Dangers of Quitting Methadone Cold Turkey

Methadone is a synthetic opioid (opiate like substance) used to treat severe, chronic pain and opiate or opioid painkiller addiction. According to a study done by The Rockefeller University, methadone is one of the most successful, and safest, ways to treat addiction to opiates or opioid painkillers. However, there are many dangers involved with methadone treatments, including addiction. This may cause someone receiving methadone treatment to want to stop taking it.

There are many ways to quit methadone. One of these is immediate cessation, otherwise known as cold turkey. For someone considering cessation of a methadone treatment program, there are some aspects of quitting methadone cold turkey that they should be aware of. These include how methadone affects the brain, mild and severe symptoms of methadone withdrawal, and the methods of quitting methadone, including cold turkey, and how they differ.

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Methadone and the Brain

Talk to your doctor about getting off methadone. They can help you plan a safe way to stop using the drug.

Opiates are considered addictive because they attach to certain receptors in the brain that regulate pain and pleasure. This effectively creates a sense of euphoria and reduces or eliminates pain. Methadone works on the receptors in a different way; this is why it is used to treat addiction. According to the National Institute of Health, methadone works by blocking the same brain receptors targeted by opiates, and not allowing the chemicals in the brain to produce a euphoric effect. They also reduce cravings by blocking these receptors from sending signals about a need for opiates. Since methadone fundamentally changes brain chemistry, suddenly stopping methadone in a cold turkey approach can cause the withdrawal effects to be worse than normal withdrawal. Cold turkey methadone withdrawal includes:

loss of judgement,
loss of motor control,
depression,
reduced pain tolerance,
mood swings, and
dependency.

If this is not dangerous enough, stopping the use of methadone suddenly greatly increases the chance that these mental effects will occur and adds even more symptoms related to withdrawal.

Symptoms of Methadone Withdrawal

Methadone is one of the most physically addictive drugs known, even more addictive than an opiate. This is because it is a longer lasting drug. For example heroin, a highly addictive drug, exits the system of an addict in a few days. Methadone does not exit a person’s body for weeks and possibly months. Because methadone does not exit a person’s body quickly, the cold turkey withdrawal symptoms may last for months. When considering quitting methadone cold turkey, it is important to remember that there will be intense withdrawal symptoms. These range from mild to severe. Here is a list of the common withdrawal symptoms:

Mild symptoms are:

Sensitivity to light
Runny nose
Fever
Sweating
Chills
Increased pain sensitivity
Jitteriness or tremors
Restlessness
Lethargy
Decrease or increase in sex drive
Agitation
Nervousness

Severe symptoms are:

Suicidal thoughts or actions
Hyperventilation
Severe anxiety and depression
Insomnia lasting as long as three weeks
Severe pain in the abdomen, joints, and legs
Visual, auditory, and olfactory hallucinations
Irregular heartbeat and blood pressure
Severe itching
Apathy
Panic
Paranoid delusions
Anorexia

While there is no guaranteed way to completely avoid these side effects when stopping methadone treatment, they can be mitigated by not quitting cold turkey.

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Differences between Quitting Cold Turkey and Quitting by Other Means

An article, written by the Center for Substance Abuse Research at the University of Maryland (CESAR), states that there are three ways to stop using methadone. These include medication replacement treatment, a steady reduction in methadone dosage known as tapering, and cold turkey. Each of these methods has its advantages and drawbacks.

Methadone Replacement

There are two main medications used for methadone replacement. These are buprenorphine, a semi-synthetic morphine that is slowly released into the bloodstream, and L-alpha-acetyl-methadol (LAAM). These medications are sometimes used to treat opiate addiction instead of methadone, because they are generally considered safer, with fewer side effects, and are less likely to create dependence and addiction. This is why they are very good at helping a person to quit methadone. However, these medications are difficult to find and very expensive. They also come with their own side effects. The side effects of buprenorphine are like those of other opiates, though less severe while the side effects of LAAM are not related to other opiates, but include liver damage, rashes, and high blood pressure.

Tapering

The tapering method of quitting methadone involves slowly reducing the amount and frequency of the dosage until the user is free of it completely. If done as part of a properly administered treatment program, overseen by medical professionals, there may be little or no withdrawal symptoms. However, it is difficult to find the right dosages to avoid withdrawal. It may take months (or even years) to get completely off methadone, and there is a very high rate of relapse and abuse related to tapering off dosages of methadone.

Cold Turkey

Cold turkey is stopping methadone completely suddenly and all at once. This causes the symptoms of methadone withdrawal including permanent mental disability, heart attack, seizures, and sometimes death. Some small, and possibly unreliable due to sample size, studies conducted in privately managed prisons have shown immediate cessation of methadone may reduce the risk of relapse. However, this is the only real positive aspect of quitting cold turkey. The drawbacks, however, far outweigh this possible advantage. Most studies agree that cold turkey cessation actually increases the chance of relapse. This relapse may be to stronger doses of illegally acquired methadone or an illicit opiate.

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Why Cold Turkey is Dangerous

Quitting cold turkey is very dangerous because it all but guarantees that the methadone user will experience most if not all of the withdrawal side effects to the extreme. There is evidence of patients going clinically insane after suddenly stopping methadone use and many of the withdrawal side effects are considered permanent damage. The human brain is simply incapable of dealing with the abrupt changes to its chemistry and function. If someone is considering quitting methadone, it is strongly recommended that they seek treatment from an accredited substance abuse program. These programs know the safest and most effective means of getting an individual off methadone, and helping keep them off it in the future.