When Will My Doctor End Methadone Treatment?

Author: Lisa Conatser

Methadone treatment is very effective if you are recovering from opioid misuse or opioid addiction, but how do you know when to end methadone treatment? The length of treatment varies based on several factors, and there are different ways you can end your methadone treatment.

What Is Methadone Treatment?

Methadone is a medicine approved by the Food and Drug Administration (FDA) to treat opioid use disorder, the clinical name for opioid addiction. Methadone is an opioid analgesic which means it attaches to the opioid receptors in your brain and works to block pain in your body.1 Methadone works similarly to opioid drugs themselves, but it does not produce the same euphoric feeling that opioids like hydrocodone, morphine, and heroin give you.

Methadone actually blocks the euphoric effects of other opioids, which is one of the reasons it is used to treat opioid use disorder.2 Methadone also helps to alleviate some of the withdrawal symptoms you experience when you are trying to quit opioid use and decreases opioid cravings.

How Do You Get Methadone Treatment?

You can only receive methadone treatment at an opioid treatment program (OTP) certified by the Substance Abuse and Mental Health Services Administration (SAMHSA).2

A physician will monitor and administer your doses, which usually require daily trips to see your doctor. After you have been in methadone treatment for some time, sometimes medical professionals approve for you to end methadone treatment in person and to take dose at home between check-ins with the doctor.

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Who Needs Methadone Treatment?

Methadone treatment is typically recommended if you have an opioid use disorder. This is indicated by a problematic pattern of opioid use that causes clinical impairment and distress.

Additionally, methadone treatment is often recommended for those who:3

• Are currently physically dependent on opioids
• Have a history of opioid dependence
• Are not currently physically dependent on opioids but would like to prevent a relapse
• Have a history of overdose or self-harm behavior about opioid use
• Are pregnant and dependent on opioids

If you have liver disease or have an intolerance of methadone, you are not a candidate for receiving methadone treatment. You may be recommended for another medication-assisted therapy, such as suboxone.

Methadone is usually prescribed in combination with other treatments, including cognitive-behavioral therapy (CBT), peer support groups, and family therapy.

How Long Does Methadone Treatment Last?

Methadone treatment times vary depending on personal factors. Twelve months is the minimum amount of time you will be in methadone treatment, and you could continue taking methadone for years or even for your liftime.4

Many people choose to remain on methadone indefinitely because it is a safe way to prevent a possible relapse and is not associated with any progressive health risks related to long-term prescriptions.

Studies show that the longer you engage with addiction treatment services, including harm-reduction services such as methadone treatment, the more likely you are to experience positive recovery outcomes such as longer periods of abstinence.3 Committing to your methadone dosing and other treatment recommendations from your team until and unless they recommend that you end methadone treatment can be a positive step in your recovery journey.

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What Are the Reasons to End Methadone Treatment?

While the timeframe of your methadone treatment does not need to be planned, there are several reasons you may end methadone treatment. Your treatment provider recommend that you end methadone treatment for one of the following reasons:3

• Methadone is no longer an appropriate treatment for you based on certain health or psychological factors
• Your healthcare provider decides that you no longer need methadone treatment as part of your recovery process
• You experience an adverse effects from the methadone
• You have a desire or need to be completely “drug-free” because of work-related requirements or for legal reasons
• You experience social pressure or harassment to divert your methadone to other people without a prescription
• You are caught diverting or misusing your methadone prescription

Potential Side Effects

While methadone is considered safe when taken as prescribed, you may experience adverse effects from methadone that require you to end methadone treatment. Side effects that would trigger the end of treatment include:2

• Difficulty breathing or shallow breathing
• Feeling lightheaded or like you are about to faint
• Breaking out into hives or a rash
• Swollen face, lips, tongue, or throat
• Having chest pain, increased heart rate, or a pounding heartbeat
• Hallucinating
• Feeling confused

Why Do Doctors End Methadone Treatment Gradually?

Methadone is used to treat dependence on opioids, but it is possible to become dependent on methadone also. This is because methadone acts on the same receptors in your brain as opioids.

Even though the medicine helps to alleviate the withdrawal symptoms that occur when you cease opioid use, you can also experience similar withdrawal symptoms if you suddenly stop taking methadone.

Some of the withdrawal symptoms you may experience are:5

• Feelings of agitation
• Anxious thoughts and feelings
• Achy muscles
• Watery eyes
• Trouble falling asleep and staying asleep
• Runny nose
• Sweating and/or chills
• Increased yawning
• Abdominal issues such as cramping, nausea, diarrhea, and vomiting
• Dilated pupils

Withdrawal symptoms from methadone use are usually not life-threatening but can be very unpleasant. For this reason, you should always talk to your treatment provider before stopping your methadone treatment.

How Do You End Methadone Treatment?

Most medical professionals will begin tapering your dosage to avoid unpleasant effects.

The World Health Organization (WHO) recommends changing your dosage slowly and reducing it by 5 to 10 mg per week until you reach a dose of 40 mg and then further reducing it by 5 mg per week.3

Tapering off methadone should happen under medical supervision and not on your own.

What Happens After You End Methadone Treatment?

Methadone treatment is only one part of dealing with a substance use disorder. After you taper off your methadone use, you will continue to be monitored for signs of withdrawal or an increased risk of relapse.

Since methadone helps to curb cravings for opioids, you may find that cravings return when you stop methadone treatment. This is why continued participation in other treatments is necessary. Your treatment team may recommend ongoing therapy and peer support groups to help with the underlying issues involved in your use of opioids.

What Are the Risks Associated With Ending Methadone Treatment?

If you have been in methadone treatment for a long period, there are some risks associated with ending your methadone treatment including:5

• Relapsing
• Increase in pain symptoms
• Feelings of depression or anxiety

According to research, the greatest risk is that of relapse.5 Returning to drug use after detox is a normal part of recovery, and it is why substance use disorders are treated as chronic conditions.

Your physician may resume methadone treatment after a period of ending it if there are signs that you need to return to a methadone maintenance plan.

If you struggle with opioid misuse or opioid addiction, please call 800-994-1867Who Answers? to speak to a specialist about addiction treatment options.

Resources

1. National Library of Medicine. (2021, February 15). Methadone: MedlinePlus Drug Information. United States Department of Health and Human Services.
2. Psychiatric Research Institute. (2022). What Is Methadone?. University of Arkansas for Medical Sciences.
3. World Health Organization. (2009). Methadone maintenance treatment – Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. National Center for Biotechnology Information.
4. National Institute on Drug Abuse. (2018). How long does drug addiction treatment usually last?. National Institutes of Health.
5. National Library of Medicine. (2020, May 10). Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. United States Department of Health and Human Services.