Methadone Withdrawal Timeline: How Long Does It Last?

Methadone is a potent opioid used to treat pain and addiction to other opioids. As a long-acting opioid, methadone is sometimes prescribed to treat opioid addiction. However, methadone has the potential for abuse, which can lead to dependence and addiction.

How Long Does Methadone Withdrawal Last?

The symptoms of methadone withdrawal tend to occur within the first 30 hours of stopping drug use and may persist for up to 10 days after quitting. Some side effects of methadone withdrawal may continue beyond this acute phase and last weeks or months after abstinence.

Discontinuing methadone use after developing dependence results in severe withdrawal symptoms that can lead to a relapse. In turn, a relapse can lead to a potentially deadly overdose as a person’s methadone tolerance can quickly decrease following drug discontinuation. Therefore, controlling withdrawal symptoms to avoid relapse is important.

Further, the symptoms of methadone withdrawal are usually not life-threatening but are difficult to cope with due to their unpleasantness. However, complications may prolong withdrawal and make it more dangerous. For example, vomiting and diarrhea are common methadone withdrawal symptoms. While not hazardous on their own, if left uncontrolled, they can lead to dehydration, which can be life-threatening in severe cases.

When Does Methadone Withdrawal Begin?

Methadone is a long-acting opioid with a longer half-life (24 hours) than other opioids like oxycodone (four hours). In other words, methadone persists for a longer time in the body relative to other opioids. As a consequence, the symptoms of methadone withdrawal emerge later than short-acting opioids (onset: within 30 hours, duration: up to 10 days) and last longer. 

Methadone Withdrawal Symptoms Timeline

Methadone withdrawal symptoms emerge within 30 hours after abstinence from drug use and may persist for around 10 days after onset. Besides these primary withdrawal symptoms, certain symptoms of methadone withdrawal may continue beyond this acute phase and persist for several months. These withdrawal symptoms that last beyond the acute phase are protracted withdrawal symptoms.

Acute Methadone Withdrawal Phase

The symptoms of methadone withdrawal tend to appear within 30 hours after abstinence and peak after the first three days of onset of withdrawal symptoms. These symptoms then gradually decrease in intensity over the next 10 days. The symptoms of methadone withdrawal observed during this period are referred to as acute withdrawal symptoms. The symptoms during this period include:

• Nausea or vomiting
• Diarrhea
• Insomnia
• Anxiety
• Agitation
• Muscle and bone pain
• Excessive sweating
• Nasal discharge 
• Dilated pupils

Days 1–3

Because methadone is a long-acting opioid, withdrawal symptoms do not occur quickly. Instead, withdrawal symptoms can take as long as 30 hours to initially appear because it takes so long for the drug to wear off. Generally, methadone withdrawal symptoms do not start to peak until after the three-day mark.

Days 4–10

After methadone withdrawal symptoms peak between days three and eight, it can take around 10 days for withdrawal symptoms to subside. In some cases, it may take longer for withdrawal to resolve completely.

Post-Acute Methadone Withdrawal Phase

Some symptoms of methadone withdrawal persist for several months beyond the acute withdrawal phase of three weeks. These symptoms may last for weeks or months and are collectively referred to as post-acute withdrawal syndrome. The symptoms experienced during this post-acute or prolonged withdrawal phase include:

• Anxiety
• Irritability
• Depressed mood
• Fatigue 
• Sleep disturbances

Long-Term Methadone Recovery Phase

Over the long term, most, if not all, methadone withdrawal symptoms will resolve as you return to a new normal of a methadone-free life. However, staying sober from methadone can be a challenge. It is important to maintain your sobriety over the long term by focusing on recovery in the following ways:

• Living in a sober living environment
• Minimizing your methadone use triggers to stay sober
• Forgiving yourself for lapses and seeking help to avoid relapsing into regular methadone use
• Surrounding yourself with supportive family and friends
• Having support from sponsors during the challenging moments
• Keeping up with therapy or Narcotics Anonymous meetings 

Factors Affecting Methadone Withdrawal Duration

The severity and duration of methadone withdrawal symptoms differ depending on the individual’s drug use history. 

Besides the severity of methadone dependence, the physiological characteristics of a person also tend to determine the severity and duration of methadone withdrawal symptoms. Thus, variables that tend to affect the duration of withdrawal and influence physiological characteristics can include:

• Genetics
• Environmental factors
• Lifestyle choices 
• Age

Dosage and Duration of Methadone Use

Severe dependence on methadone is associated with more intense withdrawal symptoms that persist longer. Factors that determine the severity of dependence on methadone, such as the dose, frequency and duration of drug use, also similarly impact the intensity and duration of withdrawal symptoms. 

Polysubstance Use

When a person is addicted to multiple substances at the same time, recovery can be more complex. Withdrawal symptoms, cravings and triggers for multiple substances must be managed in tandem. This can complicate the withdrawal process and may prolong it in some cases.

Age

The older a person is, the less tolerance they may physiologically have for taxing burdens like withdrawal. It can be harder for an older person to recover from withdrawal as quickly as a younger person might.

General Health

The healthier a person is, the greater the likelihood they will be able to undergo withdrawal while minimizing the risk of complications. As medical problems build up, it can be harder to recover quickly during withdrawal, which might prolong detox. This includes mental health struggles, which often go hand in hand with addiction.

Genetic Factors

Some people have a genetic tendency towards addiction and may have loved ones who have undergone addiction and rehab. Understanding the role that genetic factors can play in addiction is important to helping your addiction team develop a plan to help keep you methadone-free after recovery is complete.

Tapering off Methadone To Reduce Withdrawal

Abrupt discontinuation of methadone use, such as quitting methadone use cold turkey, can result in severe withdrawal symptoms associated with relapse. Hence, the methadone dosage should be very gradually tapered to avoid such adverse withdrawal symptoms. It is advisable to devise a tapering schedule with the help of a physician to prevent the onset of withdrawal symptoms due to a rapid decrease in dosage. The tapering schedule is tailored according to the needs of the individual, taking into account factors such as the severity of methadone dependence, abuse of other substances and the person’s physiological and psychological state.

Treatment for Methadone Withdrawal

If you or a loved one are dependent on or are addicted to opioids like methadone, Orlando Recovery Center can help. Orlando Recovery Center provides evidence-based medical detox and rehabilitation services for substance use disorders delivered by experienced and accredited professionals. Contact us today to get started on the path to recovery.

Other Questions About Methadone Withdrawal Timeline

How soon after my last dose will methadone withdrawal begin?

Methadone withdrawal typically begins within 30 hours after the last dose of methadone and usually lasts around 10 days.

How long does it take to taper off methadone?

Tapers are individualized and can take people different lengths of time to taper off methadone. The taper schedule is highly dependent on factors like your methadone dose, in that it will take someone on a higher dose a longer time to taper the drug than someone on a lower dose. Because tapers are meant to minimize withdrawal symptoms, your taper may even occasionally be paused if you experience withdrawal symptoms after a dose decrease.

How long does it take to detox from methadone?

Methadone withdrawal typically lasts around 10 days, although it may last longer in some cases, with certain symptoms like anxiety and insomnia lingering for weeks or even months.