How Long Do Methadone Withdrawals Last?

Published: 02/6/2024

Withdrawal symptoms from opioids vary depending on the type of opioid, how long it is used, and other factors. If you’ve been taking methadone as part of a medication-assisted treatment program and are wondering about the methadone withdrawal timelines, we’ve got you covered. This blog explains the average methadone withdrawal timeline, methods of tapering, how to reduce withdrawal symptoms, and more.  

What is Methadone Withdrawal?

Methadone is a pharmaceutical opioid used as a medication for pain, or as part of a rehabilitation program called medication-assisted retreatment (MAT), or medication-assisted recovery (MAR). When used for MAT, methadone can help individuals to stop taking illicit opioids, like heroin. It functions in several ways:

• Reduces withdrawal symptoms 
• Decrease cravings for opioids
• Block the euphoric effects of other opioids, like heroin, hydrocodone, or oxycodone
• Reduces pain
• Decreases the risk of relapse/returning to use

When stopping methadone treatment, due to dependence, or other reasons, it can cause unpleasant withdrawal symptoms like any other opioid. According to the Substance Abuse and Mental Health Services Administration, opioid withdrawal symptoms include:

• Fast pulse
• High blood pressure
• Insomnia
• Heightened reflexes
• Increased breathing rate
• Enlarged pupils
• Sweating and high temperature
• Gooseflesh
• Runny nose
• Spasm
• Nausea and vomiting
• Abdominal Cramps
• Bone and muscle pain
• Diarrhea
• Anxiety

SAMHSA’s Detoxification and Substance Use TIP sheet states that it is not recommended that individuals withdraw from opioids without medication, as they may cause unpleasant symptoms and needless suffering. Typically, it is recommended individuals taper off methadone, to reduce withdrawal symptoms, and it may be beneficial to seek treatment from a professional when considering methadone withdrawal.

Acute vs Protracted Withdrawal

Acute withdrawal simply means experiencing withdrawal symptoms when you stop taking substances. The usual opioid withdrawal timelines vary, depending on the type of opiate and other factors, like how long you’ve been taking them. This time usually ranges from 4 to 21 days. 

Protracted withdrawal, however, is the continued experience of withdrawal symptoms beyond the expected timeframe – for weeks or months. Symptoms of protracted withdrawal from opioids include:

• Anxiety
• Memory problems
• Depression
• Sleep problems
• Feeling emotionally blunted
• Difficulty concentrating and making decisions
• Alcohol and drug cravings
• Prolonged fatigue
• Impulse control problems
• Impaired ability to solve problems. 

According to SAMHSA, chronic substance use causes changes to the brain, impacting emotions and behavior. This can include a reduction in the ability to experience pleasure. For example, listening to music may be less rewarding during protracted withdrawal. These symptoms may vary depending on the type of substance a person has stopped using. For example, those stopping taking benzodiazepines may experience symptoms that cause more agitation and mimic obsessive compulsive disorders.

Do All People Experience Protracted Withdrawal?

In short, no. Some people experience withdrawal symptoms only in the withdrawal stage. However, others may experience protracted withdrawal. Some clients may have more intense symptoms than others, too.

Average Methadone Withdrawal Timeline

The average timeline for opioid withdrawal varies depending on the type of opioid. According to the Guidelines for Withdrawal Management, you can expect:

• An individual taking short-acting opioids, like heroin, will experience the onset of withdrawal symptoms 8 to 24 hours after the last use; the duration of withdrawal lasts 4 to 10 days
• An individual taking long-acting opioids, like methadone, will experience the onset of withdrawal symptoms 12 to 48 hours after the last use; the duration of withdrawal lasts 10 to 20 days

In the first 30 hours of withdrawal, you may experience:

• Fatigue
• Trouble sleeping
• Sweating
• Watery eyes
• Restlessness
• Yawning
• Anxiety

Symptoms tend to become worse at around three days and may also include:

• Nausea and vomiting
• Cramps
• Diarrhea
• Muscle aches and pains
• Drug cravings

Some symptoms may persist beyond a week, like tiredness, anxiety, difficulty sleeping, and depression.

What is the Half-Hife of Methadone?

A drug’s half-life is the time it takes for the concentration of a drug in the body to decrease by half. For example, if a drug’s half-life is 8 hours and the initial concentration is 100mg, in four hours the concentration should be roughly 50 mg in 8 hours. It’s important to know a half-life to determine dosing levels, frequency, risks for overdose, and when to expect withdrawal. 

According to the National Institutes of Health, the half-life of methadone can vary from 8 to 59 hours depending on the person. On average, however, one can expect a half-life of 24 hours. 

Individual variability in Methadone Withdrawals

Each person may experience the methadone withdrawal timeline differently. Factors impacting the duration and intensity of methadone withdrawal include:

• The person’s liver and kidney function
• Age
• Body fat
• Genetics
• The amount of time the person used methadone
• The dose of methadone used
• Co-occurring mental health issues
• The variability of methadone’s half life

For example, methadone is fat-soluble, and a person may be genetically predisposed to having more body fat meaning it may stay in the body longer. Another person may have a particularly high metabolism and excrete the drug more quickly than others. All these factors explain the variation in how a person experiences withdrawal and the drug’s half-life.

Tapering Usage to Reduce Withdrawal Symptoms

Tapering, or reducing the use of methadone slowly, has been shown to reduce the severity of withdrawal symptoms. There are several types of tapering:

• Direct tapering: a slow reduction of the drug dose over a period of time until the drug is stopped
• Substitute tapering: using a different drug instead, like heroin
• Slow taper: reducing the dose by 5 to 10 percent over several months
• Rapid taper: reducing the dose over a short period of time over a period of weeks. This type of taper is not recommended due to the risks of significant opioid withdrawal symptoms and risk to life. 

However, studies have shown that the majority of clients have returned to heroin use. This may highlight the need for effective substance use disorder treatment.

Post-Withdrawal Recovery

Following withdrawal from methadone it is important to seek support with recovery programs. This could include:

• Outpatient treatment
• Recovery support groups
• Medication-assisted recovery
• Sober living homes

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-678-5931(Paid Advertiser) today to learn about your treatment options.