How to Discontinue Methadone Use
Pending a patient is set up to successfully manage their opioid addiction without methadone, the general protocol to prevent painful methadone withdrawal symptoms is to:
- Gradually decrease the dose of methadone by 10mg until down to 40mg — dropping every 1-3 weeks as comfortable.
- Then, decrease on the same timeline by only 2.5-5mg until down to zero.
The dose should not be decreased more than once a week. If cravings or withdrawal symptoms are experienced, each step down can take several weeks. It’s never worth it to rush the process.ⓘ
Example: Quickest Possible Methadone Taper for Patient On 60mg Dose
| Week | Dose Reduction | Dose in mg |
| 1 | 10mg | 50mg |
| 2 | 10mg | 40mg |
| 3 | 5mg | 35mg |
| 4 | 5mg | 30mg |
| 5 | 5mg | 25mg |
| 6 | 5mg | 20mg |
| 7 | 5mg | 15mg |
| 8 | 5mg | 10mg |
| 9 | 5mg | 5mg |
(While the timeline in this example can help avoid methadone withdrawal, it is faster than recommended for lasting sobriety).
How Long Does It Take To Fully Detox From Methadone?
How long it takes to taper off methadone depends on the dose and the comfort of the patient. For a base calculation, add one week for every 10mg the patient’s dose is above 40mg, then add 6-12 weeks.
Length of Methadone Tapers
| Maintenance Dose | Quickest Possible Taper | For Highest Success Rates |
| 60mg | 9 weeks (2 months) | 6 months |
| 120mg | 16 weeks (2.5 months) | 10 months |
The research is clear that longer tapers have substantially higher rates of success, including tapers that take a full year and tapers that only drop doses every 3 weeks.ⓘ
The goal is not “getting off methadone.” The goal is long-term recovery.
Why does it take so long to get off methadone?
Once a patient decides to stop methadone, they are usually very eager. The timeline can feel frustrating. However, a gradual methadone taper helps minimize any withdrawal symptoms and cravings. And, rushing the process almost always leads to relapse.
It’s worth it to take a few extra weeks.
What Happens If You Stop Methadone Cold-Turkey?
Methadone is an opioid. Stopping any opioid cold turkey is likely to be painful and lead to relapse. The withdrawal symptoms for methadone are generally the same as other opioids, though may last longer.
Methadone Withdrawal Symptoms
Days 1-2
- Fever, sweating and chills
- Rapid heartbeat
- Muscle aches
Days 3-8
- Severe body aches and pains
- Nausea, vomiting and diarrhea
- Irritability, anxiety and restlessness
- Intense cravings and relapse
Days 9-15
- Irritability
- Cramps
- Depression
- Intense cravings and relapse
Days 15+
Those quitting cold turkey are more likely to experience Post-Account Withdrawal Syndrome (opioid PAWS), where withdrawal symptoms like anxiety or fatigue can last two years or even be permanent.
Any intense methadone withdrawal symptoms can be avoided by tapering down from methadone over several months and with medical supervision.
Is Methadone Withdrawal Worse Than Opioid Withdrawal?
While withdrawal symptoms are similar for both methadone and other opioids, methadone withdrawal tends to be less intense with a less rapid onset. However, methadone stays in the body longer because it is a long-acting medication, so withdrawal symptoms may last longer.
How To Get Through Methadone Withdrawal
Any severe methadone withdrawal symptoms can be avoided altogether by going to a methadone clinic and tapering down slowly!
Despite what people might post on internet forums, there is no other helpful medication to end methadone withdrawal symptoms other than a methadone taper. Specific symptoms might be treatable without methadone but would still require a medical prescription — ie. Ondansetron (Zofran) for nausea.
The best advice is to find a methadone clinic to stop the struggle of methadone withdrawal before a relapse.
See also: What is a Methadone Clinic
How to Prevent Relapse After Stopping Methadone
A distressing withdrawal from methadone is likely to lead to relapse. Patients tend to be successful when the taper is slow and they are surrounded by support
Extra support always ends better than a patient thinking they can handle it on their own. Here are some questions to consider before stopping methadone:
- Do you have stable housing where no one else in the house is using drugs?
