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January 28, 2019

How Long Does Methadone Last

You’ve likely heard some information about methadone used in treating substance use disorders. Maybe you have concerns about the drug based on things you’ve heard. If your treatment provider has put you on methadone, you may be wondering how long does methadone last? Learn more about this treatment for opioid maintenance therapy here.

METHADONE TREATMENT FOR OPIATE ADDICTION

Methadone has been used for years to treat addiction to opiates, such as heroin or prescription painkillers derived from natural, synthetic or semi-synthetic opiates. When it comes to making a determination which medication approved by the Food and Drug Administration (FDA) to use during medication-assisted treatment (MAT), the treatment providers will evaluate all the client’s unique needs, the length of time they were dependent on or addicted to opiates, what dose or strength of opiates they used, and how often they used, among many other factors. Many who have sought treatment to overcome opiate addiction have been prescribed methadone. 

Methadone may be used first during medically supervised drug detox, as the person addicted to opiates goes through withdrawal and the opiates leave his or her system. It may also be used as a treatment in opiate maintenance therapy after detox and during the formal phase of treatment. In some cases, according to research, methadone may be the preferred medication to be used instead of other MAT choices, including buprenorphine (Suboxone, Subutex), or naltrexone.

WHAT DOES METHADONE TREATMENT DO?

The biggest hurdles most people entering drug rehab face are their fear of painful or uncomfortable withdrawal symptoms and drug cravings. When the drug of choice has been opiates, these are legitimate concerns, since some withdrawal symptoms can be severe as well as either uncomfortable or painful. Feeling like they can’t take the pain of the withdrawal symptoms when trying to go cold-turkey (detoxing on their own) or only with abstinence-based therapy, many in drug rehab revert to using again. When the client is prescribed methadone, however, what happens is that the medication does take away the urge to use opiates. It also makes it impossible to get high from opiate pills or heroin while they are taking methadone.

Another evidenced benefit of methadone for opiate treatment is that those in rehab tend to stay in rehab longer. When not receiving MAT, clients tend to relapse at higher rates than those who do get MAT. After going back to doing drugs, the individuals who’ve quit rehab try to use the same quantities they did before the went into rehab. Their tolerances are now lower, though, and taking that quantity or strength of opiates they used to use may result in death.

How Do You Feel Taking Methadone?

How you feel when you start taking methadone depends on several things, one of which is whether you were already addicted to opiates or are now taking methadone to stay away from taking those opiates. Yes, methadone will block some of the cravings for your original opiate, and it will also make some of your pain go away. Some describe it as feeling a little numb, or a reprieve from pain. Others say they’ve noticed an increased desire for sweets or that their appetite has improved. Most report that taking methadone has a calming effect, although taking the same prescribed dosage at the same time each day as treatment professionals advise, gives them a boost of energy and motivation.

Other side effects of taking methadone may include:

  • Headache
  • Dry mouth
  • Flushing
  • Mood changes
  • Sore tongue
  • Constipation
  • Sleep difficulties
  • Stomach pain
  • Urination problems
  • Vision changes

Most of these side effects will subside after a while; some, such as constipation (a common side effect of opiates) can be treated with other medication.

What you absolutely don’t want to do is try to take methadone recreationally, or increase dosage in an attempt to get high. This could result in death, due to drastically slowed breathing that then stops. Furthermore, taking methadone in combination with benzodiazepines or central nervous depressants such as alcohol ratchets up the risk of life-threatening complications and death.

A study published in the International Journal of Legal Medicine found intravenous applications of methadone played an important role in 2007-2012 drug-related deaths in Hamburg, Germany. Forty-nine percent of the 114 methadone intoxications ending in death were among those in methadone opiate maintenance. Researchers cautioned that therapists only prescribe take-home doses of methadone after clients had a minimum 6-month period of successful therapy and when no intravenous use of methadone was suspected.

How Long Does Methadone Last?

Treatment professionals say that methadone’s analgesic duration, when taken as an oral dose, can last anywhere from 6-48 hours. How long the medication lasts depends on whether you’re a chronic user of methadone. When taken via the oral route, methadone gets rapidly absorbed in the gastrointestinal tract, and can be detected in the blood in a half-hour.

Prescription methadone is available in tablet form, oral solutions, and injectable solutions. Methadone is a narcotic and is classified by the Drug Enforcement Agency (DEA) as a Schedule II controlled substance. Since methadone has a high potential for abuse, most people (who must go to a licensed clinic or treatment facility to receive their methadone medication) are not allowed to take it home with them. Take-home doses of methadone (unsupervised administration) has been linked with overdose deaths.

