Methadone is a central nervous system depressant in the opioid class of drugs that are commonly prescribed to treat pain. The medication, which is cheaper than some other opioids, such as OxyContin, is commonly used to treat the symptoms of opioid addiction. 

Addiction health care professionals may use methadone to gradually taper, or wean, dependent opioid users off the drug(s) that have been using.This process allows the body to recover as the amounts of methadone are decreased in the user’s system. Unlike other opioids, methadone is long acting with a significantly longer half-life (15 to 55 hours) and an effective duration (four to eight hours with a single dose). 

Outside of medical and drug recovery purposes, methadone is also abused recreationally, and, as such, abuse can lead to addiction and possible overdose. Whether used as prescribed or for recreational purposes, all users should handle this drug with care as methadone is very addictive and has a high dependence liability. 

A Brief History of Methadone

Methadone is a synthetic opioid, which means that it was created without the use of organic or naturally occurring opium. It was first synthesized in 1937 as a response to Germany’s opium shortage. The chemical structure only vaguely resembles other opium derivatives like morphine and heroin. German research into the drug was discontinued after it was found to have potentially dangerous side effects. 

However, after World War II, the Allied confiscated most of the German research projects and the United States Department of Commerce got ahold of the methadone research. Finding that it was less addictive than morphine and caused less respiratory depression, the department decided that it would be valuable for commercial use. 

Today, the drug is widely used as a treatment for opioid dependence, particularly in patients who have tried and failed to stop using opioids multiple times. It is available either through a) certified methadone treatment centers that clients must visit daily to continue receiving a daily dose or b) a take-home dose that can last for one day or one week. Clients who are can take home the dose must first meet federal eligibility criteria.   People with this arrangement likely have been undergoing methadone maintenance for a while.

Still, more modern addiction recovery techniques have surpassed long-term methadone treatment, realizing that even people who have struggled with relapse multiple times can achieve long-term recovery without the use of potentially dangerous drugs.

Recreational methadone users may call it street or slang names including:

  • Amidone
  • Chocolate Chip Cookies
  • Dollies
  • Dolls
  • Fizzies
  • Jungle Juice
  • Maria
  • Methadose
  • Metho
  • Pastora
  • Phy
  • Salvia
  • Water

When users abuse methadone, they feel a rush of euphoric and relaxing sensations. Polydrug abuse also commonly happens among drug users who receive treatment with substitute drugs such as methadone or buprenorphine. People who engage in this practice may add other opioid medications and/or alcohol to intensify the effects of the opiate/opioid they are withdrawing from.

What are Methadone Withdrawal Symptoms?

In the fight against the opioid epidemic, methadone is a unique enemy. Regarding withdrawal, it offers some of the most intense long-lasting symptoms. The longer you use it, the more difficult it is to quit. Because of its long half-life, it can stay in your system for longer periods. Plus, it causes withdrawal symptoms well beyond the standard timeline for other opioids. Still, methadone overdose is one area in which we are gaining ground. Death rates due to methadone overdose have dropped from 12 percent of all cases to just six percent, possibly because it’s being phased out of use in treatment.

However, it’s still used as a prescription pain reliever and illegally as a recreational drug. If you are addicted to methadone, you may have a long road ahead of you before getting out from under addiction. But, it may save your life. Methadone can cause deadly heart rate abnormalities and respiratory depression, especially when abused.

In withdrawal, several symptoms come at different stages of the timeline. Opioid withdrawal symptoms often resemble the common cold or even the flu. However, it may come with a host of other symptoms as well, with both cognitive and negative effects: 

  • Abdominal cramps
  • Agitation, restlessness
  • Appetite loss
  • Diarrhea
  • Goosebumps
  • Lightheadedness
  • Light sensitivity
  • Hyperventilation
  • Runny nose
  • Sneezing
  • Gastrointestinal problems (nausea, vomiting, diarrhea)
  • Fever
  • Sweating
  • Shivering, trembling
  • Tremors
  • Tachycardia
  • Joint pain
  • Pain sensitivity
  • Hypertension
  • Depression
  • Insomnia
  • Yawning
  • Watery eyes

While opioid withdrawal is not known to be fatal, some of the above symptoms can cause serious medical complications that can be potentially life-threatening, like tachycardia and hypertension. Plus, cognitive symptoms like anxiety, depression, and thoughts of suicide can be unpleasant and dangerous to go through on your own. Some even report auditory and visual hallucinations, which can be dangerous if you experience them in a dangerous, accident-prone setting. 

