Methadone Withdrawal and Detox Timeline and Symptoms

Methadone is a commonly prescribed and effective treatment for opioid addiction. Unfortunately, methadone is itself highly addictive and can cause dependence within a few weeks, even if taken as prescribed.

Methadone dependence can cause withdrawal symptoms that can be quite unpleasant unless the patient undergoes medically supervised detox. Read more to learn about the methadone detox timeline and symptoms.

What Is Methadone Withdrawal?

When a person repeatedly uses a drug, whether legally or illegally, their body will eventually adapt to its presence. If the person stops taking that drug or significantly reduces the dose they are taking, the body will no longer function in the same way that it has become accustomed to.

When someone uses methadone, the body will reduce and eventually stop production of natural opioids that are used in the transmission of signals in the nervous system. When the person stops taking methadone, their body will struggle until its production of natural opioids resumes. Until this happens, the person will experience a collection of symptoms known as withdrawal.

What Is Methadone Detox?

Medically supervised detox, or detoxification, is a process by which medical and treatment professionals help patients get through withdrawal. Although every detox program is different, a typical methadone detox will involve a combination of medication, supervision, and various therapies. These methadone detox treatments either reduce or eliminate the unpleasant symptoms of methadone withdrawal.

The goal of methadone detox is to keep patients safe and comfortable while they go through acute withdrawal. This will make it much more likely that they will complete withdrawal without relapsing and put them in a much better state when they start an inpatient or outpatient rehab program.

When done correctly, methadone detox increases the likelihood that an individual will attain and maintain sobriety on a more immediate timeline.

Common Symptoms of Methadone Withdrawal That Are Helped by Detox

Methadone detox will help reduce many of the symptoms that appear during the methadone withdrawal timeline, including:

• Anxiety
• Body aches
• Chills
• Confusion
• Concentration issues
• Cravings
• Depression
• Digestive issues
• Flu-like symptoms
• Hallucinations
• High blood pressure
• Hot flashes
• Increased heart rate
• Irritability
• Mood changes
• Nasal discharge
• Pain in muscles and bones
• Paranoia
• Sleeping problems
• Sweating
• Tremors

According to psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger, you can reduce the effects of methadone withdrawal through “keeping yourself well hydrated, physical activity, and slower tapering of the methadone dosage.”

Acute Methadone Withdrawal Symptoms

Some symptoms of methadone withdrawal are more commonly associated with the acute phase that lasts up to three weeks after the last dose. These include:

• Acute mental symptoms, including anxiety, confusion, depression, dysphoria, hallucinations, and paranoia
• Digestive issues, including stomach pain, vomiting, diarrhea, and constipation
• Flu-like symptoms, including body aches and pains, nasal discharge, sore throat, and congestion
• Physical symptoms, including sweating, tremors, dilated eyes, and bone and muscle pains

Post-Acute Methadone Withdrawal Symptoms

Some symptoms of methadone withdrawal are more commonly associated with post-acute methadone withdrawal.

While most of these symptoms will start during the acute phase, they can continue long after other symptoms have faded away. Post-acute methadone withdrawal symptoms are more likely to be mental in nature and include:

• Anhedonia (the inability to experience pleasure)
• Anxiety
• Depression
• Irritability
• Issues with sleep cycles

How Long Does Methadone Withdrawal Last?

In general, acute methadone withdrawal (where there are the most and strongest symptoms) will last from about 24 to 48 hours after the last dose until about two to three weeks after the last dose. Post-acute withdrawal syndrome (where there are fewer and less severe symptoms) may last for up to two years.

Every patient is different, and how long their methadone withdrawal will last is heavily dependent on many factors, including:

• The length of the methadone addiction
• The severity of the methadone addiction
• How much methadone was taken in each dose
• How frequently methadone doses were taken
• The patient’s weight
• The patient’s gender
• The patient’s body chemistry
• The patient’s age
• The existence of any co-occurring addictions
• The existence of any co-occurring mental health or medical conditions

Methadone Withdrawal Timeline and Symptoms During Detox

Every individual going through methadone withdrawal and detox will experience a different timeline, which is determined by the factors listed above. However, it is possible to create a general timeline for how methadone withdrawal and detox will take.

Methadone Detox Timeline: 24-48 Hours After Last Dose

The first withdrawal symptoms will begin to appear between 24 to 48 hours after the last dose of methadone was used. In most cases, fewer symptoms will be present initially, and these symptoms will be comparatively mild. This is the beginning of the acute withdrawal period.

Enrolling in medically supervised methadone detox at this point on the timeline will usually lead to a significantly better experience for most patients.

Methadone Detox Timeline: 2-7 Days After Last Dose

After symptoms first appear, they will generally worsen for two to five days. More and more symptoms will appear, and these symptoms will be of increased severity.

This is the most difficult period of acute withdrawal for many patients to get through, and the period on the timeline where medically supervised methadone detox is most recommended and beneficial.

Methadone Detox Timeline: 1-3 Weeks After Last Dose

For most patients, the most severe symptoms of acute withdrawal will begin to plateau five to seven days after they begin. After this point, symptoms will gradually begin to decrease. Some symptoms will disappear entirely, and others will lessen in severity.

In most cases, acute withdrawal will be over within two weeks, although it is not uncommon for some symptoms to persist for up to three weeks.

Medically supervised detox is still highly beneficial and recommended at this point on the methadone withdrawal timeline, but it is almost always discontinued after.

Methadone Detox Timeline: 3 Weeks-2 Years After Last Dose

Once acute withdrawal is over, most patients will see most, if not all, of their withdrawal symptoms disappear. However, some patients will experience some symptoms for up to six months after their last dose of methadone.

In rarer cases, some symptoms may persist for up to two years. This is known as post-acute withdrawal syndrome, or PAWS. Although PAWS is not treated by medically supervised detox, medical and mental health professionals will still be able to provide treatments and therapies that will alleviate PAWS symptoms and reduce their impact on the patient’s life.

Managing Methadone Withdrawal and Detox at Home

Many who suffer from a methadone use disorder wonder if they can manage methadone withdrawal on their own and detox at home. While this is possible for some patients, it is rarely advisable.

Withdrawal is often an incredibly unpleasant experience, something that many who have gone through it describe as one of the most difficult things that they have ever endured. When a patient manages methadone withdrawal and detox at home without medical supervision, they are much more likely to relapse.

Even those who do make it through withdrawal at home are often in a poor mental state due to the mental and physical stress of detoxification. This makes them more susceptible to triggers and temptations, and therefore more likely to relapse. This poor mental state also makes it more difficult for them to focus on any outpatient or inpatient rehab program that they attend, increasing their likelihood of relapse.

For these reasons, medically supervised methadone withdrawal is always recommended.

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Get Help With Methadone Withdrawal

If you or a loved one is suffering from a methadone use disorder or going through withdrawal, you may be concerned. However, there are numerous treatment options available.

Legacy Healing Center and its entire staff are dedicated to helping you or your loved one get through methadone withdrawal using medically supervised detox. Legacy also has programs designed to help you maintain your hard-earned sobriety once detox is finished.

Our holistic approach heals our patients physically, emotionally, and spiritually, and gives our patients the tools they need to avoid relapse and keep their sobriety.

Call Legacy Healing Center today at 888-534-2295 for any questions you have regarding the methadone detox timeline or any other aspects of addiction recovery.

Sources

1. Medical News Today. (2021). What to know about methadone withdrawal.
2. National Library of Medicine. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
3. Kampman K, et al. (2015). American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use
4. Substance Abuse and Mental Health Services Administration. (2023).