Key Facts About Methadone: Detox and Withdrawal Timeline

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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

Days 2-10

Days 11-21

Days 22+

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: Patients should be administered a dose of 40 milligrams per day, 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

Oral Methadone Dosage

Injectable or IV Methadone Dosing Guidelines

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, higher and higher doses of methadone may be given. 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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