Does methadone help with opiate withdrawal

Yes, methadone lessens the symptoms of opiate withdrawal blocks the effects of opiate drugs. More on how methadone can help with withdrawal here.

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Reviewed by: Dr. Dili Gonzalez, M.D. Dr. Juan Goecke, M.D.

ARTICLE OVERVIEW: Yes, methadone helps with withdrawal. Methadone is used for drug detoxification and treatment programs to lessen the symptoms of withdrawal and to block the effects of opiate drugs. Used successfully for more than 40 years, methadone has been shown to eliminate withdrawal symptoms and relieve drug cravings from heroin and prescription opiate medications. Methadone helps people recover from addiction and to reclaim active and meaningful lives.


Why Withdrawal Happens

Opiate drugs can help relieve pain and trigger extreme euphoria. This is why people use them. In fact, illicit and prescription pain killers have caused what is being called an “Opioid Epidemic” in the U.S. Drugs like:

  • Codeine
  • Fentanyl
  • Heroin
  • Hydrocodone
  • Morphine
  • Oxycodone
  • Tramadol

…all of these drug can become habit forming. But after heavy and prolonged use of opiate drugs, the central nervous system becomes habituated to their chemical presence and adjusts itself. This is called “drug dependence.” [1]

If you develop dependence on opiates, what is actually happening is that the brain and central nervous system are trying to achieve balance to continue functioning. Otherwise, the brain would just shut down. So, in order to counter the depressant effects of opiates, the brain “speeds up” certain systems. Once you stop or dramatically reduce drug doses the “sped up” present in the central nervous system. These are the hallmark signs and symptoms of opiate withdrawal, often including nausea, vomiting, shaking, and muscle pain.

Main Withdrawal Symptoms

When a person stops taking narcotic, painkiller drugs, the body needs time to recover and withdrawal symptoms result. Withdrawal from opiates can occur any time long-term use is stopped or cut back.

Early symptoms of opiate and opioid withdrawal include:

  • Agitation.
  • Anxiety.
  • Muscle aches.
  • Increased tearing.
  • Insomnia.
  • Runny nose.
  • Sweating.
  • Yawning.

Late symptoms of opioids withdrawal include:

  • Abdominal cramping.
  • Diarrhea.
  • Dilated pupils.
  • Goose bumps.
  • Nausea.
  • Vomiting.

These symptoms are very uncomfortable, but are not life-threatening, and usually start within 12 hours of last drug dose. Still, withdrawal from these drugs on your own can be very hard and may be risky and very dangerous. Not only can the symptoms trigger relapse, but you can also fear the worst. In fact, most symptoms can be treated as they occur and are best addressed in a medical setting.

Medical Detox

Withdrawal can take place in a number of settings:

  1. At-home, using medicines and a strong support system. This method is difficult, and withdrawal may be best when managed with a taper.
  2. In medical facilities set up to help people with detoxification (detox).
  3. In a regular hospital, if symptoms are severe.

Treatment in a medical detox setting involves medicines, counseling, and support. So, you don’t need to go through the process alone. Additionally, medications can be used to assist with the treatment of opioid dependence throughout different stages of recovery, as determined by the attending doctor. You and your health care provider will discuss your care and treatment goals to determine what can work best for you.

Main medicines used in medical detox clinics include:

  • Buprenorphine (Suboxone or Subutex)
  • Methadone
  • Extended release naltrexone (Vivitrol)

These medications have demonstrated effectiveness in their ability to reduce the unwanted effects of opiate withdrawal while increasing comfort. Still, medicines are not all that you need. The National Institute on Drug Abuse recommends that medicines should be combined with behavioral counseling for a “whole patient” approach, known as Medication Assisted Treatment. [2]

How Can Methadone Help?

Methadone is the most effective known treatment for narcotic addiction. It is also the preferred drug in the treatment of opiate withdrawal, if an opiate agonist is to be used. In fact, methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. How does it work?

