Methadone Uses, Side Effects, Effective Treatment, and Risks

Synthetic opioid agonist methadone, also known by the brand names Dolophine and Methadose, is prescribed for both chronic pain and opioid dependency. Continue to read more information about the drug methadone.


Methadone Uses

Methadone is used to relieve chronic pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. It also is used to prevent withdrawal symptoms in patients who have an opiate addiction and are enrolled in opioid addiction treatment programs in order to stop taking or continue not taking the drugs.

This maintenance medication is in a class of drugs called opiate (narcotic) analgesics. It works to treat pain by changing the way the brain and nervous system respond to pain. It works to treat people who were addicted to opiate drugs by producing similar effects and preventing opioid withdrawal symptoms in people who have stopped using these drugs.

Methadone Warnings

It’s possible that using methadone prescription will lead to addiction. it is crucial that you take this medication as prescribed by your doctor. Avoid exceeding the recommended dosage, taking it more frequently, for a longer time, or in a different way than your doctor has instructed. Discuss your pain management objectives, course of treatment, and additional pain management options with your healthcare practitioner while you are taking the drug. Inform your doctor if you or any family members regularly use significant amounts of alcohol, take street drugs, abuse prescription medicines excessively, experience overdosing, or currently suffer from depression or another mental disorder. If you have or have ever used opioids, there is a higher chance that you may abuse them.

Methadone may cause significant or life-threatening respiratory issues, especially during the first 24 to 72 hours of your therapy and every time your dose is raised. Throughout your therapy, your doctor will keep a close eye on you. If you have asthma or sluggish breathing, let your doctor know. Most likely, your doctor will advise against using methadone max dose. Furthermore, let your doctor know if you currently or ever had a lung condition like chronic obstructive pulmonary disease (COPD), a group of lung conditions that also includes chronic bronchitis and emphysema, a head injury, a brain tumor, or any other condition that raises the pressure in your brain.

What is methadone used for? It is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. It has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective.
What is methadone used for? It is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. It has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective.

The likelihood that you may experience breathing issues may be increased if you are an older adult, frail, or undernourished as a result of a sickness. Call your doctor right away or get emergency medical attention if you have any of the following symptoms, such as slower breathing, protracted pauses between breaths, or shortness of breath.

You must enroll in a substance abuse treatment program if you have an opiate addiction and are taking generic methadone to assist you to quit using the substance or keeping from using it. Opiates are narcotic drugs like heroin. [1]

Methadone Dosing

IV methadone and methadone tablets are available as Lipophilic hydrochloride salt in oral, IM, IV, subcutaneous, epidural, and intrathecal formulations. They are FDA-approved for use in moderate to severe pain that has not responded to non-opioid medications or as an alternative if the pain is unresponsive to other opioid drugs. It is an analgesic used in cancer patients or other terminally ill patients and in chronic pain pathologies.

Depending on the intended usage, several dosages and formulations are necessary, although oral formulations—either in the form of tablets or concentrated syrup—are by far the most popular. There is a broad list of recommended dosage schedules.

Methadone Dosage & Administration

What is methadone maintenance? It takes an expert understanding of methadone’s pharmacologic characteristics and regulatory restrictions to evaluate its usage in various therapeutic circumstances. In the US, deaths related to the non-prescription use of opioids are a major cause of death. Professional and Federal detoxification and maintenance programs utilizing methadone 5mg, methadone 10mg pill, methadone hydrochloride 10mg (methadone HCL), or buprenorphine-naloxone are crucial in bringing down those figures.

  • Pain Management:
    • Opioid-Naive: Oral, 2.5 mg every eight hours with incremental dose increase if needed about once every week.
    • Opioid-Tolerant: Oral, 10 mg of methadone is approximately equivalent to a 15 mg dose of oral morphine. Follow dosing charts for equivalent dosing and conversion factors tailored to the individual patient.
  • Opioid Use Disorder:
    • General: Oral dosing starts at 30 to 40 mg/day and is titrated upwards by 10 to 20 mg/week to an optimal of 80 to 150 mg/day. Long-term treatment is optimal if it lasts for at least 14 months.
    • Pregnancy: Continue maintenance treatment in women who are pregnant and have opioid use disorder. Consider treating with buprenorphine instead due to less sedation on the neonate.
  • Opioid Withdrawal:
    • Adults: Oral dosing starts at 10 to 20 mg and is increased by 10 mg increments until the withdrawal symptoms are controlled, usually about 40 mg. Stabilize dosing for 2 to 3 days and then reduce dose by 10 to 20% daily and monitor for withdrawal symptoms. 
    • Neonates: Oral, 0.05 to 0.1 mg/kg every 6 hours until withdrawal symptoms stabilize. Then reduce the dose by 10 to 20% daily and continue serial monitoring of withdrawal symptoms.

Methadone Metabolism & Other Considerations

  • This medication has high oral bioavailability, with plasma levels measurable after 30 minutes and a decline in plasma levels occurring after 24 hours, all of which should be considered in frail patients or patients with altered hepatic clearance to prevent overdose.
  • CYP 3A4 and CYP 2B6 hepatically metabolize this drug to non-active metabolites, and interactions with other hepatically metabolized drugs merit consideration and monitoring.
  • As the drug is hepatically metabolized, dosing adjustments are typically not needed in patients with renal issues, but care should still be advisable in end-stage renal disease.
  • The recommended dose for parenteral administration is between 50 to 80% of the oral dose, and caution is necessary when switching to methadone from another opioid. Dosing ratios can be useful to calculate the appropriate dose. [2]

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Top 5 How Long Does Methadone Last? FAQs

  1. How long does methadone stay in your system?

    Several factors influence how long this drug stays in your system. generally, the drug will process out of an individual body within two weeks. In comparison to methadone MOA (mechanism of action), Suboxone which is another pharmaceutical medication used for opioid treatment essentially clears from the system within nine days to two weeks.

