Blog
5:38 pm July 7th, 2017

Hi Maxie. It depends. I suggest that you speak with your doctor to help you create an individualized tapering schedule. Also, download our free e-book ‘How To Quit Opioid Painkillers’ to learn more about the process: https://addictionblog.org/ebooks/how-to-quit-opioid-painkillers/

Logan
9:33 am August 22nd, 2017

I want to try methadone as my treatment to get off of heroin I tried Suboxone and it did not work well with me it intensified my withdrawal symptoms like crazy, I was off of heroin for 32hrs before trying one sublingual strip of Suboxone. Like I mentioned before it was terrible. I am terrified now at this point to try anything. I am afraid I will be denied methadone. I lost my job, house, everything I’m so tired of this addiction. I just want to be free again. I don’t want to have to go into a clinic every day to get my medicine either. I have the will power to stop as long as I am not withdrawaling I’ll be fine. I hate this. I am scared to ask for help, I don’t know what to do or say.

Lydia @ Addiction Blog
4:55 pm August 24th, 2017

Hi Logan. Don’t be afraid to seek help! Call a toll-free Heroin Helpline on 1-888-988-7934 to get in touch with trusted and confidential helpline professionals available 24/7. You will speak to a sympathetic, well-trained individual who can help you find a reliable recovery program that will meet your treatment needs.

big mam
4:38 am September 11th, 2017

As I am currently addicted to percocet but I want help quit. If I enroll in rehab that adminiterse methadone would I have to go cold turkey to begin the methadone program also how long will I be on methadone

Lydia @ Addiction Blog
12:19 pm September 13th, 2017

Hi Big Mam. It depends from the program you choose. First, I suggest that you download our free guide ‘The Definitive Guide To Rehab’ to learn everything you need to know on choosing the best rehab for you: https://addictionblog.org/ebooks/the-definitive-guide-to-rehab/
Then, call the helpline you see on the website to get in touch with a trusted treatment consultant who can help you find the best program that fits your needs.

José
7:07 am December 29th, 2017

I have been using tramadol for about 10 years. I use about 12-16 50mgs of tramadol per day in the length of time. I don’t want anyone around me, most of all my family to know about this. Is there a way that I can talk to my doctor to keep this quiet? I don’t want to be submitted into a treatment facility. Is there a way that this can be handled in an out patient method? Also, is methadone a good way to hel0 me with this problem. Thank you very much.

Lydia @ Addiction Blog
2:26 pm December 29th, 2017

Hi José. Yes, there are outpatient treatments. First, I suggest that you consult with your doctor to help you plan an individualized tapering schedule. Also, call the helpline you see on the website to get in touch with a trusted treatment consultant who can help you find a program for you.

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