Methadone is a long-acting opioid drug. It activates the same opioid receptors as stronger drugs, effectively eliminating withdrawal symptoms. In this way, it also blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. So, providing the correct dose of methadone prevents opioid withdrawal symptoms and eases drug craving but it does not provide the euphoria.

Specifically, methadone:

  • Blocks the euphoric effects of opiates.
  • Blocks the sedative effects of opiates.
  • Does not cause euphoric high.
  • Relieves drug craving.
  • Suppresses opiate withdrawal.

Over time, the dose can be slowly tapered off, freeing the person from physical dependence without withdrawal symptoms. However, some people can stay on methadone for months to years after withdrawal.  According to the National Institute on Drug Abuse publication Principles of Drug Addiction Treatment: A Research-Based Guide – 2012, the length of methadone treatment for cases of addiction should be a minimum of 12 months. [3] So, even if you think you are ready to stop methadone treatment, it must be stopped gradually to prevent withdrawal. Such a decision should be supervised by a doctor.

In addition, long term methadone maintenance has been shown to reduce illicit heroin use, decrease the incidence of infectious disease (such as HIV and hepatitis) commonly contracted through needle sharing, reduce criminal activity, improve social outcome, and reduce mortality.


Methadone used for the detox and the maintenance of opiate addiction treatment is available by prescription as oral solutions (1-2 mg/mL strength), tablets (5-10 mg), dispersible tablets (40 mg), or injectable solutions (10 mg/mL).

The dosage of methadone in maintenance therapy remains controversial. It is usually started at 10 to 20 mg and increased in 10-mg increments until the withdrawal symptoms are controlled. Most patients can be maintained at 40 mg a day to control withdrawal symptoms but not eliminate drug craving. Evidence supports the need to administer higher doses of methadone for effectiveness. In the past, it was common to administer the lowest dose possible to curb opiate withdrawal symptoms.

When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives. For optimal results, people should also participate in a comprehensive medication-assisted treatment program that includes counseling and social support.

Getting a Prescription

By law, methadone can only be dispensed through an opioid treatment program certified by SAMHSA. Also, regulatory restrictions concerning the use of methadone for the maintenance or detoxification of opiate addiction require that practitioners be registered with the DEA as a Narcotic Treatment Program.

People taking methadone must receive the medication under the supervision of a physician. After a period of stability (based on progress and proven, consistent compliance with the medication dosage), they may be allowed to take methadone at home between program visits. [4]

For the above, if you have been addicted to an opiate (narcotic drug such as heroin), and you are taking methadone to help you stop taking or continue not taking the drug, you must enroll in a treatment program. The treatment program must be approved by the state and federal governments and must treat patients according to specific federal laws. You may have to take your medication at the treatment program facility under the supervision of the program staff. Ask your doctor or the treatment program staff if you have any questions about enrolling in the program or taking or getting off your medication.

Side Effects

Side effects of methadone should be taken seriously, as some of them may indicate an emergency. You should stop taking methadone and contact a doctor or emergency services right away if you:

  • Experience a fast or pounding heartbeat.
  • Experience difficulty breathing or shallow breathing.
  • Experience hallucinations or confusion.
  • Experience hives or a rash; swelling of the face, lips, tongue, or throat.
  • Feel chest pain.
  • Feel lightheaded or faint.

Who CAN Use Methadone

Generally, methadone is indicated for patients who are dependent on opioids or have a history of opioid dependence. In the U.S., there were 11.8 million past year opioid misusers aged 12 or older, according to the 2016 National Survey of Drug Use and Health. [5] Worldwide, the 2011 Word Drug Report estimated between 24-35 million adults age 15-64 years used an illicit opiate in 2010. In sum, any of these folks who want to quit using can benefit from methadone. [6]

You must be able to give informed consent for methadone maintenance treatment, and the side effects discussed above should be considered for the selection of people who can take this med during opioid withdrawal. So, methadone is not right for everyone.

