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Methadone Detox Centers

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Gary Bowers

Article Updated: 01/24/2021

Number of References: 6 Sources

Our in-depth guide to finding a methadone detox will better prepare you to take the vital first step towards freedom from addiction. Learn about potential treatments, medications, risks, and what to look for in a methadone detox center.

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When Is Methadone Detox Recommended?

Attempting to go through methadone withdrawal without consulting medical professionals, is never recommended as a number of side effects and symptoms can manifest, making the pain of addiction seem like a better option than the pain of detox. While certain side effects are simply unavoidable during withdrawal, with the help of the medical staff these side effects can be mitigated and treated. In addition to the medical treatment received, someone in methadone detox will have access to a diverse set of psychological therapies, which, when combined with medical therapy, will dramatically improve the chances of complete recovery.

People on Methadone Maintenance To Treat Opioid Addiction

Most people who have become addicted to or dependent on methadone originally started taking methadone to treat an addiction to other opioids. Opiates are extremely powerful drugs that can alter brain chemistry significantly, creating an incredibly powerful dependence on opioids to simply feel “normal”. Intensive therapy and care can make a release from the grips of addiction possible, but where there is previous addiction, there also lies a history of pain-avoidance. Without the help of methadone detox centers, the pain of withdrawal can lead those who suffer from opiate use disorders (OUD) to seek relief in the form of other drugs.

Underlying Medical Conditions Including Mental Illness

Methadone mirrors the symptoms of withdrawal from other opiates, with the severity and intensity of symptoms typically commensurate to the extent and history of the addiction. Detox from methadone is rarely fatal but it can be dangerous for anyone who also has underlying medical conditions. OUD can lead to a phenomenon called downregulation in which the body’s natural responses to pain and pleasure, cardiovascular systems, endocrine systems, and brain neurotransmission slowly diminish as the body begins to rely upon the drug to function. Those with the following conditions should take even greater care detoxing from methadone:

  • Cardiovascular Disorders or Heart Disease: Opioid use can create stress on the heart and the associated cardiovascular functions, and especially in those with pre-existing heart issues, this can result in irregular heartbeat and a weakened heart. Detox from methadone can put added stress on these systems, causing blood pressure to spike, heart rate can increase and the risks of more serious side effects like heart attacks increases.
  • Diabetes: Blood glucose levels can increase sharply during methadone detox, and this can be dangerous for those with diabetes. If blood glucose levels aren’t managed well during this time, severe complications can occur such as diabetic ketoacidosis (DKA).
  • Mental Illness: Methadone detox can be a distressing experience, resulting in anxiety, depression, and mood swings. For someone with an underlying mental illness, the severity of these symptoms can be intensified, and if not addressed can lead to a progressively worsening cycle of symptoms.

Even the healthiest of persons will experience withdrawal once they have built a tolerance or dependence to methadone – never try to detox alone. The professionals at methadone detox centers will ensure that care is tailored to the unique medical and mental needs of each person in their care. With proper medical and psychiatric care, recovery is possible!

Intake: Methadone Detox at a Glance

The professionals at methadone detox centers will be ready to take on the challenge of assisting everyone who seeks recovery from addiction. While intake processes may vary from location to location, methadone detox centers will take time to gather some medical information that will be used to help craft a care plan unique to the individual.

Past drug use, including history with methadone and other opioids, will be discussed. Details gathered at this stage will be very important. Not only will this help set a realistic timeline for complete detox from methadone, but it may also provide insight into what the journey through detox will look like. Additionally, this conversation will open the door to discuss therapy options that may be pertinent and useful. An open and fresh dialogue about the real issues will make an immense difference in the quality of care that can be provided.

The information gathered relative to the history of drug use would likely include:

  • Amount of methadone used
  • The extent of drug use (frequency and duration of abuse)

Basic health information will be gathered as well. In addition to collecting and documenting vital signs (blood pressure, heart rate, oxygen levels), routine blood work is also collected for toxicology tests and for other medical information (such as a Basic Metabolic Panel) which could inform future care. Additional information will be gathered relating to medical history. This information will be critical in shaping the care and experience in methadone detox centers. Examples of information collected would include:

  • The existence of any co-occurring mental illness (anxiety, depression, bipolar disorder)
  • Pre-existing medical conditions (such as heart disease or diabetes)

This is an important step in the process as it will help set up appropriate plans of action based on the person being admitted into the facility. The more information the staff has, the better they can serve!

Medical Monitoring

One of the most critical aspects of the services offered by methadone detox centers is regular medical monitoring. Methadone detox can be an incredibly painful and uncomfortable experience. Some people have described the pain of methadone detox as the sickest they’ve ever been, or something like the flu, only many times worse. This is why careful medical monitoring during methadone detox is so important. It is possible to manage the symptoms of methadone detox, and with the right support, the pain of the detoxification process can be followed by the joy of a life free from addiction.

The symptoms of methadone detox will match withdrawal symptoms of all other opioid drugs, however, because methadone will metabolize at a much slower rate, the initial symptoms associated with detox may not be fully felt until up to 24 hours after the last dose. This also means that complete detox from methadone can be longer and that the symptoms may persist longer than they would when compared to detox from other opioids, although the symptoms may be milder than with other opioids.