  2. How long does methadone stay in urine?

    Urine tests are the most typical tests used to check the usage of max and average methadone doses. An hour to two weeks after the last ingested substance, it can be detected in a user’s system. Because they are easy to administer, affordable, noninvasive, and have a long detection period, urine tests are commonly used as the main method of methadone testing.

  3. How long can you be on methadone?

    Methadone pills 10 mg, methadone injection, and methadone taper maintenance are a protracted course of therapy. One or two years to twenty years or more may pass during the course of therapy. The dose is tapered down gradually over several weeks or months if the patient and their doctor decide to stop therapy, which eases the withdrawal process.

  4. Does methadone show up on a drug test?

    It will not produce positive results on a standard test for opiates, unlike heroin or prescription pain medication testing. It will only be detected if an individual is specifically tested for methadone, which is not a typical practice.

  5. What enhances methadone?

    Several medications can increase drug metabolism and the risk of opioid withdrawal. Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section of the drug label.

Methadone Mechanism of Action Drug Facts

Methadone Generic Name: Methadone (oral/injection) [ METH-a-done ]
Methadone Brand Names: Dolophine, Methadose, Methadose Sugar-Free, Diskets
Dosage Forms & Methadone Liquid Forms: Injectable solution; intravenous solution; oral concentrate; oral solution; oral tablet; oral tablet, dispersible.
Methadone Drug Class: Opioids (narcotic analgesics)
Methadone Schedule: Schedule II drug under the Controlled Substances Act.


Methadone Interactions

This medication can cause CNS depression and respiratory compromise; hence it should be used with extreme caution in patients with CNS-related pathologies such as trauma, increased intracranial pressure, dementia, delirium, etc. It should not be used in conjunction with medications or substances with similar depressant effects such as other opioids, benzodiazepines, alcohol, antipsychotics, etc., unless necessary. Drugs that may increase the clearance of methadone or decrease its effects must also be used with caution to prevent precipitating withdrawal symptoms.

The following examples are not an exhaustive list of drug interactions but provide some commonly documented drug interactions.

Examples of drugs that may increase methadone side effects long term and risk overdose symptoms: 

  • Ciprofloxacin
  • Benzodiazepines
  • Alcohol
  • Fluconazole
  • Cimetidine
  • Fluoxetine
  • Urine alkalizing agents

Examples of drugs that may decrease methadone effects and risk withdrawal symptoms:

  • Efavirenz
  • Phenobarbital
  • Phenytoin
  • Rifampin
  • Ritonavir
  • Carbamazepine
  • Urine acidifying agents

Methadone Clinic Rules and Regulations

It is crucial to seek accredited and professional options when searching for “methadone treatment near me” or “methadone doctors near me.” Opioid treatment programs (such as online methadone clinics, and clinic methadone treatment options) must meet federal certification and accreditation requirements and state licensing requirements.

Under federal regulations, opioid treatment programs must be certified by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U.S. Department of Health and Human Services. The regulations also require these programs to be accredited by an independent, SAMHSA-approved accrediting body to dispense opioid treatment medications (e.g., the Commission on Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission). Treatment programs must first obtain accreditation and then seek certification. Opioid treatment programs also must register with the federal Drug Enforcement Administration. [3]


To learn more visit:

Methadone Definition & Drug Fact Sheet by DEA. Publicly Made Available for Opioid Use Disorder Awareness

Methadone for Pain Management & Treatment of Opiate Dependence Statistics

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), effective treatment for opioid use disorder includes medication-assisted treatment (MAT) which combines behavioral therapy and medications. The Food and Drug Administration (FDA) approved medications for use in treating opioid use disorder including methadone, buprenorphine (buprenorphine with naloxone), and naltrexone. Naltrexone is an opioid antagonist, methadone is an opioid agonist and buprenorphine is a partial opioid agonist. MAT has been found to reduce morbidity and mortality, decrease overdose deaths, reduce transmission of infectious disease, increase treatment retention, improve social functioning, and reduce criminal activity. [4]


400,000

More than 400,000 people in the United States received methadone as part of their addiction treatment in 2019.

Source: NIDA

21-25%

Clients receiving treatment with methadone accounted for approximately 21 to 25 percent of all substance abuse treatment clients each year.

Source: NIDA

56,516

Deaths involving synthetic opioids other than methadone (primarily fentanyl) continued to rise with 56,516 overdose deaths reported in 2020.

Source: NIDA


Methadone for Opioid Use Disorder

Methadone and buprenorphine are FDA-approved to treat opioid use disorder as part of federally regulated opioid treatment programs. Methadone prescriptions are for detoxification and maintenance therapy. It is a useful agent for opioid withdrawal symptoms such as tachycardia, diaphoresis, nausea, vomiting, diarrhea, etc.

Abstinence rates from opioid use are better when patients undergo long-term versus short-term detox methadone treatment. This drug has been shown to improve retention in treatment and detoxification programs and has shown improvement in mortality rates for opioid abusers. Clinicians must evaluate the availability of this medication in pharmacies when referring patients to such programs, as licensing and availability can vary significantly across states.

Is methadone an opioid? Yes. It is a long-acting opioid drug used to replace the shorter-acting opioids that someone may be addicted to, such as heroin, oxycodone, fentanyl, or hydromorphone. Long-acting means that the drug acts more slowly in the body, for a longer period of time. The effects of this drug last for 24 to 36 hours.
Is methadone an opioid? Yes. It is a long-acting opioid drug used to replace the shorter-acting opioids that someone may be addicted to, such as heroin, oxycodone, fentanyl, or hydromorphone. Long-acting means that the drug acts more slowly in the body, for a longer period of time. The effects of this drug last for 24 to 36 hours.

Methadone and Pregnancy

According to the National Institute on Drug Abuse (NIDA), in terms of methadone vs buprenorphine, both medications have both been shown to be safe and effective treatments for opioid use disorder during pregnancy. While Neonatal abstinence syndrome may still occur in babies whose mothers received these medications, it is less severe than in the absence of treatment.

