Methadone: Addiction, Withdrawal, Side Effects, Alternatives, Tapering

This entry was posted in Opiate on September 13, 2018 by Diane Ridaeus.

Last Updated on January 10, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Written by Diane Ridaeus
Medically Reviewed by Dr Michael Loes MD

Methadone Stats

Methadone is one of a number of opiate agonists that have been used in opiate addiction treatment programs.

From the years 1999 to 2009, it is estimated that 5,000 people died in the US as a result of methadone use, a six-fold increase over that time period.¹ However, since 2009, deaths from methadone have declined in states that did not use methadone as a preferred drug for Medicaid patients, but death rates have continued to soar in states where methadone is a preferred drug for Medicaid patients, according to CDC 2014 statistics.

“Drug overdose deaths involving methadone peaked in 2006 and 2007, then declined 39% by 2014. Despite this decline, however, methadone continues to account for nearly one in four prescription opioid-related deaths.” ²

Whether you are considering starting or stopping a drug, it can be helpful to learn as much as possible about it in order to make an informed decision about your health and safety. There is more information below that we hope may be of assistance in doing such research.

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What Is Methadone Used for?

Pain Relief:

Methadone was first introduced to the US as a medication for the relief of extreme pain. It is still used for this purpose, although today a doctor would likely prescribe adjunct medications along with methadone in the event that faster relief was necessary, as methadone has a slower onset than other painkillers such as morphine. Methadone is a long-acting medication that may be beneficial in some cases.

Opiate Replacement Therapy:

If a person is in treatment for addiction to other opioids, such as heroin or Oxycodone, etc., a physician who is licensed to do so may prescribe methadone to prevent withdrawals, including cravings that otherwise may lead to relapse. When used for this purpose, it is called opiate replacement therapy, or methadone maintenance therapy, and is taken daily for the duration of the program, or until the decision is made to gradually taper off the drug.

Methadone Alternative Names and Slang

Methadone has acquired quite a number of slang names and has developed a significant street presence.³ One reason for its prevalence is that it is addictive, though with less intense effects as heroin or others. Another reason points to the possibility that as a drug used in many community programs, and in some areas is provided free of charge in harm reduction programs, there is just a lot of the drug in circulation. Providing low cost or free methadone is an attempt to reduce crimes related to procuring drugs. However, sometimes the drug will be sold on the street as a means to get money to buy preferred (more potent) drugs. In 2010, Methadone was reported in 25-30% of synthetic opioid overdose deaths as tabulated from ER data, and only amounted to 1% of prescriptions.^5,2

Street or slang names include: juice, water, chocolate chip cookies, junk, dolls, done, dollies, Maria, jungle juice, “meth,” phy, fizzies, pastora, metho, and many others.

Methadone hydrochloride is also sold under brand names, such as Diskets Dispersible, Metadol, Dolophine, Methadose and Methadone HCl Intensol. In countries outside the US, brand names include Polamido, Adolan, Heptanon, Depredol, Mephenon, Heptadon, Ketalgin, and Physeptone.

Methadone comes in dissolvable tablet, tablet, and liquid forms.

Methadone Side Effects

Side effects of methadone are similar to other opiates, but euphoric effects are reported as less intense. Some of these undesirable side effects can include:

Drowsiness
Lightheaded feeling or dizziness
Itchy skin, rashes, hives
Slowed breathing rate
Restless feelings
Dry mouth
Nausea
Vomiting
Profuse sweating
Loss of libido, sexual disinterest
Difficult urination
Constipation
Slowed or shallow breathing, cannot take deep breaths
Swelling in the lips, tongue, throat, face
Pain in the chest accompanied by rapid heartbeat
Hallucinations
Mental confusion
Lung problems associated with long-term use
Change in the female menstrual cycle
Pregnant women should talk with their prescribing physician before starting or stopping methadone. Aside from drug side effects, heavy withdrawal effects during pregnancy may be harmful to the baby and the mother.

Methadone Withdrawal Symptoms

Methadone withdrawals can be difficult to endure and have been described as similar to other opiates.¹ Some of these symptoms can include:

Drug cravings
Chills
Aching muscles
Pains
Twitching muscles
Flu-like symptoms, i.e., runny nose, sweating, general malaise
Bone pain
Nausea
Vomiting
Tachycardia or racing heart rate
Fever
Diarrhea
Stomach cramps
Constipation
Irritability
Anxiety
Paranoia
Suicidal ideation
Loss of focus or to concentrate
Hallucinations
Insomnia
Restlessness
Delusions
Depression

The withdrawals from methadone, like those of heroin or other opiates, can be long-lasting and severe especially if done abruptly. Gradual cessation is recommended to lessen the severity of these symptoms.