Methadone is a sedative type of medication. It depresses the central nervous system, has a relatively fast onset, and its effects can last for hours. In opiate-dependent individuals undergoing methadone treatment, a single dose may be enough to stave off withdrawal symptoms for about 24 hours. For the purposes of staying off heroin or other opiates, methadone doses may be prescribed several times a day.

It is important to note that methadone maintenance treatment may continue indefinitely (or until you and your treatment team make the determination to gradually taper off and discontinue methadone, perhaps by transitioning to another opiate maintenance medication such as Suboxone). Of course, your treatment professionals will need to monitor your dosage and frequency closely and make appropriate adjustments. Every person is different in how their body metabolizes methadone, including how long methadone lasts.

HOW DO YOU KNOW YOU’RE IN METHADONE WITHDRAWAL?

If you haven’t taken methadone as prescribed (or you haven’t taken it for a while), you will begin to experience symptoms of methadone withdrawal in about 24-36 hours after the last dose of the medication. Studies have shown that methadone gets eliminated from the body in about a 72-hour timeframe, although exactly how long this takes is specific to the individual. In some individuals, traces of methadone will remain in the urine for 3 weeks or even longer.

In general, methadone withdrawal symptoms tend to feel like a case of the flu. The more severe symptoms, however, can linger for several days. Some will peak after about day three. As for specific symptoms of methadone withdrawal, according to Drugs.com, these can include:

  • Anxiety
  • Body aches
  • Chills
  • Confusion
  • Constipation
  • Cramps
  • Cravings
  • Depression
  • Diarrhea
  • Difficulty concentrating
  • Hot flashes
  • Increased blood pressure, heart rate, respiratory rate
  • Insomnia and sleep difficulties
  • Nausea
  • Restlessness
  • Sweating
  • Vision problems
  • Vomiting
  • Weakness

HOW EFFECTIVE IS METHADONE MAINTENANCE TREATMENT?

When treatment professionals prepare a treatment program for a client who wishes to overcome opiate addiction, the main goal after detox, during and after formal treatment program is to use methadone maintenance therapy to improve the client’s health and quality of life. With a safe and effective treatment program designed to meet individual needs, clients can be assured they’re receiving evidence-based treatment with methadone maintenance.

But how effective is methadone maintenance treatment long-term? Furthermore, why do people remain in it? A 2014 study in Substance Use and Misuse found that methadone long-term maintenance helped those in opiate drug rehab to enjoy improved social functioning. They also showed increased survival rates due to reductions in infection rates and mortality caused by drugs. Researchers did note, however, that patients in the study, on average, felt it was more difficult to detox from opiate maintenance than from heroin.

Another study pointed out that while methadone maintenance is an effective treatment for opioid use disorder (OUD), there are still many individuals undergoing this maintenance therapy who continued to struggle with chronic relapse. The researchers also found an association in those undergoing methadone maintenance with depressive symptoms and drug cravings.

In line with this, an earlier study published in Harm Reduction Journal noted that increased dosage in opiate dependent clients in methadone maintenance treatment could be interpreted as development of tolerance. Researchers suggested that clinicians and treating staff should remain watchful for clients experiencing craving symptoms or relapse, both signs that methadone maintenance treatment efficiency may be decreasing.

Methadone is one of a number of MAT options available to people with opiate addiction. In recent years, newer MATs like Suboxone have been developed which are also effective but safer to take. If you’re looking for the best opiate treatment for you, talk to an addiction professional today about your options.

For more about methadone, detox, withdrawal and recovery, check out these articles:

  1. Alternative Methods for Managing Pain Without Opiates
  2. Dangers of Drug Detox at Home and Quitting Cold Turkey
  3. Do I Need Methadone Rehab?
  4. Methadone Detox – Withdrawal Symptoms and Timeline
  5. How Does Methadone Make You Feel?
  6. How to Get Off Methadone
  7. Why Medication-Assisted Treatment is Important for Opiate Addicts in Early Treatment

Sources:

Harm Reduction Journal. “Opioid tolerance in methadone maintenance treatment: comparison of methadone and levomethadone in long-term treatment.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754801/

International Journal of Legal Medicine. “Intravenous methadone application as a serious risk factor for an overdose death: methadone-related fatalities in Hamburg from 2007 to 2012.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24859230/

National Institute on Drug Abuse. “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” “Opioid Addiction.” “Methadone.” Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies

National Institute on Drug Abuse. “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” “Preface.” Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/preface

Neuropsychopharmacology. “Prefrontal cortex Response to Drug cues, craving, and current depressive symptoms are associated with treatment outcomes in methadone-maintained patients.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30375498

Substance Abuse and Mental Health Services Administration. “Methadone.” Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone

Substance Use and Misuse. “Why do patients stay in opioid maintenance treatment?” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24328842

 

 

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