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Methadone Addiction, Withdrawal, Side Effects, Alternatives, Tapering

Last Updated on January 2, 2024 by Carol Gillette

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

Methadone is a long-acting synthetic opioid used in opioid replacement therapy. Prescribed as a legal substitute for persons addicted to heroin or other opiates, it helps as part of a harm-reduction program. Methadone is also prescribed for pain relief, and has slower effects than other opiates.

Methadone hydrochloride has been in use for pain relief since the late 1940s. Originally, the drug was marketed as an all-purpose pain reliever. In 1971, this changed with a greater focus on harm reduction and detox programs. There are benefits and risks with methadone, as with all drugs.

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Methadone Withdrawal Symptoms

Methadone withdrawals can be difficult to endure and have been described as similar to other opiates.1

Methadone withdrawal 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.

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

Starting in January 2019, deaths by drug overdose involving methadone as well as not involving methadone began to rise. A federal policy change in March 2020 allowed methadone to be distributed monthly rather than daily. At that point, methadone-involved overdose deaths remained stable at 3%. It is thought that a spike in fentanyl availability contributed to the rise in overall deaths, during the pandemic period. Over the same period, statistics from various states indicated that drug overdose deaths not involving methadone continued to increase in the US.6-8

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 continued health and safety. There is more information below that we hope may be of assistance in doing such research.

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 holistic withdrawal sedona drug rehabMethadone 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 than 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.2,5

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 tablets, tablets, and liquid forms.

Methadone Side Effects

Side effects of methadone are similar to other opiates, but euphoric effects are reported as less intense.

Methadone 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.

Discontinuing/Quitting Methadone

Withdrawal symptoms appear because the body has to adjust after becoming dependent on the presence of 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. At Alternative to Meds Center, opiate withdrawal programs can accelerate the transition time due to the benefits of orthomolecular and environmental medicine in program design. Removal of neurotoxins, and addressing the severe nutritional deficiencies that often accompany opiate use have been found highly beneficial to the recovery process.

Holistic pain management and a wide range of comfort therapies are available, including therapeutic massage, nebulized glutathione, sauna therapy, IV and NAD therapy, acupuncture, Qi Gong, and much more. Please see our services overview pages for more details.9-13

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

What are Short-acting and Long-acting Opioids?

Short-acting opioids include heroin, fentanyl, and hydrocodone, with an onset of withdrawals ranging from 8-24 hours after the last dose. Withdrawals can last from 4-10 days or longer. Methadone is a long-acting opioid, with a 12-48 hour onset of withdrawal symptoms after the last dose. Withdrawals can last from 10-20 days or longer.14

Do Different Opioids Have Different Half-lives?

Fentanyl has the shortest half-life in the opioid class, approximately half an hour. Methadone has a much longer half-life, approximately 24-36 hours.

How Much Water Should You Drink During Opiate Withdrawal?

It is recommended to drink 2-3 liters (4-8 eight-ounce glasses) of water a day to avoid dehydration during opioid withdrawal.

Should You Take Vitamins During Opioid Withdrawal?

Yes, vitamins can help reverse deficiencies that are commonly associated with opioid use. Especially recommended are B complex and vitamin C, among others that the body may be deficient in.

Do Opioids Cause Intestinal Dysfunction?

Yes, opioid drugs can cause the intestines to become sluggish or stop working well. Especially during withdrawal, it may be beneficial to add psyllium husk or other natural methods to help regulate intestinal function, which is vital for many other functions in the body to begin to repair, such as cardiovascular, cholesterol, and other health concerns.

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 most commonly used strategies. An individual may desire other methods besides those used prevalently in many clinical and other settings. At Alternative to Meds, we have developed thoroughly customized transition programs allowing for a healthy, tolerable 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 withdrawal and other opiate-related programs.


1. “FDA Label Methadone Hydrochloride” Published 2014 [cited 2022 Aug 14]

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.[cited 2022 Aug 14]

3. “Street Methadone.” Information published by CAMH 2016 [cited 2022 Aug 14]

4. Kheradmand A, Banazadeh N, Abedi H, “Physical Effects of Methadone Maintenance Treatment from the Standpoint of Clients.” Journal of Addiction and Health Summer-Autumn 2010 [cited 2022 Aug 14]

5. Paulozzi L, Mack K, Jones C, “Vital Signs: Risk for Overdose from Methadone Used for Pain Relief 1999-2010.” Medscape Abstract N.D. [cited 2022 Aug 14]

6. Jones C, et al Methadone-Involved Overdose Deaths in the US Before and After Federal Policy Changes Expanding Take-home Methadone Doses From Opioid Treatmenat Programs JAMA Psychiatry Information Letter, published July 13, 2022 [cited 2022 Aug 14]

7. Substance Abuse and Mental Health Services Administration. Methadone take-home flexibilities extension guidance. Updated March 3, 2021. [cited 2022 Aug 14]

8. Amram O, Amiri S, Panwala V, Lutz R, Joudrey PJ, Socias E. The impact of relaxation of methadone take-home protocols on treatment outcomes in the COVID-19 era.  Am J Drug Alcohol Abuse. 2021;47(6):722-729. [cited 2022 Aug 14]

9. Kelly RB, Willis J. Acupuncture for Pain. Am Fam Physician. 2019 Jul 15;100(2):89-96. PMID: 31305037. [cited 2022 Aug 14]

10. Crawford C, Boyd C, Paat CF, Price A, Xenakis L, Yang E, Zhang W; Evidence for Massage Therapy (EMT) Working Group. The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population. Pain Med. 2016 Jul 1;17(7):1353-1375. doi: 10.1093/pm/pnw099. PMID: 27165971; PMCID: PMC4925170. [cited 2022 Aug 14]

11. Lee MS, Pittler MH, Ernst E. External qigong for pain conditions: a systematic review of randomized clinical trials. J Pain. 2007 Nov;8(11):827-31. doi: 10.1016/j.jpain.2007.05.016. Epub 2007 Aug 9. PMID: 17690012. [cited 2022 Aug 14]

12. Nabipour S, Ayu Said M, Hussain Habil M. Burden and nutritional deficiencies in opiate addiction- systematic review article. Iran J Public Health. 2014 Aug;43(8):1022-32. PMID: 25927032; PMCID: PMC4411899. [cited 2022 Aug 14]

13. Jeynes KD, Gibson EL. The importance of nutrition in aiding recovery from substance use disorders: A review. Drug Alcohol Depend. 2017 Oct 1;179:229-239. doi: 10.1016/j.drugalcdep.2017.07.006. Epub 2017 Aug 4. PMID: 28806640. [cited 2022 Aug 14]

14. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: [cited 2022 Aug 14]

15. Belorio M, Gómez M. Psyllium: a useful functional ingredient in food systems. Crit Rev Food Sci Nutr. 2022;62(2):527-538. doi: 10.1080/10408398.2020.1822276. Epub 2020 Sep 21. PMID: 32951436. [cited 2022 Aug 14]

Originally Published Sep 13, 2018 by Diane Ridaeus

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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Methadone Addiction, Withdrawal, Side Effects, Alternatives, Tapering
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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