Methadone Detox Centers for Opioid Use Disorder

Published: 03/31/2022 | Author:

Methadone has been FDA-approved to treat opioid use disorder (OUD) since 1947.1 It is a synthetic long-acting, full opioid agonist that helps reduce withdrawal symptoms when detoxing from heroin or prescription opioids.2 Methadone detox at a treatment center provides medical supervision during the detox process to help keep you safe and comfortable throughout the withdrawal period.

In this article:

How Does Methadone Treat Opioid Withdrawal?

Methadone works by altering the communication between the nervous system and brain, resulting in a new response to pain. Because methadone acts on opioid receptors but more slowly than other opioids, it can help to reduce cravings and withdrawal symptoms during the detox process while also blocking euphoric effects commonly associated with opioid medications or drugs like codeine, morphine, heroin, oxycodone, and hydrocodone.3

Methadone can be given in an inpatient or outpatient treatment setting and is typically administered daily in liquid, powder, or diskette form.3,4 It may sometimes be given intravenously as well.4

The dosing for methadone in detox programs starts at 10-20mg and increases by 10mg increments until withdrawal symptoms are controlled.2 The goal of this process is to find a dose that stabilizes the patient without causing sedation, which usually happens at doses around 40mg.5 During detox, you will continue to take this dose for two to three days, and then your medical team will reduce your dosage by 10-20% each day while monitoring you for withdrawal symptoms.2

Benefits of Methadone Detox Centers

If you stop using opioids abruptly, you will experience uncomfortable, painful, and potentially severe or life-threatening withdrawal symptoms and intense cravings for opioids. Because the withdrawal period is so difficult, many people will relapse to find relief. Taking methadone during the detox process can help reduce withdrawal symptoms and cravings and increase your chances of achieving and sustaining abstinence from opioids.5

Methadone has been shown to improve retention in detox and treatment programs for opioid use disorder.2 Attending a methadone detox center can help improve your overall health and support you in transitioning to an addiction treatment program once the detox process is complete.5

There are many other benefits to attending a methadone detox center, including:

  • Mitigated withdrawal symptoms
  • Reduced cravings
  • Maximize comfort levels during the detox process
  • Medical staff available 24/7 to intervene in the event of an emergency
  • Access to detox counseling, peer support groups, treatment referrals, and other resources.

Do All Detox Programs Utilize Methadone?

Not all detox programs offer methadone detox treatment. Some detox centers provide social support during the detox process but not any medical care or supervision. Other medically supported detox programs may use alternative medications such as buprenorphine or non-opioid medications. If you are seeking methadone detox, you will have to find a hospital detox program or a free-standing detox center that is licensed to offer methadone detox treatment.5

Is Methadone Safe for Detox?

Methadone is a Schedule II controlled substance due to its high potential for addiction. However, it is a safe and effective treatment for opioid detox when taken as prescribed and under medical supervision.3

Methadone is far safer than using illicit drugs like heroin or misusing prescription opioid pain medications. Because it is a long-acting opioid and is administered by a medical team, they can help control your dosage and find the correct dose for you to minimize withdrawal symptoms and keep you safe and comfortable during the detox process.

Side Effects of Methadone

While methadone is a safe and effective detox treatment when taken as prescribed, it still may cause side effects. Some commonly reported methadone side effects include:2,3

  • Nausea or vomiting
  • Constipation
  • Restlessness
  • Dry mouth
  • Flushing
  • Sweating
  • Itchiness
  • Sedation
  • Lethargy
  • Slow breathing

Some more serious side effects of methadone that may occur include: 3

  • Chest pain
  • Fast or pounding heartbeat
  • Lightheadedness
  • Difficulty breathing
  • Extremely shallow breathing
  • Hives, rash, or swelling of the throat, tongue, lips, or face
  • Confusion
  • Hallucinations

These side effects are similar to those you would experience with other opioid medications and illicit drugs and can be minimized and controlled with the help of your medical team.2

Contraindications for Methadone Treatment

Not everyone is a good candidate for methadone detox treatment. It is essential to disclose your complete medical history with your detox treatment team to determine if methadone will be a safe and effective treatment for you.2

Because methadone is central nervous system (CNS) depressant and can compromise respiratory function, it should be avoided or used with extreme caution in people with the following conditions:2

      • Dementia
      • Delirium
      • Head trauma
      • Intracranial pressure

Methadone should not be used in conjunction with other substances that are CNS depressants, such as:

  • Other opioids
  • Alcohol
  • Benzodiazepines
  • Barbiturates
  • Antipsychotics

While not an exhaustive list, some other medications that should be avoided while taking methadone because they may increase the side effects, withdrawal symptoms, and risk of overdose include:2

  • Fluconazole
  • Ciprofloxacin
  • Carbamazepine
  • Fluoxetine
  • Cimetidine
  • Ritonavir
  • Phenytoin
  • Urine alkalizing or acidifying agents

Methadone Safety Tips

Methadone detox treatment is safe and effective when provided with medical supervision and guidance. Methadone detox is tailored specifically for each person. Your medical team will help you find the dosage that is right for you. Below are some tips to help you stay safe and achieve the best treatment results in detox:3

  • Be honest with your medical team and give them a comprehensive medical history to create a treatment regimen that is safe and effective for you and your unique needs.
  • Take methadone in a medical methadone detox center with full medical supervision.
  • If you are given take-home doses of methadone, take it exactly as prescribed. Do not alter the dosage or timing of the dosing at all. If you miss a dose or feel like your dose isn’t working, do not take another dose to make up for it.
  • Do not share methadone medication with anyone under any circumstances.
  • Avoid driving or operating heavy machinery until you have adapted to methadone and know how it affects you.
  • Keep your methadone medication in a cool, dry place, away from light and out of reach of children and pets.
  • Call 911 if you experience signs of an overdose, including feeling faint, having difficulty breathing, or developing rashes.

Tapering Off Methadone Under Medical Supervision

Because methadone is an opioid, it can lead to dependence and can cause withdrawal symptoms if you suddenly stop taking it. For this reason, your medical team will help you slowly wean off the medication by tapering your dose down gradually. This process can vary from person to person.3

Some people may choose to stay on methadone after they complete their initial opioid detox as a form of maintenance to help reduce cravings and prevent relapse. This form of medication-assisted treatment (MAT) with methadone can help minimize cravings and allow you to engage in further treatment for OUD. According to the National Institute on Drug Abuse, methadone maintenance treatment is most effective for treating OUD if it lasts at least 12 months.3

Tapering off methadone may only take about one week for those detoxing from short-acting opioids like heroin. However, if patients are coming off methadone maintenance, they may need to taper slowly by decreasing the dose by just 3% each week.5

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How to Find a Methadone Detox Center

Methadone detox centers are a safe and effective way to detox from opioids and begin your journey to recovery from OUD. Only licensed and certified addiction treatment centers with physicians who have completed specific training for opioid detox can provide methadone detox treatment.5 For more information on methadone detox centers in your area, call 800-483-2193(Who Answers?) to speak with an addiction treatment specialist.

Resources

  1. National Institute on Drug Abuse. (2021). Medications to Treat Opioid Use Disorder Research Report.
  2. Durrani, M. & Bansal, K. (2022, February 12). StatPearls.
  3. Substance Abuse and Mental Health Services Administration. (2022, March 4). Methadone.
  4. Shah, M. & Huecker, M. (2021, October 11). Opioid Withdrawal.
  5. Shuckitt, M. (2016, July 28). Treatment of Opioid Use Disorders. The New England Journal of Medicine, 375: 357-368.
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