Understanding Methadone Abuse
When someone is addicted to opioids, it can be very difficult to overcome without help. Methadone is an FDA approved prescription medication that is used as part of treatment for opioid addiction.
While methadone is safe and effective when used as prescribed, methadone misuse and addiction is on the rise. Our guide will help you learn more about methadone addiction, overdose signs and symptoms, and how to get the help you need for substance use disorders.
Methadone Intended Use and Addiction Potential
Methadone is used primarily in the United States as part of treatment protocols for opioid addiction. However, in the past two decades, methadone has increasingly been prescribed to treat chronic pain that has not responded well to other medications.
People with methadone prescriptions can ingest this medication in pill, liquid, or powder form. The general recommended length of methadone maintenance treatment is at least 12 consecutive months.
When used as prescribed, methadone is used as a maintenance therapy to help people who struggle with opioid addiction by easing withdrawal symptoms. The drug binds to the same receptors as opioid drugs like heroin or oxycodone. For people who have struggled with heroin or opioid painkiller addiction, methadone should not produce the same euphoric effects due to its slow onset; however, for people who take methadone as a prescription painkiller and who have not built up a tolerance to this drug, methadone can induce a “high.”
The Drug Enforcement Administration lists methadone as a Schedule II drug, meaning that the medication has a medical use but also a high potential for abuse. Because methadone works essentially the same way that opioid drugs do, it can become addictive. Due largely to changes in prescribing practices and the use of methadone as a painkiller, there has been an increase in the number of methadone overdoses.
How Methadone Addiction Develops
Addiction is a chronic but treatable disorder characterized by compulsive behaviors, including consumption of drugs or alcohol, that continue despite negative or harmful consequences to their physical and mental health, interpersonal relationships, and quality of life.
When a person has used other prescription painkillers for chronic pain, and these no longer work, doctors may turn to methadone as a palliative treatment. This group is, unfortunately, more likely to accidentally overdose on methadone. People who receive methadone prescriptions as maintenance therapy may develop a tolerance to the medication, so they may begin craving more of the drug in order to receive the same effects. Addiction and tolerance are not the same condition, however.
Symptoms and Side Effects of Methadone Addiction
Signs of methadone abuse include:
- Poor coordination.
- Euphoria or a “high.”
- Drowsiness or inability to stay awake.
- Taking more than prescribed.
- Inability to stop taking the drug.
- Cravings for the drug, and concern or anxiety about when the next dose will come.
- Stealing, forging, or illegally purchasing prescriptions.
- Doctor-shopping to get more of the drug.
Side effects of long-term methadone use, or methadone abuse, include:
- Upset stomach; nausea or vomiting
- Shallow, slow, or depressed breathing.
- Chest pain.
- Dizziness or fainting.
- Drowsiness or fatigue.
- Rapid or irregular heartbeat.
- Flushed cheeks.
- Anxiety or depression.
Methadone Addiction Statistics
The National Survey on Drug Use and Health reported that in 2020 4.7 million people misused prescription medications containing hydrocodone; methadone was part of this category.
Risks of Abusing Methadone
The greatest risk of methadone addiction or abuse is overdose. The Food and Drug Administration reports that the painkilling and euphoric effects associated with methadone last between 4 and 8 hours; however, doses of methadone are typically prescribed to be taken every 12 hours. This means the patient taking methadone, either for maintenance or as a painkiller, is likely to begin craving the drug before it is safe to take their next dose.
Potentially harmful respiratory depression from a dose of methadone can remain in effect for 59 hours, meaning that an extra dose can easily lead to depressed or stopped breathing, overdose symptoms, and even death.
People who receive a prescription for methadone may also not feel any of the effects of the medication for 3-5 days at regular doses, which can be very frustrating. This can lead to taking too much of the medication to feel its effects, and this can cause an overdose.
According to a report from the American Society of Addiction Medicine (ASAM), there are three patterns leading to methadone overdose. These are:
- Single overdose: Overdose can occur on the initial dose, especially in a person who has no built-up tolerance for opioid medications or in people who have lost their tolerance over time.
- Accumulated toxicity: Because methadone remains in the body for a long time, toxicity can build up even if the individual does not feel the effects of the medication. Doses can accumulate over several days and lead to respiratory depression.
- Combining methadone with other drugs: Other central nervous system (CNS) depressants, alcohol, sedatives, and stimulants should all be avoided while taking methadone.
Mixing methadone with other prescription or illicit drugs dramatically increases the risk of overdose death as well. At least half of reported opioid-related deaths in 2012 involved other drugs: Heroin or cocaine were involved in opioid overdoses 15% of the time, while Xanax or Valium (both benzodiazepine medications) were involved 17% of the time.
There are other long-term effects of methadone use or abuse, including breathing problems, changes in the menstrual cycle, hormone disruption in both males and females, and dangerous interactions with other drugs and alcohol.
Overdose and Withdrawal Symptoms
Methadone misuse can lead to overdose and withdrawal symptoms.
Overdose symptoms from methadone include:
- Slow or shallow breathing.
- Bluish tint to fingernails or lips.
- Clammy skin.
- Stomach cramping.
- Weak pulse.
When a person stops taking methadone or lowers their dose after physical dependence has taken hold, withdrawal symptoms will take place. These symptoms are not life-threatening but they can be very uncomfortable. Methadone withdrawal symptoms include:
- Excessive sweating.
- Nausea or vomiting.
- Intestinal issues.
- Appetite fluctuations.
- Anxiety or depression.
- Mood swings.
- Trouble sleeping.
Because methadone releases slowly into the body, it can take days before withdrawal symptoms begin. On average, most people begin to feel methadone withdrawal symptoms 30 hours after the last dose. The most intense symptoms occur in the first week of withdrawal, but symptoms can continue for weeks after the last dose.
Although tolerance to methadone declines quickly during the detox process, cravings for the drug do not, which can be dangerous for people attempting to detox cold turkey. It is very important for people who want to overcome their addiction to methadone to undergo medical detox to ensure success and safety throughout the withdrawal process.
Methadone Addiction Treatment in South Florida
Whether you need substance use disorder treatment for yourself or a loved one, the caring and compassionate specialists at Recovery First are here to provide the help you need. Using a range of evidence-based therapeutic approaches, we tailor your treatment to your needs and treatment goals.
Contact our helpful and knowledgeable admissions navigators at to find out more information about our different levels of care and to start the admissions process. They can also answer your questions about ways to cover the cost of rehab and help you find out if your insurance will cover some or all of treatment.