Neonatal abstinence syndrome (NAS) occurs when an infant becomes dependent on opioids or other drugs used by the mother during pregnancy. The infant experiences withdrawal symptoms that can include (but are not limited to) tremors, diarrhea, fever, irritability, seizures, and difficulty feeding.

Although breastfeeding is typically low among mothers with opioid use disorder, studies have found that breastfeeding can reduce the length of hospital stay and the need for morphine treatment in infants. Unless there are specific medical concerns (e.g., maternal HIV infection), encouraging mothers to breastfeed and swaddle newborns may ease infant NAS symptoms and improve bonding. [5]

Benefits of Treatment During Pregnancy. Buprenorphine or methadone pregnancy treatment improves infant outcomes by:

  • Stabilizing fetal levels of opioids, reducing repeated prenatal withdrawal
  • Linking mothers to treatment for infectious diseases (e.g., HIV, HBV, HCV), reducing the likelihood of transmittal to the unborn baby
  • Providing an opportunity for better prenatal care
  • Improving long-term health outcomes for the mother and baby

Compared to untreated pregnant women, women treated with methadone or buprenorphine had infants with:

  • Lower risk of neonatal abstinence syndrome
  • Less severe neonatal abstinence syndrome
  • Shorter treatment time
  • Higher gestational age, weight, and head circumference at birth
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How does methadone work? and what does methadone do? It is a synthetic opioid agonist that eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain—the same receptors that other opioids such as heroin, morphine, and opioid pain medications activate.
How does methadone work? and what does methadone do? It is a synthetic opioid agonist that eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain—the same receptors that other opioids such as heroin, morphine, and opioid pain medications activate.

Side Effects of Methadone

As with other opioid medications, general adverse effects of methadone are related to excess opioid receptor activity, including but not limited to:

  • Diaphoresis/flushing
  • Pruritis
  • Nausea
  • Dry mouth
  • Constipation
  • Sedation
  • Lethargy
  • Respiratory depression

This medication is also associated with QTc prolongation (>450 ms), leading to cardiac dysfunction and severe hypoglycemia in certain patient populations. It can also cause CNS (central nervous system) depression and respiratory compromise; hence it should be used with extreme caution in patients with CNS-related pathologies such as trauma, increased intracranial pressure, dementia, delirium, etc.

The QTc is the QT interval corrected for heart rate, and it estimates the QT interval at a heart rate of 60 beats/min. 

Short Term Methadone Effects

Methadone will help in reducing withdrawal symptoms and cravings in the short term without producing the euphoria seen when using other opioids. To reduce withdrawal symptoms and prevent drowsiness and other adverse effects, a medical professional will put a patient on medication at the lowest dose feasible. However, too much of the drug might result in euphoria or excessive sleepiness. You have to cooperate with your doctor to determine the best dose, it may take some time and effort, and regular observation of the drug’s effects is necessary to assist the medical professional determine the right dosage.

Long Term Effects of Methadone

It is crucial to understand that using methadone in conjunction with another substance that depresses the central nervous system, such as alcohol, benzodiazepines, or other opioids, can result in respiratory depression, a coma, or even death. It is noteworthy that most methadone overdose deaths show levels of the drug that by themselves would not constitute a lethal dose, but are frequently the result of the interaction of other medications or drugs taken with them. Overdose death occurs when the impact of the medication on the heart functioning and respiratory system of a person exceeds that person’s tolerance.

Liquid Methadone Side Effects

Methadone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • Headache
  • Weight gain
  • Stomach pain
  • Dry mouth
  • Sore tongue
  • Flushing
  • Difficulty urinating
  • Mood changes
  • Vision problems
  • Difficulty falling asleep or staying asleep

Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical help:

  • Seizures
  • Itching
  • Hives
  • Rash
  • Swelling of the eyes, face, mouth, tongue, or throat
  • Hoarseness
  • Difficulty breathing or swallowing
  • Extreme drowsiness
  • Agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
  • Nausea, vomiting, loss of appetite, weakness, or dizziness
  • Inability to get or keep an erection
  • Irregular menstruation
  • Decreased sexual desire

Methadone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

Methadone Program

What is a methadone clinic? Methadone clinics in the United States operate under strict regulations by state and federal laws. before the medication program, a patient must be given adequate information to provide informed consent about starting treatment. Therapy options, suggestions, adverse effects, dangers associated with treatment, and guidelines that must be followed in order to obtain medication-assisted treatment are all included in this information.

Treatment planning can start after a doctor is certain that the patient willingly agreed to accept treatment by having them sign a permission form. The patient must demonstrate current opioid addiction using recognized medical standards such as those in the DSM-5 and provide proof that the addiction started at least a year prior to admission for treatment. DSM-5 is the standard classification of mental disorders used by mental health professionals in the United States.

Before the administration of treatment, a clinical evaluation is required asking about drug use history, co-occurring disorders, and the impact of substance use on life, along with providing information about the treatment goals and guidelines. A medical evaluation is also given in the form of a urinalysis test, a review of past and current health history, and a test for certain conditions which are known to be prevalent in addict populations, such as HIV, hepatitis, and tuberculosis. The medication is monitored by nursing staff and is prescribed by a physician. Below list are the common answers to the questions patients usually ask during medication-assisted treatment in a methadone clinic.

