In 2015, over 2.5 million Americans struggled with addiction involving opioid drugs, including both prescription painkillers and the illicit drug heroin, the American Society of Addiction Medicine (ASAM) publishes
 

Misuse of opioid prescription drugs has reached epidemic levels in the United States, as these drugs are some of the most widely abused prescription medications. The National Institute on Drug Abuse (NIDA) reports that around 20 percent of all American adults have misused a prescription drug at least once in their lives.

Methadone is a synthetic opioid drug designed both as a pain reliever and also as a medication to treat addiction involving opioids. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that methadone is commonly used as a replacement for other opioid drugs like heroin during opioid addiction treatment, helping individuals to stay in treatment programs longer.

Methadone is a long-acting opioid agonist drug, which is what makes it a candidate for managing opioid dependence and withdrawal symptoms. Methadone can stay in a person’s system longer than a drug like heroin, meaning that a person will be able to take lower doses less often to keep withdrawal symptoms and drug cravings to a minimum. As an opioid agonist, methadone still activates the opioid receptors in the brain that other opioids do, and in higher doses, methadone can also produce a euphoric “high.”

When used as directed as part of a comprehensive opioid addiction treatment program, methadone can be helpful as a replacement medication, however it is often misused. Just like other opioid drugs, chronic methadone abuse can lead to drug tolerance, dependence, and addiction.

Dangers of Abusing Methadone

Opioid drugs like methadone can cause a burst of euphoria when abused, leaving individuals feeling mellow, happy, and pain-free. The drug works on the central nervous system, slowing heart rate, blood pressure, and respiration, and lowering body temperature. It impairs a person’s ability to make sound decisions, and users may put themselves in potentially hazardous situations, take bigger risks, and engage in erratic or out-of-character behaviors. When methadone wears off, it can leave a person feeling depressed, anxious, irritable, and agitated.

When someone takes methadone regularly, their brain and body may become tolerant to the dosage, and the person will need to increase their dosage to keep feeling the drug’s desired effects. Taking more methadone at a time, or mixing it with other drugs and/or alcohol, can raise the risk for a potentially life-threatening overdose. Deaths from opioid overdose reached an all-time high in 2015, killing more than 33,000 people, according to the Centers for Disease Control and Prevention (CDC). As central nervous system depressants, opioids can slow and even stop a person’s breathing when the drugs reach toxic levels in the bloodstream, thereby leading to coma or death.

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    In time, and with regular methadone use, drug dependence can form and powerful physical and emotional withdrawal symptoms can occur when methadone isn’t active in the bloodstream. In addition to emotional distress, mood swings, and trouble feeling pleasure without methadone, a person can experience intense cravings for the drug and physical symptoms that are similar to the flu.

    The National Highway Traffic Safety Association (NHTSA) reports that methadone withdrawal is generally less severe than withdrawal from other opioids, although it may last longer. Symptoms of methadone withdrawal include watery eyes, dilated pupils, tremors, chills, sweating, restlessness, insomnia, muscle aches, loss of appetite, pain sensitivity, diarrhea, stomachache, nausea and vomiting, runny nose, and irregular heart rate.

    Studies published by Medical News Today suggest that, as with other opioids, exposure to methadone likely damages brain cells, which can lead to issues with memory, attention, and learning. Methadone’s effect on respiration may cause damage to the lungs and breathing issues. The method in which a person abuses methadone can impact possible physical complications as well. For example, injecting the drug can lead to collapsed veins, skin infections around the injection site, and an elevated risk for contracting an infectious disease like HIV/AIDS or hepatitis. Smoking and inhaling methadone may cause damage to the lungs and respiratory system while snorting it can damage sinus and nasal cavities.

    The Drug Abuse Warning Network (DAWN) publishes that in 2011, nearly 70,000 Americans received treatment in an emergency department (ED) for a negative reaction related to abuse of methadone.

Recognizing Addiction Involving Methadone

Methadone addiction can create a host of physical, emotional, social, financial, behavioral, and interpersonal problems that early intervention and treatment can help to minimize and potentially even prevent. Whether or not someone is taking methadone with a viable prescription or not, dependence and addiction can result if the medication is misused, or not used exactly as directed, under close professional medical supervision. Signs that an individual may be misusing methadone include:

  • Taking higher doses at a time than prescribed
  • Taking methadone in between scheduled doses
  • “Shopping” around to different doctors to try and get multiple prescriptions of methadone
  • Amplifying symptoms to get more methadone
  • Taking methadone after a prescription has run out
  • Needing to take more methadone more often for it to work effectively
  • Drug cravings and withdrawal symptoms in between doses or when not taking methadone
  • Trouble feeling happy without methadone
  • Any use of methadone outside of a legitimate prescription

Those suffering from addiction involving methadone may put themselves into potentially dangerous situations while under the drug’s influence and continues to use the drug despite knowing it will have harmful effects. Relationships often suffer as individuals become more socially withdrawn, moody, uninterested in activities they enjoyed before, and secretive.

Medical Detox for Methadone Withdrawal

Methadone withdrawal typically starts within 30 hours of the last exposure to the drug, the National Library of Medicine (NLM) publishes. Since methadone is a long-acting opioid, it stays active in the bloodstream longer than most other opioids, which is part of the reason it is often used to treat opioid dependence.

When a person battles addiction involving methadone, the drug may be tapered off slowly during detox in order to lessen withdrawal symptoms and reduce cravings. The dosage can be slowly lowered over a period of time in order to avoid “shock” to the system that can occur with suddenly stopping the drug. This weaning method is optimally supervised and monitored in a medical detox program that can provide around-the-clock medical care.

Other medications, like the partial opioid agonist buprenorphine, may be used in place of methadone during detox as well. Buprenorphine does not fully activate opioid receptors, and it even stops working after a certain amount is taken; therefore, it may be less likely to be abused. Since it works on the same opioid receptors in the brain, it helps to reduce withdrawal symptoms and cravings but without causing the euphoria that other opioids can.

Specific medications for certain withdrawal symptoms can be helpful during detox as well. Sleep aids, antidepressants, and anti-nausea medications, among other options, can aid in minimizing some of the negative side effects of methadone withdrawal.

Since methadone is often used to treat opioid dependence, when a person suffers from addiction involving methadone specifically, special care should be taken during detox and treatment. Direct supervision by highly trained medical and mental health providers is important. Medical detox is considered the safest method for allowing the drug to process out of the body. With medical detox, a person’s vital signs can be closely monitored while mental health concerns are attended to as well.


Methadone withdrawal symptoms can last longer than traditional opioid withdrawal symptoms.


Trained professionals can offer tools to prevent relapse, or a return to drug use, both during this time and in the future in ongoing recovery. Inpatient, or residential, addiction treatment programs that directly follow detox, and include both supportive and therapeutic treatment methods, are highly beneficial in treating addiction involving methadone. Comprehensive care is key to ensuring the best chances of long-term success.