Methadone overdose: How much amount of methadone to OD?

What are the signs and symptoms of methadone overdose? And how much methadone does it take to OD? We review here.

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As with other prescription drugs, methadone is the reason for many cases of abuse and fatal overdoses. In this article, we hope to inform you on methadone overdose, its most common manifestations on the body as well as the recommended dosage and prognosis. Then, we invite your questions about ODing on methadone at the end. In fact, we try to respond to all legitimate queries with a personal and prompt response.

How does unintentional methadone overdose happen?

Methadone has been used safely and effectively for decades to treat opiate addiction. In fact, the most common use for methadone is as pharmacological treatment for drugs like heroin, morphine, or pain medication. But methadone can also be used as a pain reliever, or abused by drug users to get high. Methadone prescriptions for pain relief have increased as has the nonmedical or recreational use of methadone.

According to some reports, methadone used for heroin substitution treatment does not appear to be a major part of the overdose issue. But one important element for the occurrence of methadone overdose is the fact that methadone is accessed as a low-cost generic drug and is often listed by preferred drug by insurance agencies. This is why, generally, methadone overdose is usually linked with trying to get high on methadone and is connected to abuse and misuse of this opioid medication. Individuals who abuse other narcotics such as heroin, turn to methadone because of its increasing availability. However, methadone does not produce the same euphoric rush compared to other drugs, so they end up consuming dangerously large quantities in order to attain the desired effect. A common outcome of those cases are methadone overdoses.

Methadone overdose – How much is too much?

Developing tolerance to methadone plays a role in the quantities which provoke an overdose. The official lethal dose for methadone is 25 mg for a non-tolerant adult. A 200 mg dose may be fatal for a regular user.

One of the highest risk factors to overdosing on methadone is that the difference between prescribed doses and dangerous doses of methadone is small. Dosage also depends on the form of methadone you are using. In general, a starting dose of 2.5 mg to 10 mg is recommended every 8 to 12 hours by oral administration recommended for pain, going to 15 to 120 mg a day for opioid maintenance. This daily amount is used as therapy for addiction treatment, which would be about enough to keep users in a state between withdrawal and intoxication.

Methadone overdose complications

Methadone carries more risks than other painkillers because it tends to build up in the body and can disrupt a person’s breathing or heart rhythm. Because of the exceptionally prolonged duration of action with a half life averaging 25 hours, methadone overdose can be fatal, especially if taken with other narcotic medications. Methadone also has the ability to increase the effects of alcohol.

Overdose symptoms may include

  • apnea (temporary cessation of breathing)
  • blue lips and finger nails
  • breathing at an abnormally slow rate
  • cold and clammy skin
  • coma
  • confusion
  • extreme drowsiness and sleepiness
  • fainting
  • fatigue
  • pinpoint pupils
  • shallow breathing
  • vomiting
  • weak pulse

Methadone overdose prognosis

Significant psychomotor impairment is not expected after methadone overdoses in tolerant individuals. Overdose symptoms occur up to 10 hours after overdose. So if suspected, the methadone user should be instantly taken to the hospital. Overdose symptoms are to severe to handle if you are not a professional. For example, a cold shower could make him go into shock or faint.

Furthermore, methadone has much longer duration of action compared to heroin and other shorter-acting agonists so it is treated with Naloxone. The only problem is that Naloxone has shorter half-life compared to methadone, so if its effects wear off and the pharmacological treatments are interrupted, the user may go back to experiencing methadone overdose or withdrawal symptoms, based upon time and dosage ingested.

Methadone overdose death rate

Methadone accounts for a small percentage of painkiller prescriptions, but it is involved in more than 30% of prescription painkiller overdose deaths. Up to 4 of every 10 overdose deaths from a single prescription painkiller involved methadone, twice as many as any other prescription painkiller.

Methadone overdose amount questions

Any topic covering methadone overdose is broad and complex, and we hope that we have covered the basics. In case there is something specific you want to know, you are more than welcome to post your question(s) in the comments section below. The tem of Addiction Blog will try to provide you with a personal and prompt response.

Reference Sources: Center for Disease Control and Prevention: Press Release on Methadone
CDC Vital Signs: Methadone Overdoses
US Department of Justice: Fast Facts on Methadone
National Highway and Traffic Safety Association: Methadone
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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