- Do you have a stable job?
- Are you enrolled in IOP or weekly therapy sessions?
- Do you doctor and therapist agree you are ready to start a methadone taper?
- Street methadone isn’t always real, pure methadone.
- Medications can be prescribed to combat withdrawal symptoms like anxiety or medical advice can be given for symptoms like withdrawal insomnia to avoid self-medicating that leads back to addiction.
- Accountability and support helps prevent feelings of uncertainty or deterring from the process that prevents the process.
- Other anti-craving options like switching to Suboxone or the non-addictive monthly Vivitrol shot can offer physical help with cravings.
Get Help With Your Methadone Taper
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1 2 3 4 MORE ›After a year should you be off methadone completely?
Most medical providers recommend maintaining methadone for at least 12 months before consideration of a tapering/discontinuation plan, but this doesn’t mean that every patient should be tapering off methadone after 12 months. There is no set timeline for how long a person should be maintained on methadone. The decision to stop the use of methadone should be a joint decision between the patient and the patient’s methadone medical provider and addiction counselor if applicable. Factors to consider before stopping methadone should include: 1) Has there been maintained abstinence from illicit opioid use while on the methadone? 2) Is the home life stable at this time? 3) Is the work-life stable at this time? 4) Is there a social support structure (i.e. friends, family, counselor) in place to help prevent the patient from returning back to substance use? 5) Regarding whatever led the patient to use opioids in the first place, (i.e. depression), has it been adequately treated, and/or resolved? If the answer is “No” to any of those questions, then there is a much higher likelihood of the patient returning to opioid use after stopping methadone.
I have been on methadone for 6 years. I’ve been on 240mg but now on 60. I suffer from chronic pain and also take tramadol…can I stop taking methadone while maintaining my tramadol dose without experiencing side of withdrawal?
Stopping your methadone while 60mg daily will cause you to experience opioid withdrawal, regardless of being on Tramadol. I’d recommend you work with your methadone provider to gradually taper your methadone to 30mg or lower before discontinuing it. By doing so, you will have less likelihood of developing opioid withdrawal, and less intense opioid withdrawal if it does occur.
I ‘ve cut down from 30 mg to 7.5 mg in 2months how long should I take to taper off from the 7.5 ?
It depends on how soon you want to be off of it, and if you are willing to tolerate mild opioid withdrawal symptoms. If you want to do a slow taper with the lowest risk of withdrawal, then I’d recommend decreasing your daily dose by a maximum of 2.5mg every month. So if starting at 7.5mg it would take you 3 months total to taper off the methadone completely.
I am on 2.5mg of methadone now and I am experiencing withdrawal symptoms, how slowly should I reduce down to zero
A methadone clinic can only adjust your daily dose of methadone by a minimum of 2.5mg. If you are on 2.5mg of methadone now and already feeling withdrawal, you may have tapered too quickly, so one option is to have the clinic increase you back to 5mg for at least another month before considering decreasing to 2.5mg daily. Sometimes it’s impossible to avoid opioid withdrawal even when tapering slowly and by the smallest increment. In those situations, I’d recommend resting, staying hydrated, and using other comfort medications to help with the withdrawal symptoms until they resolve. Comfort medication can include Benadryl (for anxiety, restlessness), Tylenol or ibuprofen (for muscle aches and pains), and Imodium AD (for diarrhea). Your physician can prescribe you other medications if needed to address other symptoms, such as nausea.
Im on 118 mg but Medicaid cut me off. How do I taper without withdrawls? What is the best way?!
118mg is a high dose to stop taking abruptly, as this can lead to intense opioid withdrawal and increased risk for return to other opioid use. I recommend you discuss with your methadone clinic to develop a reasonable taper plan that is within your budget. Most clinics will offer a self-pay rate if you do not have any insurance. The best way to taper off it with the lowest risk of withdrawal would be to decrease your daily dose by a maximum of 10mg per month. If this is not possible given your time or financial constraints, then I’d highly recommend you coordinate with the medical provider at your methadone clinic to have them prescribe comfort medications to you to help you with opioid withdrawal symptoms.