Does methadone get you high? unfortunately, it can. It is a federally designated Schedule II drug, meaning it has a legitimate legal use but also a high likelihood of its users developing a dependence. This also means that it is illegal to use this medication to get high and that abuse can lead to severe mental impairment and physical dependence. Other Schedule II drugs include Hydrocodone and Morphine.
Does methadone get you high? unfortunately, it can. It is a federally designated Schedule II drug, meaning it has a legitimate legal use but also a high likelihood of its users developing a dependence. This also means that it is illegal to use this medication to get high and that abuse can lead to severe mental impairment and physical dependence. Other Schedule II drugs include Hydrocodone and Morphine.
  • Methadone vs Suboxone – In terms of “suboxone vs methadone treatment,” they are different medications with different ingredients. Methadone only has one ingredient, methadone hydrochloride. Suboxone is a combination of two medications, buprenorphine, and naloxone. Suboxone works chemically to decrease the severity of withdrawal symptoms and reduce a patient’s dependence on opioids in the long term. Suboxone is a powerful opiate-an anesthetic to emotional pain. It immediately alleviates anxiety and depression and makes a person feel more emotionally stable. A lesser dose of Suboxone (2 mg a day) will block an estimated 80% of a person’s feelings, while higher doses can make a patient practically numb.
  • Buprenorphine vs Methadone – Both medications are opioids. Buprenorphine is a semi-synthetic compound, made from both natural and synthetic compounds, while methadone is a fully-synthetic compound. Both prevent withdrawal symptoms by interacting with opioid receptors in the brain. Buprenorphine is also a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD). Buprenorphine is a schedule III narcotic analgesic. It was first marketed in the United States in 1985 as a Schedule V narcotic analgesic. Initially, the only available buprenorphine product in the United States had been a low-dose (0.3 mg/ml) injectable formulation under the brand name, Buprenex®. [6]
  • Methadose vs Methadone – The difference between methadone and “Methadose” liquid is that “Methadose” is ten times more concentrated and dispensed undiluted. This makes Methadose easier to take and distribute than other types of medication. But, because you take a smaller volume of medication, exact doses for methadone are more critical.
  • Methadone vs Oxycodone – The primary distinction between these two drugs is that the former is mostly used to treat opiate addiction, while the latter is typically recommended as a pain reliever. Methadone can be administered as a painkiller, but for certain people, doing so might potentially be rather harmful. Oxycodone, sold under various brand names such as Roxicodone and OxyContin, is a strong, semi-synthetic opioid used medically for the treatment of moderate to severe pain. Unfortunately, it is also highly addictive and a commonly abused drug.
  • Subutex vs Methadone – Subutex tablets contain the active ingredient buprenorphine hydrochloride. It acts as a substitute for opioids like heroin, morphine, oxycodone, or codeine and it helps withdrawal from opioids over a period of time. Subutex should be used exactly as prescribed by your doctor. Currently, professionals measure the effectiveness of medication-assisted treatment by its ability to reduce the patient’s opioid use. In this sense, both drugs have similar results. Research shows that methadone and Suboxone have equal success rates in lowering opiate use. The main difference between Subutex and Suboxone is that Suboxone contains both buprenorphine and naloxone, whereas Subutex contains only buprenorphine. Suboxone and Subutex are both brand names.
  • Methadone and Xanax – It is a dangerous combination. A class of anxiety medication called benzodiazepines can increase the side effects of methadone. Both drugs depress the central nervous system. Combined, they can cause too much central nervous system depression and result in an overdose or death. Xanax is used to treat anxiety disorders and panic disorders (sudden, unexpected attacks of extreme fear and worry about these attacks). Xanax is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain.
Does methadone make you tired? Yes. Drowsiness is one of its characteristic side effects. Extreme fatigue is common after taking this medication because the medication stimulates changes in brain chemistry, which can interfere with sleep regulation.
Does methadone make you tired? Yes. Drowsiness is one of its characteristic side effects. Extreme fatigue is common after taking this medication because the medication stimulates changes in brain chemistry, which can interfere with sleep regulation.

Gabapentin and Methadone – According to a Randomized Controlled Trial published in the National Center for Biotechnology Information, [7] Gabapentin is a potentially useful drug in alleviating the hyper excitatory painful states in the control of opiate dependence in acute detoxification and the stabilization phase. The results of the trial showed that gabapentin is an effective add-on therapy when added to methadone. This drug leads to the relief of withdrawal symptoms and lowers methadone consumption. Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat partial seizures and neuropathic pain. It is a first-line medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain.

Lamotrigine and Methadone – According to a study, Oxcarbazepine, Lamotrigine, and Topiramate have not been reported to have adverse drug interactions with methadone or buprenorphine. These anticonvulsants are likely to be better choices for clinical use in opioid-maintained patients. [8]

Methadone Morphine Conversion

According to a comparison of intraoperative morphine sulfate and methadone hydrochloride on postoperative visual analog scale pain scores and narcotic requirements, published by the NCBI, [9] Morphine sulfate and methadone hydrochloride exhibit very different half-lives but are described as having analgesic potency of one.

The use of a drug like methadone may provide prolonged and constant analgesia in the perioperative setting. This double-blinded investigation used methadone and morphine intraoperatively and measured pain scores and narcotic requirements in the first 24 hours postoperatively.

Thirty American Society of Anesthesiology (ASA) patients, a physical status I through III, between the ages of 18 to 65 years were scheduled for orthopedic surgery and randomly assigned to receive morphine or methadone at 0.30 mg/kg. Fifteen patients received morphine and fifteen patients received methadone. There was no significant difference between the two groups in terms of age, height, weight, and ASA status. No statistically significant difference was observed among the two groups between the number of analgesic requirements postoperatively or in the visual analog scale pain score.

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Methadone Addiction

Although methadone is a medication that has helped countless people who were struggling with opioid addiction, it is not the best solution for many. Considering how long this narcotic does stay in your system and the associated risks, getting off this medication should always be the long-term goal for opioid addiction treatment. A drug and alcohol rehab program can offer different recovery options that any opioid addict should consider. Sometimes individuals in treatment have to try different therapies or even go through multiple attempts to find what works for them. Ultimately, the goal is a better life free from drugs.

