Key Facts About Methadone: Detox and Withdrawal Timeline

Methadone Key Facts Detox Methadone Withdrawal Timeline - Family First Intervention

Methadone. More addictive than OxyContin or heroin. Harder to detox from than OxyContin or heroin. A dangerous opioid. Horrible side effects. Rough withdrawal symptoms.

How Long Does It Take to Detox from Methadone?

A physical addiction to methadone doesn’t take long to develop. And for people who are interested in quitting methadone, the withdrawal symptoms can be powerful. Methadone users usually start feeling withdrawal symptoms within 24 hours of their last dose. However, others don’t feel the pangs of withdrawal for several days after their last dose.

The first seven to 10 days are the most painful days of withdrawal. The entire withdrawal process takes three to six weeks or longer for those with a severe addiction and for those who have been taking a higher dose than 40 milligrams.

Here is the breakdown of the detox timeline for methadone. Click on any of the following four-time frames to learn the methadone withdrawal symptoms one may experience during that span:

The First 24 Hours of Methadone Withdrawal

  • Chills, fever
  • Rapid heartbeat
  • Muscle aches
  • Flu-like symptoms

Days 2-10

  • Strong methadone cravings
  • Paranoia, hallucinations
  • Insomnia
  • Irritability, anxiety
  • Flu-like symptoms persisting

Days 11-21

  • Most physical symptoms are over
  • Strong methadone cravings
  • Depression – sometimes severe
  • No motivation, no feelings of pleasure

Days 22+

  • Intermittent depression may occur
  • Other mild symptoms may remain for several weeks

This timeline is for someone taking up to a maximum of 40 milligrams. For those using more than that dosage, the timeline will likely be different.

Methadone Dosing

Methadone is most commonly used for two reasons: detoxification of opioid dependence and opioid replacement therapy. Dosage depends on the goal of treatment. The medically approved dosing information below applies to adults.

Short-Term Detox with Methadone

When medical professionals use methadone to detox a patient from opioid addiction, they should treat it as a brief course to stabilize the patient. After stabilization, a period of medically supervised withdrawal should occur with a gradual reduction in dosage.

Day 1: Administer a dose of 40 milligrams per day to the patient, in divided doses.

After 2-3 days: Gradually decrease the dose in two-day intervals while maintaining a sufficient dose to keep withdrawal symptoms tolerable.

Methadone Dosing for Opioid Dependence

When methadone is used for detoxification and maintenance treatment of opioid addiction, the dose administered is different than in short-term detox. When seeking treatment for opioid addiction, patients should only use methadone in conjunction with appropriate medical, social and psychological services.

Why Methadone May Be Given for Opioid Detox

The goal of using methadone to detox someone from heroin or other strong opioids is to:

  • Titrate to a dose that prevents opioid withdrawal.
  • Reduce the patient’s hunger and craving for their addictive drug of choice.
  • Block the euphoric effects of recreational opioid use.
  • Ensure the patient is tolerant of the sedative effects of methadone.
  • Reach a commonly targeted range of 80 to 120 milligrams daily for therapeutic efficacy.

For cessation of therapy, abrupt discontinuation is not advised due to severe withdrawal effects. Decreasing the patient’s dose should typically be only 10 percent at a time every 10 to 14 days.

Oral Methadone Dosage

The initial oral dose of methadone for opioid addiction typically is 20 to 30 milligrams. An additional dose of 5 to 10 milligrams can be given orally if withdrawal symptoms are not repressed or if symptoms reappear.

The guidelines are:

  • Maximum initial dose: 30 milligrams
  • Maximum first day dose: 40 milligrams
  • Adjust the dose over the first week to control symptoms two to four hours after dosing.

Methadone levels accumulate over time, so the detox professionals should carefully and gradually titrate each patient down.

Injectable or IV Methadone Dosing Guidelines

For patients in a hospital or recovery facility, an injectable form of methadone is still currently available. Particularly for patients who cannot take medications orally, parenteral methadone can be a temporary treatment for opioid dependence.

A patient’s oral dose should be converted to an IV version in a 2-to-1 ratio (i.e., oral methadone 10 milligrams is equivalent to 5 milligrams of parenteral methadone).

General Guidelines for Dosing

Keep in mind that all dosing information and guidelines for methadone in this article are for adults only. Pregnant women will require different detoxification guidelines. This information is not for medical advice or to take the place of a professional doctor’s opinion for any specific patient.

Here are some general guidelines for methadone dosing:

  • Lower doses are for patients whose tolerance is expected to be lower upon entering treatment.
  • Patients who have taken opioids for fewer than 5 days may no longer be tolerant.
  • The initial doses are not based on previous treatment.
  • Patients should not expect methadone to work as a complete pain reliever.
  • If patients in treatment are in acute pain, they may require higher or more frequent doses.

High-Dose Methadone

What constitutes a high dose of methadone?

Most traditional methadone detox programs will not accept patients who have been taking more than 80 milligrams of methadone daily. It is considered high-dose methadone.

However, many people end up using 150, 200 or even 300 milligrams per day.

Oftentimes, the people who go to treatment for other opioid addictions, like heroin, end up being weaned with methadone. When withdrawal symptoms are severe, professionals may administer higher and higher doses of methadone. Finally, the patient only ends up with a new addiction to methadone instead of heroin.

Other times, patients with acute pain end up depending on methadone at increasing doses until they have a dependency on a high dose. Using methadone for long-term opioid maintenance can leave you feeling stuck since you’re taking a drug that you can never seem to reduce for years and years.

Getting Off Methadone

You can get off methadone, but it’s not easy. You must be sure it’s what you want to do and be willing to stick to a plan for anywhere up to 18 months to achieve it on your own.

Here are some guidelines for detoxing from methadone:

  • Educate yourself about the subjects methadone, detox and endorphins.
  • Talk to your doctor about how to gradually stop taking methadone.
  • Find an alternative medicine doctor to help you with the process.
  • Find a therapist if you are stopping methadone from a previous heroin or opioid addiction.
  • Focus on good hydration, multivitamins and enriching nutritious meals.
  • Learn how to monitor your blood pressure, heart rate and pulse.
  • Start doing exercise now to prepare and work your way up.
  • Search methadone detox centers that will taper you down quickly, and find out what services they offer beyond detox.

These ideas should not take the place of a physician’s advice. For patients on high-dose methadone, this process typically takes six to 18 months to do on your own.

Finding Guidance

Family First Intervention does not assist families in finding methadone clinics or long-term opioid maintenance programs, nor do we assist in getting individuals on methadone for any long-term use.

However, we can help you get a family member into a methadone detox facility and off an opioid maintenance plan or opioid replacement therapy permanently. Family First Intervention can indeed help in finding a detox center for high-dose methadone as well.

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Mike Loverde

Mike Loverde created Family First Intervention with a primary purpose and that is to save your loved one before it is too late and to help the family that suffers waiting for them to change. Every day we hear families tell us that they were told that there is nothing that they can do if their loved one does not want help or that they need to hit bottom and that is frustrating to me.

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About Mike Loverde

Mike Loverde created Family First Intervention with a primary purpose and that is to save your loved one before it is too late and to help the family that suffers waiting for them to change. Every day we hear families tell us that they were told that there is nothing that they can do if their loved one does not want help or that they need to hit bottom and that is frustrating to me.