What are the Stages of the Methadone Withdrawal Timeline?

The stages of methadone withdrawal vary significantly based on several factors including the size of your last dose, the length of time you spent using it, and the dosage that you are used to. Your age, medical history, drug use history, and mental health history are also factors that determine what your timeline looks like. If you have used methadone chronically, or if you’re dependent on a high dose, your timeline may be different than someone who has only recently become addicted.

Again, methadone’s unique and lengthy half-life causes it to affect people in withdrawal differently than other opioids. You will begin feeling withdrawal symptoms when the positive effects wear off after eight hours. However, with prolonged use pain relief and withdrawal prevention effects can last up to two days. After that, the worst symptoms are typically felt within the first week. 

Still, methadone stays in your system for weeks, and symptoms can persist for up to a few weeks after it has left your system. Most symptoms should clear up by the second month but certain ones, like anxiety and depression can persist for years without treatment. Lingering symptoms such as these are known as Post-acute withdrawal syndrome, or PAWS. Some people receive ongoing therapy and support for this condition. Efforts to manage PAWs post-methadone dependence include eating healthy, exercise, and getting adequate rest. 

Why Should I Detox?

Though methadone causes some of the same effects that other opioids do, it’s different in many ways. It’s long-lasting and its intense withdrawal effects make it more dangerous than other opioids when it comes to withdrawing by yourself. Plus, with flu-like symptoms affecting you for that long, it may be difficult to go about daily life. In some people, especially older ones, symptoms like tachycardia, hypertension, and fever can be life-threatening. 

Drug cravings will also be present among your withdrawal symptoms. Combined with other uncomfortable symptoms, it can be difficult to withstand cravings without any accountability or supervision. In detox, medical professionals can help alleviate symptoms and keep you away from the drug your brain might be desperately craving.

Chronic methadone users who find themselves battling an addiction are advised to seek professional help from a licensed drug rehabilitation center. Managing methadone addiction on your own is dangerous. If you stop use and notice physical, mental, and emotional changes, then you have likely entered into a withdrawal period, and symptoms that you may experience are noted below. 

If you or someone you know wants to quit using methadone, do not do it abruptly. Suddenly quitting an addictive substance after long-term use, a practice also known as going cold turkey, only increases the chances of relapse and overdose.

Sad woman with a glass of water and a pill

If you do quit cold turkey, expect intense symptoms during the first week. Because of its long half-life, methadone is present in the body for up to two weeks, which means withdrawal symptoms are extended for a few weeks longer. To withdraw from the drug safely, and avoid cravings that can return at any time, a medical detox is recommended. 

What is the Next Treatment Step?

Opioids are powerfully addictive, and methadone addiction takes unusually long to overcome. That’s why it’s important to continually pursue recovery, even after the drugs have left your body. Treatment programs that are tailored to your specific needs can help you reach underlying issues that may have led to your initial addiction and teach you how to deal with cravings and triggers that can potentially lead to relapse. After your treatment is complete, you will have the tools to maintain lasting sobriety. 

Still, addiction is a chronic disease and relapse is a possibility. Continuing your commitment to recovery can help you safeguard your sobriety. Support groups, 12-step programs, and alumni programs can connect you to a community of people who share your goals.

According to the National Institute on Drug Abuse, addiction is a complex but treatable disease that affects brain function and behavior. The disease also can result in brain changes that last long after substance abuse has stopped, which is why users are vulnerable to relapse. While it is treatable with the appropriate programs, research shows that at least three months (90 days) or more are needed to properly treat a substance addiction. 

Before a treatment program is planned to treat methadone addiction, recovering users likely will undergo an evaluation that reviews factors such as the severity of the addiction and if other health issues are present. In the case that a mental health disorder is uncovered, a treatment plan that includes therapies for co-occurring disorders, such as anxiety, depression and Post-traumatic stress disorder among others, will be recommended.

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