Although methadone is used to treat opioid addiction, it can be extremely physically addictive, especially when taken in high doses. Moreover, uncomfortable withdrawal symptoms can occur when this medication is stopped in people who have been taking the drug long-term. Although some people find the withdrawal from methadone takes longer than that of heroin or other opioids, others do not, and in the majority of cases, the methadone withdrawal symptoms are milder than that of other opiates and safer because it is usually undertaken under supervision. Although it may seem like you are trading one addiction for another, there are benefits to taking methadone over continuing misuse of other opioids, for example:

  • Methadone does not cause impairment or permanent damage to the brain and body
  • Because this narcotic is regulated it is not cut with other, unknown, substances
  • Because this medication can be legally obtained through a clinic, it does not require its users to engage in secretive, illegal, and self-destructive behavior
  • This medication is difficult to overdose on when taken as prescribed

Testing for Methadone Abuse

As the medication is processed through the body, there are certain methods of testing that may or may not be able to detect its presence. This is approximately how long this narcotic can be detected via each method of testing:

  • Blood: After 30 minutes and up to 3-4 days
  • Saliva: After 30 minutes and up to 2-4 days
  • Urine: After 1 hour and up to 2 weeks
  • Hair: After a couple of weeks and up to several months

Factors to Consider

You may notice that there are ranges for how long most of these tests can detect methadone in an individual’s body. These factors include:

  • Food and water intake
  • Length of use
  • Amount used
  • Age and overall wellness

Methadone Toxicity

Drug poisoning or toxicity can occur accidentally or intentionally for suicide or homicide purposes. The most commonly reported early signs of severe methadone toxicity are ataxia (Ataxia is a term for a group of disorders that affect co-ordination, balance, and speech. Any part of the body can be affected, but people with ataxia often have difficulties with balance and walking), and evident euphoria. The late signs were unconsciousness, loud snoring, and brown pulmonary edema fluid coming from the mouth or nose.

Addiction, age, gender, attempt to suicide, and a history of psychiatric disorder are the most important factors in toxicity, which should be considered in the public training and prevention of poisoning.

When someone is experiencing drug toxicity, seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to.

Before Calling Emergency

Have this information ready:

  • Person’s age, weight, and condition
  • Name of the medicine (strength, if known)
  • The time it was swallowed
  • Amount swallowed
The half life of methadone in an opioid-tolerant patient is approximately 24 hours; its half-life in an opioid-naive patient is approximately 55 hours. If you are looking for a "methadone clinic near me," call us today for treatment resources information.
The half life of methadone in an opioid-tolerant patient is approximately 24 hours; its half-life in an opioid-naive patient is approximately 55 hours. In case you are looking for a “methadone clinic near me,” call us today for treatment resources information.

Methadone and Alcohol

Maintenance patients often abuse other drugs, including alcohol. The combined use of medication-assisted treatment and alcohol could impair performance and daily functioning. Combining this narcotic and alcohol can have a considerable adverse effect on cognitive function and result in severe health complications. When the medication is combined with alcohol, the probability of experiencing severe side effects is exponentially increased.

Consuming alcohol while taking your maintenance medication for opioid use management can generate severe side effects due to the negative interaction between the two substances. Both these drugs directly impact the brain and central nervous system (CNS), and combining them can amplify the effects of both substances. Some individuals simultaneously consume both these substances to generate stronger sedative effects. This risk is even higher in individuals who struggle with opioid dependence and alcohol use disorder. 

Methadone High

It is an opioid after all, like heroin or opium. It can be addictive, like other opioids. However, being on this medication is not the same as being dependent on illegal opioids such as heroin:

  • It is safer for the patient to take this medication under medical supervision than it is to take heroin of unknown purity.
  • This medication is taken orally. Heroin is often injected, which can lead to HIV transmission if needles and syringes are shared.
  • People who are heroin dependent often spend most of their time trying to obtain and use heroin. This can involve criminal activity such as stealing. Patients on maintenance programs do not need to do this. Instead, they can undertake productive activities such as education, employment, and parenting.

How Long Does Methadone Withdrawal Last?

The length of time a person persists on methadone treatment depends on their situation. Some say that six months to a year is a good term for medication maintenance. Others may stay on this medication indefinitely if it keeps them clean.

  • The duration of these drug withdrawal symptoms varies from person to person but may last anywhere from two to three weeks to up to six months.
  • It may take 24 to 36 hours for withdrawal symptoms to start when the medication is stopped.
  • Initial withdrawal symptoms are usually mild and may include anxiety, restlessness, a runny nose, sweating, tiredness, and watery eyes.
  • Other withdrawal symptoms such as drug cravings, muscle cramps, severe nausea or vomiting, diarrhea, and depression are likely to be at their worst over the first week.

Furthermore, what classification of drug is methadone? Opioids are drugs such as heroin, opium, morphine, codeine, and methadone. Opioid withdrawal can be very uncomfortable and difficult for the patient. It can feel like a very bad flu. However, opioid withdrawal is not usually life-threatening.

There are some patients who should NOT complete opioid withdrawal:

  • Pregnant women: It is recommended that pregnant women who are opioid dependent do not undergo opioid withdrawal as this can cause miscarriage or premature delivery. The recommended treatment approach for pregnant, opioid-dependent women is methadone maintenance treatment.
  • Patients commencing methadone maintenance treatment do not need to undergo withdrawal before commencing treatment.

Methadone Withdrawal Symptoms

Short-acting opioids (e.g. heroin): Onset of opioid withdrawal symptoms 8-24 hours after last use; duration 4-10 days.

Long-acting opioids (e.g. methadone): Onset of opioid withdrawal symptoms 12-48 hours after last use; duration 10-20 days.

Symptoms include:

  • Nausea and vomiting
  • Anxiety
  • Insomnia
  • Hot and cold flushes
  • Perspiration
  • Muscle cramps
  • Watery discharge from eyes and nose
  • Diarrhoea

Methadone Half Life

This medication is a synthetic opioid agonist. This means it produces effects in the body in the same way as heroin, morphine, and other opioids. It is taken orally as a tablet or syrup. When an opioid-dependent person takes this maintenance medication, it relieves withdrawal symptoms and opioid cravings; at a maintenance dose, it does not induce euphoria.

The onset of effects occurs 30 minutes after swallowing and peak effects are felt approximately three hours after swallowing. At first, the half-life (the length of time for which effects are felt) of methadone is approximately 15 hours; however, with repeated dosing, the half-life extends to approximately 24 hours. It can take between 3 and 10 days for the amount of methadone in the patient’s system to stabilize.