2016 Statistics on Opioid Misuse I the U.S.

Who SHOULD NOT Use Methadone

Patients diagnosed with severe liver disease should not be prescribed methadone maintenance treatment because methadone can trigger hepatic encephalopathy.

When taken as prescribed, methadone is safe and effective. But all medicines have risks. The physical effects of methadone must be managed in order to get the maximum benefits of the medication. Therefore, people who are intolerant of methadone or ingredients in methadone formulations should not be prescribed methadone. And because methadone is habit-forming, it’s not always the best choice for someone who wants to quit drugs altogether.

Furthermore, drinking alcohol, taking prescription or non-prescription medications that contain alcohol, using street drugs, or overusing prescription medications such as benzodiazepines during your treatment with methadone increases the risk that you will experience serious, life-threatening side effects. Talk to your doctor about the risks of drinking alcohol or using street drugs during your treatment.

Methadone may harm or cause death to other people who take your medication, especially children. Store methadone in a safe place so that no one else can take it accidentally or on purpose. Be especially careful to keep methadone out of the reach of children.

Methadone medication is specifically tailored for the individual person (as doses are often adjusted and readjusted) and is never to be shared with or given to others.

Methadone Safety

Methadone safety is well established and research goes back to the 70’s to back this up. Still, methadone can be addictive and even lethal when misused, so it must be used exactly as prescribed. Taking more methadone than prescribed can cause unintentional overdose, for example. And mixing methadone with alcohol can cause respiratory depression. This is particularly important for persons who are allowed to take methadone at home and are not required to take medication under supervision at an opioid treatment program. [7]

Tell your doctor if you are pregnant or plan to become pregnant. If you take methadone regularly during your pregnancy, you’ll need special medical attention. This is because withdrawal can provoke miscarriage or premature birth. Even so, your baby may experience withdrawal symptoms after birth….but methadone maintenance can help stabilize you during pregnancy.

Other medications may interact with methadone and cause heart conditions. Even after the effects of methadone wear off, the medication’s active ingredients remain in the body for much longer.

The following tips can help achieve the best treatment results:

  • Be careful driving or operating machinery on methadone.
  • Dispose of unused methadone by flushing it down the toilet.
  • Do not consume alcohol while taking methadone.
  • Never use more than the amount prescribed, and always take at the times prescribed. If a dose is missed, or if it feels like it’s not working, do not take an extra dose of methadone.
  • Store methadone at room temperature and away from light.
  • Take steps to prevent children from accidentally taking methadone.

Need Methadone Help?

Are you considering methadone for an opioid problem? Are you scared, nervous, or confused? Leave your questions or concerns in the comment section below, and we will get back to you as soon as we can. Or, give us a phone call on the number listed above. You are also welcomed to leave a comment with advice and experiences of your own.

Reference Sources: [1] HHS: What is the U.S. Opioid Epidemic
[2] NIDA: Effective Treatments For Opioid Addiction
[3] NIDA: Principles Of Drug Addiction Treatment: A Research-Based Guide – 2012
[4] SAMSHA: Medication Assisted Treatment
[5] SAMSHA: Key Substance Use And Mental Health Indicators In The United States: Results From The 2016 National Survey On Drug Use And Health
[6] UNODC: World Drug Report 2011
[7] NCBI: Medical Safety And Side Effects Of Methadone In Tolerant Individuals
WHO: Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings
NCBI: Maintenance Medication for Opiate Addiction: The Foundation of Recovery
CDC: Methadone maintenance treatment
DEA: FAQs prescriptions
MEDLINEPLUS: Opiate withdrawal
NCBI: Use of methadone
SAMHSA: Follow directions, methadone brochure
TOXNET: Methadone
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Dili Gonzalez, M.D. is a general surgeon practicing women's focused medici...
Dr. Goecke is a medical doctor and general surgeon with personal experience of...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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