Methadone Detox Treatment Programs and Process
Detoxing From Methadone
Methadone withdrawal can be a difficult, drawn-out experience. But you do not need to go through withdrawal alone.
This article explains the methadone detox process and discusses different program options. It focuses on:
- How long methadone withdrawal takes.
- Side effects of methadone withdrawal.
- Different detox program options.
- What happens after detox.
- Detoxing at home.
How Long Does It Take to Get Off Methadone?
Methadone is a synthetic opioid medication. It is prescribed to help treat serious opioid addictions – such as those to heroin – or, in some cases, to manage chronic pain.1 Methadone comes in the form of an injection, oral solution, pill, liquid or tablet you place under your tongue. Prescription names include Dolophine and Methadose.
Like a lot of other opioid medications, some prescribed methadone ends up being diverted for sale on the illicit market. Some of the street names include amidone, chocolate chip cookies and fizzies.2
Compared with other shorter-acting opioid medications such as morphine or oxycodone, methadone is long-acting, metabolized relatively slowly and maintained in the body for longer periods of time. It affects the brain and spinal cord for 8 hours to 12 hours. 1 Though it is not as strong as some of the other abused opioids, you can still easily become physically and psychologically addicted to methadone if you use it without the supervision of a healthcare provider.
When you stop using methadone, withdrawal symptoms will usually begin to appear 36 hours to 72 hours after use and peak at roughly 96 hours (4 days). 1
Methadone Detox Side Effects
Methadone withdrawal symptoms are similar to those of other opioid drugs. During early withdrawal, you may experience:
- Psychological symptoms such as anxiety, dysphoria and irritability.
- Lack of an appetite.
- Rapid breathing.
- Watery eyes.
- Runny nose.
- Dilated pupils.3
During the peak stages of withdrawal, you may experience:
- Abdominal cramps.
- Hot and cold flushes.
- Increased blood pressure.
- Increased heart rate.
- Bone aches and muscle twitching.
- Vomiting. 3
While withdrawal from methadone is rarely life-threatening, if you have any medical conditions – such as a heart, liver or seizure condition – you should never detox alone.4 Even without other medical conditions, methadone withdrawal can be scary and painful, putting you at risk for relapse. Further, as your body rids itself of methadone, you may experience feelings of depression or anxiety, which are difficult to manage alone.4 If you have thoughts of suicide, you should tell someone immediately. Seeking medically supervised detox will help ensure your safety, comfort and success.
Types of Methadone Detox Treatment
Detoxing is the process of ridding your body of harmful substances and overcoming a physical addiction to a certain drug. Whether it is administered via a structured detox center or done at home, technically everyone must complete a period of detox as a first step on the path to recovery.
Professional detoxing occurs under the supervision of a healthcare provider and typically involves supportive treatment to minimize withdrawal symptoms.4 These programs are available in a variety of settings including standalone detox centers, inpatient treatment, partial hospitalization and outpatient treatment. 3 You and your healthcare provider will decide what is best for you.
A standalone detox center is a facility that specializes in providing treatment for people who are withdrawing from different substances. You will receive supportive care, including medications and any necessary medical care. You’ll be closely monitored throughout the process to make sure there are no complications. The center may have therapists or counselors as well to provide addiction counseling and recovery guidance.
You remain in the facility until the detox process is complete, and the staff may recommend you transition to a formal inpatient or outpatient addiction treatment program when you discharge.
An inpatient detox program may be incorporated into either a hospital-based or residential treatment center and will provide you with 24-hour care. You may transition into the center’s treatment program after completing the detox process. During the day, you participate in individual and group activities. Inpatient settings may be best suited for those who have been using methadone for a long time or who have a history of repeated relapse. These programs are typically the most effective because they remove you from your day-to-day activities, and you will have access to your treatment team throughout your stay.3
Partial hospitalization allows you to come in during the day for detox services, but return home at night. These programs are also structured and intensive like inpatient settings, but they allow some flexibility and the comfort of sleeping in your own bed at night. During partial hospitalization, you will occasionally meet with your treatment team, and you may be involved in group activities.3
Outpatient detox refers to a light-touch treatment, where you may visit your team for short appointments or attend group therapy sessions during the day. Those with milder addictions, or those who have strict employment, school or other obligations may find this type of treatment beneficial. Outpatient settings are usually not as effective as inpatient settings for more severe cases of methadone dependency. 3
Selecting a Detox Program
Besides figuring out which type of treatment is right for you, you might want to ask a few additional questions about the specific program you’re considering, such as:
- Does the facility allow smoking?
- Can you bring your phone or laptop?
- What features does the program have? (gym, fine dining, swimming, tennis, private rooms, etc.)
- Does your insurance cover treatment?
- Where is the center located?
- Can the center accommodate any dietary needs you have?
What Happens in Detox Treatment?