Methadone Overdose Symptoms

An overdose of this drug occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose. An overdose can also occur if a person takes this medication with certain painkillers. These painkillers include oxycontin, hydrocodone (Vicodin), and morphine.

Disclaimer: This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Methadone can help in reducing pain and withdrawal symptoms, but the pain-relieving effects can begin to wear off in as little as 8 hours even though the substance is still in their system for much longer. This means that a patient experiencing pain could feel the need for more of the drug before even half of it has left their system. Taking too much of this opioid drug in a short period of time does carry a significant risk of overdose. The overdose risk and general risk of addiction are why the distribution of this medication is so highly regulated. Below are symptoms of an overdose of this medication in different parts of the body.

EYES, EARS, NOSE, AND THROAT

  • Tiny pupils

STOMACH AND INTESTINES

  • Constipation
  • Nausea and vomiting
  • Spasms of the stomach or intestines

HEART AND BLOOD

  • Low blood pressure
  • Weak pulse

LUNGS

  • Breathing problems, including slow, labored, or shallow breathing
  • No breathing

NERVOUS SYSTEM

  • Coma (decreased level of consciousness and lack of responsiveness)
  • Confusion
  • Disorientation
  • Dizziness
  • Drowsiness
  • Fatigue
  • Muscle twitches
  • Weakness

SKIN

  • Blue fingernails and lips
  • Cold, clammy skin

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Methadone Wafers

When methadone comes in tablet or wafer form, it can either be swallowed whole or mixed in liquid if it’s a dispersible tablet. Dispersible tablets should not be chewed or swallowed. Instead, the whole tablet or part of it is placed in at least 4 ounces (120 milliliters) of liquid, such as water, orange juice, or another citrus beverage to dissolve. The entire mixture is then taken immediately.

Many are wondering “What is crystal methadone?” as others often mistakenly use the term “crystal meth” for methadone. Others also use slang terms such as “wafers.” It is a term used as slang for 40mg Methadone. Normally white, but also come in orange. A wafer is round and about the size of a quarter. According to the DEA (Drug Enforcement Administration), 40 mg of this drug formulation is indicated for the detoxification and maintenance treatment of opioid addiction. The 40 mg strength is not FDA-approved for use in the management of pain. Thus, the distribution and availability of the 40 mg formulation will be limited to registrants in only those settings using the 40 mg formulation for the appropriate indication.

Even though methadone is used in addiction treatment, it is still an opioid, meaning that it fosters physical dependence. There is also a place called “Methadone Mile.” Mass and Cass, also known as Methadone Mile or Recovery Road, is a tent city located at and around the intersection of Melnea Cass Boulevard and Massachusetts Avenue in Boston, Massachusetts. It has been characterized as “the epicenter of the region’s opioid addiction crisis.”

Due to its concentration of service providers, the area around Mass and Cass has attracted a large number of people dealing with homelessness and drug addiction, especially after the closure of the treatment facility on Long Island. As of September 2021, the number of tents in the area was estimated to have grown from a dozen to more than 100.

Methadone Clinics Near Me

You can contact us at We level Up addiction treatment centers for referrals and treatment information resources. You may also visit FindTreatment.gov – this locator provides information on state-licensed providers and clinics that specialize in treating substance use disorders and mental illness.

Methadone Alternatives

Medication-Assisted Treatment (MAT) is the use of medications, in combination with counseling and other therapeutic techniques, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications relieve the withdrawal systems and psychological cravings that cause chemical imbalances in the body. Research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, or physical functioning.

Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders. There are three medications commonly used to treat opioid addiction. Check with your doctor about the right one for you. Methadone, Buprenorphine, and Naltrexone.

  • Buprenorphine – Buprenorphine is the first medication to treat opioid use disorder (OUD) that can be prescribed or dispensed in physician offices, significantly increasing access to treatment. As with all medications used in treatment, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other services to provide patients with a whole-person approach. Buprenorphine offers several benefits to those with OUD and to others for whom treatment in an Opioid Treatment Clinic is not appropriate or is less convenient.
    • The following buprenorphine products are FDA approved for the treatment of OUD:
      • Generic Buprenorphine/naloxone sublingual tablets
      • Buprenorphine sublingual tablets (Subutex)
      • Buprenorphine/naloxone sublingual films (Suboxone)
      • Buprenorphine/naloxone) sublingual tablets (Zubsolv)
      • Buprenorphine/naloxone buccal film (Bunavail)
      • Buprenorphine implants (Probuphine)
      • Buprenorphine extended-release injection (Sublocade)

Buprenorphine is an opioid partial agonist. It produces effects such as euphoria or respiratory depression at low to moderate doses. But when taken as prescribed, buprenorphine is safe and effective. Buprenorphine has unique pharmacological properties that help:

  1. Diminish the effects of physical dependency on opioids, such as withdrawal symptoms and cravings
  2. Increase safety in cases of overdose
  3. Lower the potential for misuse
  • Naltrexone – Intramuscular extended-release Naltrexone is a medication approved by the Food and Drug Administration (FDA) to treat both Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD). Naltrexone can be prescribed and administered by any practitioner licensed to prescribe medications and is available in a pill form for Alcohol Use disorder or as an extended-release intramuscular injectable for AUD and OUD.

Naltrexone is not an opioid, is not addictive, and does not cause withdrawal symptoms with the stop of use. Naltrexone blocks the euphoric and sedative effects of opioids such as heroin, morphine, and codeine. Naltrexone binds and blocks opioid receptors, and reduces and suppresses opioid cravings. There is no abuse and diversion potential with naltrexone.

To reduce the risk of withdrawal symptoms caused by opioid use disorder, patients should wait at least 7 days after their last use of short-acting opioids and 10 to 14 days for long-acting opioids, before starting naltrexone.

