Stopping methadone should not be uncomfortable, but does take time — often many months. Patients that rush the process experience unpleasant methadone withdrawal symptoms and are at high risk for relapse.
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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.
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