Methadone, a common treatment for opioid use disorder acts as a substitute for opioids. It can block the “high” effect from other opioids and reduce pain from withdrawal symptoms, making it easier to detox. But methadone is also an opioid, and you can experience additional withdrawal symptoms if you stop taking it abruptly.

Methadone withdrawal can be unpleasant, but withdrawal symptoms are manageable as long as you taper off of methadone with medical support.

This guide will give you an idea of what to expect from methadone withdrawal symptoms, plus how long they last and how to minimize them.

Why Methadone Withdrawal Symptoms Occur

Methadone is an opioid, so it’s possible to become physically dependent on it if you take it for a long time or in high doses. Having a physical dependence means your body gets used to having methadone regularly. When you stop using it quickly, your body feels like something is missing.

Your body begins to crave the methadone it no longer has, which results in withdrawal symptoms. It’s best to taper off of methadone gradually so your body can comfortably adjust.

How Methadone Withdrawal Differs From Other Opioid Withdrawal

Methadone is a little different from other opioids. While it can cause similar withdrawal symptoms, it has a longer half-life than prescription opioids or heroin. A medication’s half-life describes how long it stays active in your body.

Because it’s a longer-acting drug, methadone withdrawal symptoms can last for a longer time than withdrawal symptoms from other opioids. However, this longer withdrawal is often less unpleasant than withdrawal from other opioids. It’s also generally safer to withdraw from methadone because it’s taken under medical supervision.

Typical Methadone Withdrawal Timeline

Methadone’s long half-life can lead to long-lasting withdrawal symptoms, which typically begin at least 24 hours after your last methadone dose. Tapering off of methadone treatment can take months, but timelines vary from person to person.

Post-acute withdrawal syndrome (PAWS) is a concept increasingly used by practitioners in the substance use treatment community. PAWS can reportedly happen after the initial withdrawal phase.

Symptoms reported include trouble sleeping, low energy, worsening anxiety, depressed mood, problems with concentration, and opioid cravings that come and go for weeks or even months. Presently, no major medical or psychological organization has made PAWS a formal diagnosis or syndrome.

6 Common Physical Methadone Withdrawal Symptoms

Physical symptoms of methadone withdrawal can set in just a day or two after your most recent methadone treatment dose. Below are some common symptoms you might experience.

Many people experience bone pain, muscle pain, or muscle cramps during methadone withdrawal. You may also experience increased pain sensitivity, which means things can feel more painful than they normally would.

Aches and pains tend to start around three or four days after you last used methadone. Pain can improve after withdrawal peaks, usually sometime after the first week.

During withdrawal, you may experience gastrointestinal (GI) symptoms, which can start as early as day 3 or 4. These symptoms can persist for days or weeks even after their peak.

GI symptoms related to methadone withdrawal can include:

• Nausea
• Vomiting
• Diarrhea
• Stomach cramps

Methadone withdrawal can speed up your heart rate or cause arrhythmias (abnormal heart rhythms). You might also experience increased blood pressure, which can be especially risky if you have preexisting heart problems.

Opioid withdrawal, even from methadone, can trigger major cardiovascular events. This is another reason why it’s important to taper off of methadone under professional medical supervision.

It might surprise you to hear that methadone withdrawal can affect your eyes. Eye symptoms can include:

• Droopy eyelids
• Dilated pupils
• Eye watering or tearing

Insomnia, or trouble sleeping, is a common symptom of methadone withdrawal. You might feel restless and unable to settle down. Other symptoms, like physical pain or anxiety, can make it even harder to rest while going through withdrawal.

Methadone withdrawal can dysregulate your body temperature, leading to chills, goose bumps, and fever in some cases.

Other physical symptoms of methadone withdrawal can include teeth chattering, muscle weakness, and tiredness or low energy.

2 Common Psychological Methadone Withdrawal Symptoms

It’s common for your mental health to be affected during methadone withdrawal, especially if you stop using methadone abruptly. Not everyone will experience the same psychological symptoms, but here are some of the most common:

Anxiety, restlessness, and irritability tend to appear around day 3 or 4 after you stop using methadone. Anxiety can lead to muscle tension, feelings of being in danger, and sweating.

If your anxiety is severe during the withdrawal period, your healthcare provider might prescribe an antianxiety medication. There is some evidence that some of these medications, like benzodiazepines, may help with managing withdrawal symptoms in addition to anxiety.

Depression can appear days or weeks into methadone withdrawal. You may have trouble feeling any positive feelings, and you might lose all motivation. Usually, depression in methadone withdrawal is at its worst during the first week.

Factors That Affect Withdrawal Severity

Methadone withdrawal symptoms can be severe for some and not so bad for others. It depends on several factors, including:

• Methadone dosage — Taking high doses of methadone can make you more physically dependent, which can make stopping more difficult.
• Duration of use — How long you used methadone can affect withdrawal severity because it stays in your body for a long time.
• Tapering approach — Slowing reducing your use of methadone under the supervision of a healthcare provider can help you step down your dosage without extremely severe symptoms. Your provider can lower your dose faster or slower based on how symptoms change.
• Your overall health — Certain health conditions, such as inflammatory bowel disease (IBD) or breathing problems, can make methadone withdrawal riskier or more severe.

Treatment and Support Options for Methadone Withdrawal

You’ll need to work closely with a medical provider who can monitor you and manage your methadone withdrawal syndrome. Here’s how they can help:

Medically Supervised Tapering

It’s important to never quit methadone “cold turkey.” This can cause unbearable or even life-threatening withdrawal symptoms.

Instead, a medical provider can help you steadily and gradually decrease the dose. This allows your body time to adjust and minimizes methadone withdrawal symptoms.

Symptom Management

Your healthcare provider can prescribe or recommend treatments to target individual symptoms of methadone withdrawal. They’ll encourage you to get enough rest and drink plenty of water. They might also give you medications for anxiety, insomnia, diarrhea, or other symptoms.

Ongoing Care

It can take months or years to taper off methadone safely. You may need ongoing care during and after detoxification, including mental health support to prevent opioid relapse.

When To Seek Medical Attention

Tapering off methadone under medical supervision or at a methadone clinic can help prevent serious and even life-threatening complications. However, during and after withdrawal, you may be at an increased risk of overdose because of a lowered opioid tolerance.

Seek medical attention right away if you experience strong or overbearing cravings for methadone or other opioids.

Never ignore signs of an overdose, including slowed breathing, a slowed or stopped heartbeat, or cold and clammy skin. If you or a loved one shows signs of an overdose, call 911 or your local emergency number right away.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

Which methadone withdrawal symptoms did you find the most challenging? Let others know in the comments below.