Methadone Withdrawal

Methadone, an opioid meant to help manage and treat pain, is primarily used to help wean people off of opioid dependence and ease withdrawal symptoms in what’s known as medication-assisted treatment, or MAT.

Methadone has proved itself an invaluable tool in helping to treat addiction in the midst of the opioid crisis that still has the country in its grip. It also appears on the World Health Organization’s List of Essential Medicines, a running list of the medications that are most necessary for an effective health system.

But while no one can argue with the fact the methadone has undeniably saved lives that might have otherwise been lost to a deadly opioid overdose, it is not without its dangers and detriments.

The most obvious problem with methadone is that, while it is significantly less potent than the opioids it helps to treat, like heroin or oxycodone, there is still a risk of someone becoming addicted unless its usage is tightly restricted and closely monitored by a medical professional.

If methadone is used without any restriction, someone can all-too-easily end up swapping out one addiction for another, or, instead of using it as a way to taper down doses of stronger opioids, methadone becomes a way to stave off cravings in between uses.

In fact, as the opioid epidemic first began to explode, so did methadone abuse, with overdose deaths from methadone rising a whopping 460 percent from 1999 to 2005 and currently accounts for nearly one in four prescription opioid-related overdose deaths.



What Are the Methadone Withdrawal Symptoms?

Because it is what’s known as a “full opioid” unlike other maintenance therapy medications like buprenorphine, which is only a “partial opioid,” methadone works in a way that’s similar to heroin and other opioids. Methadone binds itself to the brain’s opioid receptors, neurotransmitters in charge of regulating pain, stress levels, and more.

By occupying those receptors, methadone helps reduce drug cravings and, by extension, withdrawal symptoms, while also blocking them off from the other, stronger opioids and their euphoric and sedative effects. Through this process, methadone can create its own high, but it is significantly milder than the opioids it is blocking, so the user doesn’t feel that same huge spike of pleasure.

However, even with lessened effects, methadone is still an opioid, and when someone has been regularly abusing it long enough, they will develop a physical and psychological dependence on it. This means that when they stop using, their body will endure a kind of shock as it struggles to function without the pain-blocking effects and dopamine produced by methadone, which is what produces methadone withdrawal symptoms.

The symptoms of methadone withdrawal are, if not exactly identical, definitely similar to the usual symptoms associated with opioid withdrawal, including:

  • Fever
  • Runny nose
  • Nausea
  • Vomiting
  • Diarrhea
  • Chills
  • Paranoia
  • Anxiety and panic attacks
  • Hallucinations
  • Insomnia
  • General restlessness
  • Depression
  • Tremors
  • Muscle cramping

Can Methadone Withdrawal Kill You?

While the symptoms listed above will typically present themselves with less intensity than other opioids, if someone attempts to do a methadone detox by stopping their use of methadone all at once or “cold turkey,” the symptoms will become significantly more uncomfortable and difficult to manage.

This is compounded by the fact that because methadone stays in your system much longer than fast-acting opioids like heroin, oxycodone, or even tramadol, which means you’ll be feeling these symptoms for an unpleasantly long stretch of time, which creates an increased risk of relapse.

Methadone Treatment Steps

When someone relapses during the methadone withdrawal process, they are more likely to take a much larger dose than they normally would in order to relieve the methadone cravings and other symptoms, which means they are also more likely to accidentally overdose.

And while the process of methadone withdrawal itself is rarely potentially fatal, the withdrawal symptoms themselves can indirectly put someone in a life-threatening situation. The combination of depression, paranoia, and hallucinations can, if not closely monitored, cause someone to try to harm themselves or even attempt to commit suicide.

In short, methadone withdrawal will not kill you, but attempting to do a methadone detox on your own creates a needlessly dangerous situation that can have deadly consequences.

This is why the best and safest way to do a methadone detox is under the supervision of a medical professional in a medical detoxification center. There, not only can doctors provide around-the-clock care, but they can also help relieve the worst of the withdrawal symptoms, taking away the risk of relapse, and implement a schedule to help you taper your methadone usage down safely.

What are the Stages of the Methadone Withdrawal Timeline?

So, how long will methadone withdrawal last? As we mentioned before, methadone’s long half-life creates a much more prolonged withdrawal period than the general timeline for opioid withdrawal.