Discontinuing/Quitting Methadone

Withdrawal symptoms appear because the body has to adjust after becoming dependent on the presence of the opiates in the system. It can take a substantial period of time to totally normalize.

It is advisable to undergo methadone cessation, if possible, in a medical or inpatient environment which can significantly help reduce the severity of discomfort when coming off medications such as methadone.

Methadone FAQs

Below you will find further information and some frequently asked questions about methadone and methadone withdrawal treatment. Please contact us for further information which we can freely provide on request.

Is Methadone an Opioid?

Yes. Methadone is a synthetic opioid, derived from opium poppies and produced in a lab.

It has developed some street presence as a substitute for other drugs, which may be why the death rate continues to be so high for methadone overdoses.³

Treatment for Methadone Abuse and Addiction

Methadone may have filled a useful role in the relief of chronic or moderate to severe pain, or as a way to transition from other forms of opiate addiction. Yet, there may still be a decision to come off the drug for various reasons. At Alternative to Meds Center, we strive to analyze all available information for each client, including history and other factors, and discuss all available options with the client before proceeding. Methadone use has become part of mainstream addiction treatment not only in the US and North America but in countries like Iran, China, India, etc.⁴

There are several techniques that have been commonly used, two of which are applicable to those who have a pain diagnosis, for managing the process of withdrawal from an opiate medication like methadone.

Short-Acting Opiate Equivalency Method (concurrent pain diagnosis)

This method uses a straightforward approach where there has been a pain diagnosis, by transitioning quite seamlessly to a short-acting opioid prescribed at an equivalent potency. The person continues on this medication for three days, and then it is stopped. This is to enable a steep enough withdrawal to successfully induct Suboxone, which will quickly neutralize the withdrawals. After some days, the Suboxone can be gently and comfortably tapered to zero in approximately 2 weeks. The above method will be made most tolerable using the Alternative to Meds Center process of neurotransmitter replacement protocols concurrently.

Tapering Methadone Directly

A pain diagnosis is not necessary for this technique. Weekly reductions, for example, 10mg per week, continue on until the medication is reduced to zero. The process has been described as difficult and possibly even agonizing. Adding a non-opioid medication may lessen the discomfort.

Vicodin/Suboxone Rapid Transition (concurrent pain diagnosis)

In this method, timing is critical for success. Methadone is restricted until withdrawal symptoms begin to appear. At that point, a nominal dose of Vicodin, just enough to avoid intense withdrawal, is given at 4- to 6-hour intervals, over the next 36 hours. This method prevents severe withdrawals. After the 36-hour window, the Vicodin is stopped. When withdrawals become highly pronounced, a 2mg dose of Suboxone is administered. Timing is important as if the Suboxone has been given too early, the withdrawals will worsen; and, if so, waiting until the patient is further along into the withdrawal phase is prudent. Concurrently, the patient can be continued on a non-narcotic medication to provide comfort during the additional wait time.

After several hours have passed, the induction of Suboxone can be repeated, at 2mg, and if well-tolerated, adding 4mg in one hour. If the 4mg dose is well-tolerated, then the dose can be increased up to the desired level of Suboxone. After reaching stability on Suboxone after approximately 3 to 7 days, the Suboxone taper process can then begin, gently reducing the dose at appropriate intervals, until reduction to zero is attained.

Methadone and Opiate Alternative Treatment

There are other methods that may be more pragmatic than the above strategies that are still the ones most commonly used. Though used prevalently in clinical and other settings, they may not be right for everyone. We have developed thoroughly customized transition programs allowing for a healthy transition to drug-free living. Our attention to root causes, lifestyle counseling, neurochemistry rehabilitation, and other protocols are geared to long-term success for each client.

Please contact us for further information or discussion on the best program and techniques available at Alternative to Meds Center that would be most appropriate for you or a loved one for correct and tolerable Methadone and other opiate-related programs.

1. “FDA Label Methadone Hydrochloride” [Internet] Published 2014 [cited 2020 Sep 17]
2. Faul M, Bohm M, Alexander C, “Methadone Prescribing and Overdose and the Association with Medicaid Preferred Drug List Policies — United States, 2007–2014” Centers for Disease Control and Prevention, 2017 Mar 31.

3. “Street Methadone.” Information published by CAMH [Internet] 2016 [cited 2020 Sep 17]
4. Kheradmand A, Banazadeh N, Abedi H, “Physical Effects of Methadone Maintenance Treatment from the Standpoint of Clients.” Journal of Addiction and Health [Internet] Summer-Autumn 2010 [cited 2020 Sep 17]
5. Paulozzi L, Mack K, Jones C, “Vital Signs: Risk for Overdose from Methadone Used for Pain Relief 1999-2010.” Medscape Abstract [Internet] N.D. [cited 2020 Sep 17]

This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.

Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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Diane Ridaeus

Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.

Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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