Rehab 4 Addiction

Methadone is a prescription drug that has a number of uses. Its main use is to help people stop using opioids such as heroin, but it can also be used for the purposes of pain relief. [1]

It is a synthetic opioid agonist, which means that it binds to opioid receptors in the brain. [2] Unlike heroin and morphine, methadone has a slower effect on these opioid receptors, and does not produce a feeling of euphoria. This makes it effective for people who are trying to stop using drugs such as heroin.

The main problem with methadone as a medication is that it is addictive in its own right. Some find that they are able to switch from heroin to methadone without too much difficulty, but then struggle to stop using methadone.

For those who become addicted to methadone, a detox may be necessary. This involves ridding your system of methadone.

A methadone detox should be carried out with the help of medical professionals. In this article we discuss the merits of a methadone detox, the withdrawal symptoms that are associated with methadone detox, and other aspects of treatment for methadone addiction.

Withdrawal from methadone

The longer you use methadone, the more likely you are to develop a physical dependence. Physical dependence is when your body becomes reliant on a substance.

If you try to stop taking methadone when you are physically dependent, you will experience withdrawal symptoms. These can be quite severe.

Due to the severity of methadone withdrawal symptoms, methadone detox should be done under medical supervision. Experienced medical staff can help you through the detox process.

Methadone withdrawal symptoms

Withdrawal symptoms for methadone addiction vary depending on the dosage and duration of methadone use. The main physical withdrawal symptoms include:

  • Abdominal spasms
  • Aches and pains
  • Bluish tinge to lips
  • Cold, clammy skin
  • Coma
  • Constipation
  • Constricted pupils
  • Difficulty breathing
  • Disorientation
  • Drowsiness
  • Fatigue
  • Light-headedness
  • Nausea
  • Vomiting
  • Weak muscles

Mental withdrawal symptoms include:

Why do methadone withdrawal symptoms occur?

Methadone withdrawal symptoms occur because the body has become accustomed to a certain amount of methadone, and takes time to adjust once the supply of methadone is cut off.

Acute withdrawal symptoms are a natural response to changing conditions in the body. They are unpleasant in the short-term, but rarely last for longer than a few weeks.

What are the stages of methadone withdrawal?

  • Stage one. Methadone withdrawal typically kicks in around 30 hours after the final dose, although it can take longer if the last dose was especially large. The first withdrawal symptoms to set in are muscle aches, fever, and an accelerated heartbeat.
  • Stage two. After the first 48 hours has passed, you will enter the second stage of withdrawal, in which acute withdrawal symptoms are at their worst. This stage normally lasts from the third day of detox to the eighth day, although timings vary from person to person. During stage two you will experience flu-like symptoms, as well as depression, vomiting and cramps
  • Stage three. Lasting from the ninth day to the fifteenth day of detox, stage three is characterised by a reduction in physical symptoms, although some physical symptoms may still persist. Mental withdrawal symptoms also remain fairly severe during this period, and may even get worse. Cravings and depression are common among people going through this stage of methadone withdrawal
  • Stage four. Beyond the fifteenth day of detox, you can expect there to be very few physical symptoms of withdrawal. However, cravings, anxiety and insomnia are likely to persist for another two to three weeks. Beyond that, many people experience post-acute withdrawal symptoms, or PAWS, which include symptoms such as brain fog, loss of memory/concentration, trouble sleeping and irritability. These symptoms can continue for months or even years, although they are likely to come and go in waves

What medication is available to ease methadone withdrawal?

A similar medication to methadone, which is considered to be less addictive, is buprenorphine (sometimes referred to as Subutex). Buprenorphine is a semi-synthetic opioid used for helping people to come off stronger opioids, such as heroin. It produces less of a high than methadone.

Other medications that can be prescribed for methadone withdrawal include naltrexone and suboxone. These medications are opiate agonists, which means that they stop opiates from binding to the brain’s opioid receptors.

Finally, if you detox at a rehab clinic, the medical staff can prescribe other forms of medication to deal with the side-effects of withdrawal, such as anti-depressants and beta-blockers.

Methadone detox as part of a cohesive treatment plan

In order to make a full recovery from methadone addiction, a medical detox is the first step you need to take. However, if your recovery is going to be a long-lasting one, you should consider going through a full treatment regime including rehab therapy.

A medical detox rids your body of toxins, including methadone, but it does not treat the root causes of addiction, which often include trauma and mental illness. If you detox without going through therapy, you run a higher risk of relapsing.

So what happens in therapy? Therapy helps you to explore the reasons behind your substance use. Different forms of therapy take different approaches: cognitive behavioural therapy, for example, helps you learn to recognise negative thought patterns which can lead to substance use.

When you go through a full methadone treatment plan, you have a medical detox, followed by a range of therapies – including CBT, family therapy, contingency management, group therapy and more – as well as 12-step programmes, alternative therapies such as yoga and acupuncture, and aftercare.

Inpatient vs outpatient methadone rehab

There are two types of rehab to consider if you want to start comprehensive methadone treatment.

In inpatient rehab, you stay overnight for the duration of your treatment. Inpatient rehab carries several advantages, such as:

  • You can access 24/7 medical care while you are going through methadone detox. This is especially important for methadone users since the withdrawal symptoms for methadone can be quite severe.
  • You will be far away from any stressors and triggers which may be present where you live.
  • There is very little opportunity for relapse since there will be no substances at the rehab.

It also has a few disadvantages, which are:

  • It is more expensive than outpatient rehab.
  • It can be difficult to take time off work for a full stay in residential rehab.

Outpatient rehab is a type of rehab where you continue to live at home, but receive treatment at an outpatient centre. The advantages of outpatient rehab include:

  • It is less expensive than inpatient rehab.
  • It is easier to fit around a job/other commitments.

However, there are some disadvantages:

  • Greater potential for relapse.
  • No 24/7 medical care during detox.
  • Continued exposure to triggers and stressors at home.

You can read more about the differences between inpatient and outpatient rehab here.

Frequently Asked Questions

Do I need to go to methadone rehab?

If you have an addiction to methadone, rather than just a physical dependence – i.e. you are experiencing severe cravings for methadone, you continue using it despite its negative effects on your health, etc. – then you should strongly consider going to methadone rehab.

You may not realise it, but your addiction is harming you and your loved ones. The sooner you start your recovery, the better.

How bad is methadone detox?

Methadone detox is just as unpleasant as any other substance detox. The withdrawal symptoms are severe, although they will vary depending on the extent of your addiction.

If you have a very mild methadone habit, then the withdrawal symptoms will not be as bad; a heavier methadone habit will entail more unpleasant withdrawal symptoms.

Is there a risk to my life from methadone withdrawal?

Complications can occur during any substance withdrawal process. Complications are more likely if you are in a very poor state of physical health, have a severe substance addiction, and detox on your own.

The risk of complications goes down dramatically if you choose to detox under medical supervision. Medical professionals can identify problems before they get out of hand.

Am I addicted to methadone, or do I just have a physical dependence?

Physical dependence can occur whenever you take an addictive drug such as methadone. With physical dependence, you may experience withdrawal symptoms after you stop taking the drug, without necessarily feeling a burning desire to use methadone.

Physical dependence is a component of addiction, but it is possible to have physical dependence without being addicted.

So how do you know if you are addicted? Signs to watch out for include: using more methadone than before, needing more methadone to feel the same high, using other substances as well as methadone, experiencing cravings for methadone, and avoiding work or education in order to use methadone.

Working out if you are addicted is not an exact science, but if these signs apply to you, you may want to seek help.

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892816/

[2] https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work