methadone abuseMethadone is a synthetic, long-acting opioid used to help people struggling with addiction to opioids, particularly heroin, manage their addictions and remain in treatment programs. It is part of medication-assisted treatment, which, combined with counseling and social support, is designed to help people overcome addictions and achieve meaningful lives. However, methadone is also an opioid with a potential for dependence and abuse, so the Drug Enforcement Administration (DEA) lists methadone as a Schedule II substance.

Although methadone maintenance therapy has been in use in the US for decades, reports of methadone abuse and overdose are on the rise, concurrent with the growing epidemic of opioid addiction and abuse. According to the Centers for Disease Control (CDC), methadone contributed to one in three opioid painkiller deaths in 2009. The number of methadone overdose deaths in 2009 was six times higher than the previous decade.

Methadone is a synthetic, long-acting opioid used to help people struggling with addiction to opioids, particularly heroin, manage their addictions and remain in treatment programs. It is part of medication-assisted treatment, which, combined with counseling and social support, is designed to help people overcome addictions and achieve meaningful lives. However, methadone is also an opioid with a potential for dependence and abuse, so the Drug Enforcement Administration (DEA) lists methadone as a Schedule II substance.

Although methadone maintenance therapy has been in use in the US for decades, reports of methadone abuse and overdose are on the rise, concurrent with the growing epidemic of opioid addiction and abuse. According to the Centers for Disease Control (CDC), methadone contributed to one in three opioid painkiller deaths in 2009. The number of methadone overdose deaths in 2009 was six times higher than the previous decade.

Methadone: Use and Abuse

In theory, methadone is less likely to be diverted, or sold illegally, than other opioid medications because it is tightly controlled in methadone clinics. However, doctors have started prescribing methadone to patients with chronic non-cancer pain, since it is less expensive than other opioids and binds to the opioid receptors in the brain for a long time. This can increase the risk of diversion.

Proponents of methadone insist that the medication is safe as long as it is taken as prescribed. The drug has a half-life between 8 and 59 hours, which means it binds to the opioid receptors in the brain for that length of time. It can still interact with other drugs like alcohol if they are introduced to the body during this time period.

Despite the long half-life, the analgesic properties of methadone last only 4-8 hours. For individuals who are using methadone as part of a treatment plan to overcome addiction, the pain relief properties are not as important as the reduction in cravings and withdrawal symptoms. For people who have chronic pain, however, the analgesic properties are necessary; when those end, the person is more likely to attempt to take more methadone or other painkillers to ease their pain. Other medications can interact with the methadone already in their system and lead to overdose, since the respiratory depressant effects remain after the painkilling effects have gone.

According to the CDC, more than 4 million prescriptions for methadone in 2009 were specifically written to treat issues like back pain, despite FDA warnings about the medication’s risks. Although that number decreased to 3.9 million in 2013, according to the DEA, the increased prevalence of methadone still increases its abuse potential.

The National Survey on Drug Use and Health found in that, in 2012, 2.46 million individuals ages 12 and older reported that they had used methadone for a nonmedical purpose at least once in their lives. That was an increase from 2.1 million people the previous year.

Why Is Methadone Abused?

What to Look for in a Treatment Facility
Methadone is a very addictive narcotic. Since its original use was in patients who had become addicted to other powerful narcotics like heroin, it was considered a wonderful drug to use for tapering people off opiates. It worked in the brain for a long time, allowing people struggling with heroin addiction to function without distressing cravings. However, when it is diverted for abuse among people without an opioid tolerance, or used in patients to treat chronic pain, the drug can be very dangerous.

One of the biggest concerns is people using methadone to enhance their intoxication. The “high” from methadone can be increased when it is taken with other central nervous system (CNS) depressants, such as alcohol or benzodiazepines. Since methadone binds to the brain’s opioid receptors for about 24 hours, in theory, other opioids cannot bind to those receptors, so short-acting narcotics like heroin are ineffective and simply eliminated from the body. However, when other CNS depressants are used, these bind to other receptors in the brain and can enhance the effects of methadone, including the detrimental effects like depressed breathing.

In a United Kingdom study on methadone abuse involving 673 completed questionnaires, 3 percent of respondents admitted that they abused methadone to get high. In the US, the National Forensic Laboratory Information System (NFLIS) noted that methadone had become the 10th most identified drug of diversion by 2006.

Symptoms of Methadone Intoxication and Abuse


The psychological effects of methadone intoxication include:

  • Drowsiness
  • Sedation
  • Dizziness and lightheadedness
  • Mood swings
  • Reduced reflexes
  • Altered sensory perception, such as hallucinations
  • Stupor and/or coma

Physical effects include:

  • Analgesia, or pain relief
  • Headache
  • Nausea or vomiting
  • Constipation
  • Muscle weakness
  • Small pupils
  • Reduced breathing – shallow or slow, most typically
  • Decreased heart rate

Withdrawal from Methadone


Methadone withdrawal symptoms include:

  • Nausea
  • Diarrhea
  • Excessive sweating
  • Muscle tremors
  • Fever
  • Chills
  • Pain, especially in the limbs
  • Depression and/or anxiety
  • Insomnia
  • Paranoia
  • Hallucinations
  • Delirium

Because methadone is such a long-acting opioid, the physical effects of the last dose may not be felt for two days. However, this means that withdrawal symptoms can also persist for longer if the individual is attempting to quit all of a sudden, or go “cold turkey.” The psychological effects like cravings can begin at any point, depending on the nature of the individual’s addiction.Withdrawal from Methadone

Get Help for Methadone Addiction

If a person has become addicted to methadone, either through recreational use or due to a painkiller prescription, it is important to contact a doctor or professional rehab center to get help with the detox process. Although there are medications like buprenorphine that are often used to help people addicted to oxycodone or heroin, buprenorphine has many of the same potential issues as methadone, since they are both long-acting medications that bind to the opioid receptors. Instead, find a program that has experience working with people who are addicted to methadone.

Tapering is one of the best options for people addicted to opiates. This method takes months or even years, but it reduces the body’s physical dependence on the medication while controlling withdrawal symptoms and dramatically reducing the potential for harmful withdrawal symptoms and relapse. After individuals are switched to a safer medication, such as buprenorphine, they are then gradually weaned off that drug over time. During this time period, they are also actively participating in therapy.

get help for methadone addiction