The symptoms that will accompany methadone detox include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Insomnia
  • Body aches and pains
  • Joint pain
  • Weakness
  • Lethargy

The intensity of these symptoms will vary based on the individual, but will almost always be present.

Methadone Withdrawal Timeline

Methadone Detox Medications

The most common medical approach to methadone detox is to taper doses of the drug over a period of time. Buprenorphine is also commonly prescribed to alleviate withdrawal symptoms. Additionally, there are a number of widely recognized and proven medications that can help alleviate symptoms and address the collateral effects of methadone detox. The medical professionals at methadone detox centers will be able to prescribe medications as part of the overall recovery plan. Here are some commonly prescribed drugs when used in this context:

  • Buprenorphine: Often sold and marketed under the brand name Suboxone, the actual medication is two drugs combined. The first is buprenorphine, which is a synthetic opioid that binds to opioid receptors in the brain and blocks the effects of other opioids. The result is fewer cravings and reduced detox symptoms. The other drug is naloxone, which is added to prevent the buprenorphine from being misused. Naloxone is an opioid ‘antagonist’, meaning it reverses opioid effects and will trigger withdrawal symptoms. When used under the care and supervision of a doctor, buprenorphine is an effective tool in treating methadone detox.

Other medications may be prescribed as needed, to address the more commonly experienced symptoms during methadone detox.

  • Anti-Anxiety Medications: There are two types of anxiety that can be experienced, and both are common during methadone detox. The first is acute or episodic anxiety, this is brought on suddenly by certain situations (such as social situations). The other is chronic, which is more like being in a constant state of anxiety. Both can be treated medically. Acute anxiety is typically treated medically by addressing the causes themselves such as neurotransmitter imbalances, as well as treating the symptoms of acute anxiety, like increased blood pressure and heart rate. Most medications used for treating chronic anxiety will alter brain chemistry, seeking to correct the chemical imbalances that can be attributed to this disorder.
  • Antidepressants: Depression is a common condition, and those in methadone detox are likely to experience depressed moods, even if they haven’t necessarily experienced depression before. Depression can be treated medically by addressing brain chemistry. The most common medications work by stabilizing serotonin levels in the brain.
  • Blood Pressure Medications: Methadone detox can wreak havoc on the body, and the cardiovascular system will be affected. Blood pressure medications fall under many different classifications and can address blood pressure in different ways. These medications are typically safe, non-habit forming, and can be stopped or tapered off the body normalizes during the detoxification process.
  • Sleep Medications: Anyone who has suffered through methadone detox will attest to restless nights, tossing and turning, and a seemingly perpetual state of dreariness. This lack of quality sleep and rest can be painful and lead to an array of other health concerns. To address this, doctors may prescribe medications that can help reintroduce natural sleep patterns or produce deeper sleep.

Therapy During Detox

Studies have repeatedly shown that successful detox from methadone is more likely when a comprehensive plan including multiple forms of therapy are adopted and implemented. Methadone detox centers will provide an introduction to and access to a variety of therapy options, which, when combined with medical therapy, will continue to build upon an established foundation of recovery. In addition to the exposure to therapy during methadone detox, methadone detox centers will provide information and access to a host of therapeutic options. Below are some of the forms of therapy to consider:

Group Therapy

A life of addiction can be fraught with isolation and loneliness. Group therapy provides the perfect counterpoint to this troubling element. By working towards common solutions with people who share a similar path, and have experienced similar struggles, group therapy will engender a sense of belonging and community; two things that in and of themselves can help build resilience and hope in recovery. Group therapy may be more or less structured, but when offered at methadone detox centers, the underlying message is the same: you are not alone!

Cognitive Behavioral Therapy

The skills uncovered, practiced, and applied during cognitive-behavioral therapy (CBT) can pay a lifetime of dividends. CBT is an evidence-based therapy that works by revealing and working on the thought patterns, reactions, beliefs, and motivations behind our thoughts and actions. In this way, CBT can quite literally change the way someone behaves. For example, by examining the deeper context of the decision to use drugs in the very first place, CBT can help instill behavioral interventions to use the next time the choice of whether or not to use drugs is presented.

12 Step Programs

12 Step Programs work and have been working for over 80 years. Precisely what makes them so successful could be debated, but they are appealing for many reasons. First, the fellowship of 12 step programs is composed of others who are recovering from addiction. There is an immediate sense of bonding over the shared affliction. The 12 steps themselves promote healing, self-awareness, and service. 12 step programs are also extremely accessible, with fellowships and groups of all sizes, shapes, and ethnicities in almost every country, every state, every large city, and many small cities. This sense of shared purpose and community is a major factor in helping those in recovery, one hour at a time.

Continuing Care for Methadone Addiction

There is no “easy” button, no “easy” path, but a life in recovery does get easier. One thing is certain, recovery doesn’t just “happen”, it requires work and ongoing medical and talk therapy. Following methadone detox, medical therapy can be continued and evaluated on a regular basis through a general practitioner or psychiatrist if applicable. This will be critical in addressing the physical and mental health issues that can accompany life in the early days and weeks after you’ve completed your stay at a methadone detox facility. Continued talk therapy is also very important, whether it be with a clinical or licensed professional in the form of CBT, or as a member of a 12-step fellowship group. In many ways, the growth in recovery is a lifelong process, but each day free from drug use is a day to celebrate, and proof that recovery is possible!

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