Your body can also become dependent on methadone and other opioids. Your brain relies on the pain relief they bring, and you have withdrawal symptoms if you stop taking them suddenly. People react to these drugs in different ways. Changing your dosage on your own can lead to dangerous side effects or an overdose.
Your body can also become dependent on methadone and other opioids. Your brain relies on the pain relief they bring, and you have withdrawal symptoms if you stop taking them suddenly. People react to these drugs in different ways. Changing your dosage on your own can lead to dangerous side effects or an overdose.

Patients taking naltrexone should not use any other opioids or illicit drugs; drink alcohol; or take sedatives, tranquilizers, or other drugs. Patients should notify their practitioner about all medications they are currently taking as well as any changes in medications while being treated with naltrexone.

While the oral formulation will also block opioid receptors, only the long-acting injectable formulation is FDA-approved as a medication for OUD and requires REMS. A Risk Evaluation and Mitigation Strategy (REMS) is a drug safety program that the U.S. Food and Drug Administration (FDA) can require for certain medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks.

Patients on naltrexone, who discontinue use or relapse after a period of abstinence, may have a reduced tolerance to opioids. Therefore, taking the same, or even lower doses of opioids used in the past can cause life-threatening consequences.

Detox from Methadone Near Me

When it comes to addiction to drugs as dangerous as opioids like heroin, finding a treatment that could reduce overdose rates was a big deal. Methadone has been available for opioid addiction treatment for several decades. It is used to help treat both chronic pain and opioid addiction. This medication can only be administered via a SAMHSA-certified opioid treatment program like maintenance clinics. This maintenance medication works by blocking the receptors that opioids affect and therefore reduces the cravings and withdrawal symptoms that typically start shortly after an individual stops using opioids.

However, the use of it does come with an array of potential side effects. Some of the common side effects include lethargy, nausea, sweating, constipation, and stomach pain. The more severe symptoms that are possible with its use include heart rate and breathing irregularities, stomach pain, seizures, an allergic reaction, withdrawal, and addiction.

Withdrawal management refers to the medical and psychological care of patients who are experiencing withdrawal symptoms as a result of ceasing or reducing the use of their drug dependence. Patients who are opioid dependent and consent to commence methadone maintenance treatment do not require withdrawal management; they can be commenced on methadone immediately. [10]

Unfortunately, it is very common for people who complete withdrawal management to relapse into drug use. It is unrealistic to think that withdrawal management will lead to sustained abstinence. Rather, withdrawal management is an important first step before a patient commences psychosocial treatment. Providing withdrawal management in a way that reduces the discomfort of patients and shows empathy for patients can help to build trust between patients and treatment staff in closed settings, such as an inpatient treatment program.

A trained addiction treatment professional is the best place to start in developing a treatment plan for yourself or a loved one. They can evaluate your needs to determine if methadone is a good medically assisted treatment option and develop a schedule for group therapy, individual therapy, and possibly alternative therapies. Get started on the road to recovery at We Level Up. Contact us today for more treatment information resources and referrals near you.

We Level Up Opioid Addiction Treatment

We Level Up is a trusted treatment center for opioid addiction. Patients in our residential therapy programs here at We Level Up addiction treatment center will live comfortably within the facility during this crucial and fragile time. This supportive environment is designed to give patients 24-hour care for sobriety, removing temptations for relapse and applying an air of recovery into every component of the treatment timeline, including opioid addiction treatment. At We Level Up, we find that when clients are living in a supportive community, especially during their early recovery process, they can truly focus on what matters most: their recovery.

Some of the many modalities applied and practiced within our residential treatment facility are:

Opioid detox at home can be difficult and sometimes unproductive. Unassisted withdrawal may not be life-threatening, but there is a major possibility that it will lead to relapse. When opioid substances such as begin to leave the human blood system, they begin to develop severe cravings for the substance.

Strong cravings mixed with unpleasant flu-like symptoms can make it easy for someone going through withdrawal at home to give up and relapse before their recovery really gets in its way. Without the medical and social support that a detox center offers, it is tempting to abandon withdrawal and start using again. Medications and therapy are accessible at a medical detox center to help reduce the discomfort and simultaneously reduce the risk of relapse compared to detoxing at home.

Medical opioid detox helps smooth the withdrawal process, reduces side effects, prevent serious complications, and lessens opioid cravings. Overall, professional treatment offers a decent start towards recovery and helps to maintain sobriety long-term. Opioid detox has to be followed with counseling, education and awareness, family and individual therapy, and support groups that can aid an individual in their attempt to stop using drugs and continue sobriety.

Above all, we’re passionate about providing the best care and treatment options for clients and their families. Our treatment team is dedicated to giving each and every client the best chance for recovery. We know that finding a trusted addiction and mental health rehabilitation center is a critical part of finding the best treatment options. A great way to weed through to uncover the best recovery programs should include seeking accredited organizations like We Level Up. If you or a loved one is struggling with opioid addiction, you may reach out to us. Our counselors are always ready to answer any of your possible questions. Your call is private and confidential.

Top 10 Is Methadone Addictive? FAQs

  1. Is methadone an opiate?

    Not an opiate but a synthetic opioid agonist used for chronic pain and also for opioid dependence. It is used to treat chronic pain, and it is also used to treat addiction to heroin or other opioids. Opiates refer to natural opioids such as heroin, morphine, and codeine. Opioids refer to all-natural, semisynthetic, and synthetic opioids. Synthetic opioids are substances that are synthesized in a laboratory and that act on the same targets in the brain as natural opioids (e.g., morphine and codeine) to produce analgesic (pain relief) effects.

  2. Does methadone make you high?

    Yes. Being addicted to methadone produces a mild state of relaxation, euphoria, and drowsiness. However, the drug is still an opiate, which means the drug side effects are similar to other drugs in this class, and the potential for dependence and addiction are the same when it’s abused.

  3. How to get off methadone?

    The safest method of quitting is tapering, which involves gradually lowering the dose over time. A taper can aid in preventing uncomfortable withdrawal symptoms and lower the chance of withdrawal-related medical issues.