Upon entering a methadone detox program, you will be evaluated by an addiction treatment professional who will help establish your diagnosis and treatment plan. Be honest about your consumption history so that the best detox regimen can be created for you.
Your diagnosis will be based on criteria in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition and will likely include opioid use disorder.5
Detoxing and Supportive Care
The staff will create a detoxification plan for you. This plan may include tapering a methadone dose along with supportive medications to manage withdrawal symptoms.4 For example, clonidine is often prescribed to manage the anxiety, high blood pressure, sweating and restlessness that often occur during the withdrawal period.4 You may be encouraged to drink lots of water to prevent dehydration as well.
Your progress may be monitored using a withdrawal scale such as The Clinical Opiate Withdrawal Scale.4
Referral to Substance Abuse Treatment
When you complete the detox process, your provider may encourage you to continue substance abuse treatment in an inpatient or outpatient setting to deal with the root causes of your methadone addiction.
Detoxing is designed to help you overcome the initial hurdle of withdrawal. Detox treatment helps to manage the physical addiction to methadone but not necessarily the psychological addiction. For this reason, the next steps on your road to recovery are psychosocial interventions such as individual counseling or a 12-step program.6 To support their early recovery, and encourage prolonged abstinence, some people may also choose to attend a residential program for a few months.
These psychosocial interventions will help you:
- Learn new coping strategies.
- Build a supportive network.
- Overcome feelings of guilt and loneliness.
Residential or inpatient treatment settings are usually 30-day, 60-day or 90-day programs where you live with a group of other previous methadone or other recovering substance users as well as professional support staff. You may participate in individual and group therapy to build coping skills and relapse prevention skills to manage cravings and triggers. 3
Many therapeutic approaches can be used to address methadone addiction. Popular forms of treatment include cognitive behavioral therapy and motivational interviewing. 6 These therapies usually occur in a one-on-one setting with a trained counselor such as a nurse, social worker, or psychologist.
- Cognitive behavioral therapy, also called CBT, attempts to alter faulty thinking patterns in order to change behaviors that may be unhealthy. Your CBT therapist will help you identify maladaptive thoughts you may have about yourself or your addiction, and they will teach you strategies to change these thoughts, as well as your reaction to them 6
- Motivational interviewing is a therapeutic technique that helps you talk about and move past any ambivalence that you have about methadone addiction. This type of counselor will help you identify discrepancies between your values and your actions.6
Twelve-step programs such as Narcotics Anonymous offer social support. These programs believe that treatment should be a combination of behavioral, spiritual and cognitive interventions. Participants are encouraged to find a program sponsor as they begin to work through the 12 steps of recovery, which include admitting powerlessness over your addiction and making amends to people you harmed during active addiction.
Detoxing at Home and Natural Remedies
Detoxing from methadone is rarely life-threatening, but it can be extremely uncomfortable. The unpleasant experience can be difficult to bear, and often leads to relapse.
Some attempt to manage the symptoms of withdrawal with over-the-counter medication such as anti-diarrheal and mild analgesic agents. When you are at the pharmacy, you can ask the pharmacist or technicians to recommend medications for whatever troublesome symptoms you may be experiencing.
The withdrawal process can also leave you undernourished and dehydrated, so it will be important to drink as much water as possible and eat any light, but healthy foods that you are able to tolerate. The best course of action is to seek professional medical help.Your detox team will ensure your comfort and well-being throughout the process.
Frequently Asked Questions
Can You Die From Methadone Withdrawal?
Methadone withdrawal is typically not life-threatening. However, it can be extremely uncomfortable with symptoms such as anxiety, diarrhea, abdominal cramping and vomiting beginning 36 hours after use. You may become dehydrated, which can require medical attention. If you have any additional medical conditions such as heart disease, liver disease or a seizure disorder, you should never go through withdrawal alone.
What Is the Best Way to Detox Off a High Dose of Methadone?
Inpatient detox programs are the most effective and safest way to detox off methadone. These programs offer 24-hour care, and they are staffed with professionals who will create the best detox plan for you.
Find a Methadone Detox Program
Methadone addiction can be an escalating problem with serious consequences. The most important action you can take is to seek treatment. If you or someone you know needs more information about methadone detox centers, please call us toll-free, 24 hours a day at .
Detox for Specific Drugs
Learn more about the detox process for commonly abused drugs, including:
. Chisholm-Burns, S. Schwinghammer, T. Wells, B., Malone, P., & DiPiro, J. (2013). Pharmacotherapy principles and practice (3rd ed.). New York, NY: McGraw-Hill Medical.
. Drug enforcement Administration. (2014).
. Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Synopsis of psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
. Gabbard, G. O. (2014). Gabbard’s treatments of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Association.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
. Jhanjee, S. (2014).
Evidence based psychosocial interventions in substance abuse. Indian Journal of Psychological Medicine. 36(2):112-118. doi: 10.4103/0253-7176.130960