However, the methadone withdrawal timeline will always vary from person to person, because there are many factors involved that come together to determine an individual’s withdrawal experience in terms of both length and severity of symptoms, including:

  • How long someone has been abusing methadone
  • How they were taking it (via injection, as a pill, snorted as a powder, etc.)
  • How much methadone they were taking
  • If they were taking methadone at the same time as other drugs or alcohol (which is often the case due to methadone’s use in medication-assisted treatment)
  • If they have a history of previous addictions or mental health issues
  • The overall state of their current health
  • If they are on a tapering schedule or stopping methadone cold turkey
man in need of methadone treatment

Depending on the answers to these questions, someone’s methadone withdrawal timeline may be longer or shorter or more intense or milder. Still, it will at least follow what has been established as the general stages of the methadone withdrawal timeline closely enough:

15-60 HOURS

Unlike the opioids it treats, methadone is a long-acting drug that stays in your body for a long time. The physical, flu-like symptoms will usually start within about 24 hours after the last use, but it can sometimes be as early as 15, or as late as almost three days.


During the next 10 days to two weeks, all of the symptoms will have manifested and be at their peak intensity. This is also when methadone cravings are at their strongest and the point of detox when people are at the highest risk of relapse.


At this point, the worst of the symptoms will have either lessened and become easier to manage or otherwise faded away completely. Psychological symptoms like depression and anxiety; however, will most likely still persist.


After three weeks, any remaining symptoms should be very weak if not already gone. Still, even after the methadone withdrawal has run its course, individuals can expect intermittent periods of depression and drug cravings in the following weeks or even months as their body readjusts to life without methadone.

While some symptoms of lingering depression are to be expected, there is also the chance of experiencing what is known as Post-acute-withdrawal syndrome, or PAWS, a secondary withdrawal period that can randomly appear after the initial withdrawal period and last months after someone has stopped using methadone. Some signs and symptoms of PAWS include:

  • Trouble sleeping
  • Clumsiness and lack of coordination
  • Unstable moods and frequent mood swings
  • Inability to concentrate
  • Extreme pain sensitivity
  • Suicidal thoughts

While there is, unfortunately, no established timeline for how long PAWS can last, at The Palm Beach Institute, we can help provide you with plenty of resources that you can go to for help.

What Can Help Methadone Withdrawal?

Most medical detox centers will use medication-assisted treatment for patients suffering from opioid dependence so that they can slowly lower the dosage instead of stopping all at once, which creates the risk of relapse as well as medical complications.

But since methadone is used to help wean someone off of opioids like heroin, what medications can be used to help relieve the symptoms of methadone withdrawal and help taper down usage?

In this case, there are several options, the most common of which is buprenorphine. Buprenorphine works in a way that’s similar to methadone, but unlike methadone, it is only a partial opioid agonist, which means that its effects are even milder than methadone’s, creating a much lower risk of dependence and making it a safer option for medical maintenance therapy.

Other MAT options include:


Which is actually a combination of buprenorphine and naloxone, a medication that has no opioid components and completely blocks the effects of opioids. Naloxone is too strong to be used on its own in cases outside of reversing an overdose, and so it is paired with buprenorphine.


A drug that is perhaps more well-known as a blood pressure medication but has been shown to be successful in helping to suppress cravings and works with methadone, since it is weaker than other opioids.


Unlike most MAT medications, carries no risk of addiction or opioid qualities and instead negates any feelings or effects of an opioid high.

What Is the Next Treatment Step?

While detoxification works to flush the methadone out of your system and put a stop to the damage caused by prolonged abuse before it gets worse, what it doesn’t do is solve the addictive behavior that led to this point, especially if this addiction developed during methadone maintenance while detoxing from a stronger opioid.

If someone does not address the root issues behind their addictive behavior, then they will most likely be unable to change it, almost guaranteeing a swift relapse.

Whether you choose an inpatient or outpatient program, ongoing recovery treatment will help you understand the underlying causes of your addiction and provide you with the tools you need to help manage your addiction and maintain sobriety in the form of different therapies and treatment types customized to be the best fit for you.

If you or a loved one is struggling with an addiction to methadone, it can feel especially frustrating if it was first being used to break a dependence on a different opioid. But there is still hope, and there is always help at The Palm Beach Institute, where we work with you through every step of the path to recovery. Call (855) 960-5456 now to speak to an addiction specialist, or contact us online for more information.