  4. Can you overdose on methadone?

    Yes. It can cause life-threatening changes in breathing and heart rate. The best way to prevent an overdose is to stop using the drug or any drugs illicitly.

  5. How can I get emergency methadone?

    If you are experiencing a medical emergency due to opioid withdrawal, you should call 911 right away, and not just look for medication. You may need to be transported to a hospital for treatment. If appropriate, emergency methadone can be administered as determined by a healthcare provider for acute withdrawal.

  6. Is methadone meth?

    No. Meth is the short name for methamphetamine. Meth is a potent central nervous system stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity.

  7. Is methadone a narcotic?

    Yes. But it is a synthetic (man-made) narcotic. It is used legally to treat addiction to narcotics and to relieve severe pain, often in individuals who have cancer or terminal illnesses. Although it has been legally available in the United States since 1947, more recently it has emerged as a drug of abuse.

  8. Is methadone heroin?

    No. Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance, known as black tar heroin. Heroin is highly addictive. People who regularly use heroin often develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects. A substance use disorder (SUD) is when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. SUD can range from mild to severe, the most severe form being addiction.

  9. Does methadone rot your teeth?

    Unfortunately, yes. Without proper medical management, like many medications, this narcotic can cause dry mouth (xerostomia). A lack of saliva can make teeth more prone to the production of plaque, a major cause of gum (periodontal) disease and tooth decay. This drug increases cravings for sugary carbonated beverages and food, which can also damage teeth and gums.

  10. Is suboxone the same as methadone?

    No. But research shows that methadone and Suboxone have equal success rates in lowering opiate use. Suboxone, a combination medication containing buprenorphine and naloxone, is one of the main medications used to treat opioid addiction.

Alumni Coordinator, Nicole Baxter’s Methadone Addiction Recovery Journey With Support From Daughter Video

Nicole Baxter’s Addiction Recovery Story and Testimonial Video

“I’m here with the Nicole Baxter, one of our alumni coordinators.

What does your bottom look like?

My bottom was like a spiritual bottom. I was I wanted to die every day. I was putting a lot of drugs in my system every day, trying to make the pain go away. And it wasn’t going away anymore. So I was using for no reason anymore, because when I first started using, that’s what that was for, was to make it all go away. And it was still there. So it was like a spiritual bottom for me. I felt dead inside, and I was looking for a way out. So I prayed really hard that night, and my brother a few days later called me.

How long were you in treatment for?

A long time. I went to detox for almost a month because I was on methadone when I came down here, so my detox was painful when I finally came.

Knowing that I was away from them was hard to deal with because it was like a reality check. It was the hardest part of getting sober.

It was my biggest excuse prior to coming to not like that was my excuse. Like, I can’t go to treatment, I can’t be away my kids, but, like, I wasn’t a mom anyway, so I was getting high every day, you know? And I struggled with telling my daughter the truth about where I was. She thought that I had just comedown here to visit her uncle.

It wasn’t until I was in, like, IOP one afternoon, my therapist had me go outside and make a phone call, and I told her that I had come down for detox. And in my head, I thought that she was gonna hate me. But it was the best conversation ever. All she said to me was, Mummy, I just want you to get better. I’m just happy that you’re getting better.

What is your life like today? In sobriety, in recovery?

I’m happy, sober happier than I was high. And I thought that I’d never be happy sober. I didn’t think it was possible.

What do you do for your recovery every day? I have sponsees that I talk to on a daily basis, so I give back what I was given, which is what I think keeps me sober at most. I go to meetings, I work in treatment. So I’m like hands on with clients all daylong, people that are right where I was. So I try my best to use my story to help them get to a better place.

Oh, yeah.”

Does Addiction Rehab Work?

Longer stays in treatment frequently result in better outcomes, however success can vary from person to person. Detox alone is rarely beneficial for long-term recovery. Does treatment work? Attending treatment increases a person’s chances of long-term recovery compared to not attending.

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Sources

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[2] Durrani M, Bansal K. Methadone. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562216/

[3] Methadone Clinic Regulationhttps://www.cga.ct.gov/2022/rpt/pdf/2022-R-0232.pdf – Office of Legislative Research

[4] TRENDS IN THE USE OF METHADONE, BUPRENORPHINE, AND EXTENDED-RELEASE NALTREXONE AT SUBSTANCE ABUSE TREATMENT FACILITIES: 2003-2015 (UPDATE) – (SAMSHA) Substance Abuse and mental health Services Administration Available from: https://www.samhsa.gov/data/sites/default/files/report_3192/ShortReport-3192.html

[5] Treating Opioid Use Disorder During Pregnancy and Risks of Opioid Misuse During Pregnancy – (NIDA) National Institute on Drug Abuse Available from: https://nida.nih.gov/publications/treating-opioid-use-disorder-during-pregnancy#:~:text=Buprenorphine%20and%20methadone%20have%20both,opioid%20use%20disorder%20during%20pregnancy.&text=While%20NAS%20may%20still%20occur,in%20the%20absence%20of%20treatment.

[6] BUPRENORPHINE – DEA Diversion Control Division Available from: https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf

[7] Moghadam MS, Alavinia M. The effects of gabapentin on methadone based addiction treatment: a randomized controlled trial. Pak J Pharm Sci. 2013 Sep;26(5):985-9. PMID: 24035957. Available from: https://pubmed.ncbi.nlm.nih.gov/24035957/

[8] McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone, and buprenorphine, and other frequently prescribed medications: a review. Am J Addict. 2010 Jan-Feb;19(1):4-16. DOI: 10.1111/j.1521-0391.2009.00005.x. PMID: 20132117; PMCID: PMC3334287. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334287/

[9] Laur DF, Sinkovich J, Betley K. A comparison of intraoperative morphine sulfate and methadone hydrochloride on postoperative visual analog scale pain scores and narcotic requirements. CRNA. 1995 Feb;6(1):21-5. PMID: 7599543. Available from: https://pubmed.ncbi.nlm.nih.gov/7599543/

[10] Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310652/