How Long Should I Methadone Taper?
Last Updated: November 3, 2023
Tapering off methadone should only be done under the care of a doctor, as trying to quit on your own can increase the chances of a relapse.
Methadone is one of the gold standard medications prescribed to treat opioid use disorders. Although methadone is an opioid, it is often used to help reduce a person’s dependence on illicit opioids and relieve withdrawal symptoms.
Many addiction recovery centers prescribe methadone as part of a medication-assisted treatment (MAT) program to help people stop abusing prescription or illicit opioids. Although a person’s methadone dose may decrease over time in some cases, it is typically continued long-term to help keep people off other opioids.
Experts recommend that people with opioid use disorder should continue methadone indefinitely. This is because those who overcome opioid addiction and then stop methadone are extremely likely to relapse. Only around 13% of people who quit opioids with methadone and then stopped treatment remained opioid-free over the long term. For this reason, it is very important to discuss the pros and cons of stopping methadone with your addiction specialists before quitting the drug on your own. If the joint decision is made to stop methadone, it is generally best to slowly decrease the dose over time instead of stopping the drug cold turkey.
What Is Methadone Used For?
Methadone (Methadose, Dolophine) is a Schedule II opioid that can be used to treat pain as well as help people quit opioids. Methadone can be continued indefinitely when used for opioid use disorder, as it can help blunt withdrawal symptoms and prevent the euphoria that opioid use can cause. This removes both the pain of withdrawal and the pleasure of opioid use, making people more likely to stay abstinent over the long term.
As a Schedule II controlled substance, methadone carries a risk of abuse, addiction and dependence. Although it is a long-acting opioid that is less likely to cause a high, methadone addiction is still possible.
Risk factors for methadone addiction include:
- Taking a higher dose of methadone than prescribed
- Taking methadone more often than it is prescribed
- Seeking different doctors and pharmacies to try to get methadone
- Exaggerating pain symptoms to try to get methadone
- Stealing, buying or borrowing methadone from other people
Signs of methadone addiction are similar to those for other drugs and can include:
- Focusing on finding and taking methadone, or recovering from methadone use
- Losing interest in activities you once enjoyed
- Having poor performance at school or work because of methadone
- Losing track of life responsibilities because of methadone use
- Financial or legal problems linked to taking methadone
When you become physically dependent on an opioid like methadone, your brain and body get used to its presence. For this reason, if you suddenly stop taking the drug, your system needs to quickly adjust to the drug’s absence. This can lead to a host of unpleasant withdrawal symptoms.
Methadone Withdrawal Symptoms
Methadone withdrawal symptoms are often less severe than those of other opioids. Symptoms often start within 30 hours after you have stopped methadone and can last up to 10 days. Methadone withdrawal symptoms can include:
- Muscle aches
- Trouble sleeping
- Increased tearing
- Runny nose
- Enlarged pupils
- Abdominal cramps
- Nausea or vomiting
Can You Die From Methadone Withdrawal?
Although methadone withdrawal can be extremely unpleasant, death from opioid withdrawal is very rare. Often, a person who dies during opioid withdrawal actually dies due to dehydration which can occur because of excessive, untreated nausea and vomiting. It is for this reason that a medically supervised detox is safest if you are quitting methadone.
How To Get Off Methadone
If you are planning on stopping methadone, the first step is to talk to your doctor. If you are taking methadone as part of MAT for opioid use disorder, it can be very risky to stop methadone because it can increase your relapse risk. That said, there are two main ways a person can quit methadone: quitting cold turkey or slowly tapering the drug.
Quit Methadone Cold Turkey
Quitting methadone cold turkey can increase your chances of experiencing opioid withdrawal. This, in turn, can increase your risk of cravings and relapse. If you need to stop methadone, it is best to avoid quitting cold turkey and instead talk to your doctor about a methadone taper.
Methadone Taper Plan
Tapering, or slowly decreasing, the methadone dose can help you avoid withdrawal symptoms. Tapering should always be supervised by a doctor, as they can advise you on the best taper to use. While tapering, the dose is typically reduced by 5% to 20% every four weeks until the methadone is stopped. In some cases, tapers are done more quickly. Quick tapers are often limited to circumstances where:
- The methadone is being used in ways other than prescribed
- There are illegal activities involving the methadone
- The risks of continuing methadone even for a few weeks outweigh the benefits
How To Wean Off Methadone at Home
Although it is important to only taper off methadone while under a doctor’s care, your doctor may tell you that you can start weaning yourself off methadone at home. Important tips to help you remain comfortable during the methadone taper process include:
- Make sure there are no drugs (including opioids) or alcohol in the house. This can help reduce the temptation to use substances if any withdrawal symptoms start.
- Find a supportive person who can check in on you and make sure you are doing well on your taper.
- Call your doctor if you are having any withdrawal symptoms, including diarrhea, nausea or vomiting.
- Stay well-hydrated and make sure to eat healthy foods, avoiding junk food and sugary drinks.
- Try to stay busy to help keep your mind off your methadone taper.
- Make sure to get a full night’s sleep to conserve your health and energy.
Medical Detox for Methadone Withdrawal
Trying to quit methadone on your own can be difficult. This is especially true if you have been taking methadone to treat an opioid use disorder. Fortunately, help is available with medical detox and rehab. In medical detox, you can be slowly weaned off methadone under the supervision of professionals who can address withdrawal symptoms as they occur. In addition, the methadone taper can be adjusted as needed to minimize your withdrawal symptoms.
The Recovery Village Cherry Hill at Cooper is a spacious, 90-bed rehab center that is designed to meet your unique needs throughout the treatment process. Our facility offers a bright, calm and healing environment that can help support your mind and body during the critical first steps of your recovery journey. Located just 30 minutes from Philadelphia International Airport, we are nationally accredited and staffed with experts in methadone addiction and withdrawal.
If you or someone you love struggles with methadone, help is available at The Recovery Village Cherry Hill at Cooper. Contact us today to learn more about treatment programs that can work well for your situation.
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U.S. Department of Veterans Affairs. “Opioid Taper Decision Tool.” October 2016. Accessed March 17, 2022.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.