I. The Basics of Methadone Rehabilitation

This guide was written to provide an overview of the methadone rehabilitation process as well as to offer helpful resources for persons recovering from methadone addiction.

Each individual’s path through methadone rehab is unique, and where your path might begin depends on factors such as your history of drug use, how you became addicted to methadone, and other personal and health circumstances. For example, someone who became dependent on methadone while completing rehab for heroin use might require a different treatment path than someone who became addicted to methadone after taking it as a prescription opioid pain reliever or using it recreationally without other drug involvement.

Regardless of your path, options common to methadone addiction treatment include detoxification, which helps your body rid itself of the drug and work through the withdrawal period, as well as behavioral therapy and social support. During therapy, which can take place in inpatient and outpatient settings, you work with professionals to identify root causes for methadone abuse and develop positive thought processes and coping mechanisms to replace negative ones. Aftercare, which might include individual counseling, group therapy, and regular checkups with your medical professional, typically provides ongoing support for recovery after you’re discharged from any treatment program.

the four steps of rehab process

II. What Makes Methadone Rehabilitation Difficult?

One of the biggest challenges when facing a methadone addiction is that methadone is also a drug used to treat addiction. Methadone is considered an agonist medication, which means it counters the effect of other opioids in your body. Individuals who are taking methadone don’t experience a euphoric high if they take heroin. While it’s considered safe when taken as prescribed, methadone does have sedative effects that can create euphoria if abused, and individuals can become physically dependent. Methadone is also a long-acting opioid, which means it stays in the system longer. It can also create longer-lasting withdrawal periods.

If you become dependent on the medication that hundreds of thousands of programs use to treat opioid addiction, it may seem like your options are limited. Luckily, that’s not true, and if you’re struggling to quit using methadone, talking to your medical provider or a rehab professional can help you understand choices for treatment.

The Unique Struggle of Methadone Addicts
Methadone…
  • is used in the treatment of opioid addiction but is a synthetic opioid with its own addictive properties.
  • is highly addictive, just behind illicit drugs such as cocaine and heroin in expert ratings of risks for physical dependence.
  • creates a sedative effect that can become euphoric when it is abused.
  • may be prescribed for the treatment of other addictions or as a pain reliever, which can cause someone to become dependent even if they aren’t abusing the drug.
  • is a long-acting opioid, which means withdrawal symptoms can last as long as 20 days.

Methadone Rehabilitation Statistics

The Substance Abuse and Mental Health Services Administration estimated that:

  • In 2017, around 0.1% of Americans age 12 and older abused methadone within the past year.
  • The abuse of opioid pain relievers was highest among individuals age 18 to 25, with around 7.1% of individuals in that age range reporting pain reliever misuse in 2016.
  • In 2016, around 8% of individuals age 12 and older in the nation sought treatment for addiction to opiates other than heroin. That includes prescription opioids such as methadone.

Opiates Other Than Heroin Treatment Admissions by Gender

52.7% Male
47.3% Female

Demographics of Individuals Seeking Treatment for Methadone Addiction

According to a 2017 SAMHSA report that charts admissions to and discharges from publicly funded substance use treatment facilities, men are slightly more likely to seek treatment for opioid abuse other than heroin, which includes methadone. The gender breakdown of treatment admissions for opiates other than heroin was 52.7% male and 47.3% female. While methadone addiction occurs in all age groups, the most common age group admitted to a treatment facility for methadone abuse was individuals aged 25 to 34, with 35 being the average age of all individuals from all age groups who are seeking rehabilitation.

Opiates Other Than Heroin Treatment Admissions Percentages by Age Group, 2017
Age at the Time of Treatment Admission Percentage of Opiate Treatment Admissions
12-17 0.4%
18-24 10.4%
25 – 34 44.9%
35 – 44 25.4%
45-54 12.1%
55-64 5.9%
65+ 0.9%

III. Methadone Detoxification & Withdrawal Process

Detoxification occurs when you stop using methadone and allow the drug to fully leave your system. If your body has become dependent on methadone because you’ve been taking it for a long time or have been taking more than you were prescribed, withdrawal symptoms may occur during detox. Your body has become used to having methadone in its system and has taken this to be the new normal; withdrawal symptoms are your body’s way of alerting you that the “normal state” is being disrupted.

Withdrawal symptoms for methadone typically start within 12 hours to two days of the last time you used the substance. That’s in contrast to withdrawal symptoms for short-acting opioids, which typically start much sooner. The counter is that methadone withdrawal symptoms can last for several weeks, though they typically peak within the first week or two.

Withdrawal Symptoms

Body Mind
Short-Term Symptoms Muscle aches
Runny nose
Sweating
Yawning
Difficulty sleeping
Agitation
Anxiety
Long-Term Symptoms Stomach discomfort or cramping
Dilated pupils
Nausea and vomiting
Diarrhea
Anxiety
Depression
Cravings

Untreated methadone withdrawal symptoms can lead to dehydration

Methadone withdrawal symptoms can be flu-like in nature and include distress of the digestive system. Without interventions, the vomiting and diarrhea that may accompany withdrawal can cause dehydration, which can lead to additional physical complications, as well as a lack of energy that fosters some of the mental side effects.

Methadone withdrawal can drive someone to return to drug abuse

As with all opioids, methadone’s withdrawal cycle can be enough to drive individuals back to using the drug again, especially if they’re trying to quit on their own. In cases in which someone can’t take methadone, they may turn to other opioids, including heroin, to alleviate the withdrawal symptoms.

Methadone Detoxification Medications

Methadone itself is a detoxification medication, so some treatment approaches look at slowly tapering off methadone use within a controlled inpatient environment. For example, an individual might be transitioned to other detoxification medications, such as buprenorphine. According to the American Society of Addiction Medicine, if a user can reduce his or her intake of methadone to 30 to 40 mg a day or less via tapering, it may be possible to transition to buprenorphine to continue managing the detox process. If someone is completely withdrawn from methadone, naltrexone may be an option for treatment.

For more information about withdrawal, read our guide on methadone addiction.

IV. Treatment for Methadone Addiction

Information published by the U.S. National Library of Medicine notes that medication-assisted therapy is a common option for treatment of opioid addiction. It’s meant to provide holistic treatment, tending to the physical, mental, and emotional needs of the addict. While medication can help with withdrawal symptoms and may stave off cravings and make it easier to quit using drugs, behavioral therapies in either an inpatient or outpatient setting help to develop healthier coping mechanisms and understand addiction so you have a greater chance at remaining free of drug use in the future.

Rehabilitation Settings

Within either an inpatient or outpatient setting, options such as detoxification services, behavioral therapies, and medication-assisted treatments are offered for varying lengths of time.

Inpatient treatment involves living full-time (including overnight) at a treatment facility for a set period of time. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Methadone Treatment Programs
Setting Type of Treatment Description Duration Time Commitment
Inpatient Short-Term Residential Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

24

Days Per Week:

7

Long-Term Residential Intensive treatment in a non-hospital setting, most often a therapeutic community with other patients. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-12 months Hours Per Day:

24

Days Per Week:

7

Partial Hospitalization Intensive treatment in a hospital setting. Patients do not stay overnight. Considered inpatient due to the hospital setting. Extensive services are provided and require a near full-time commitment every week. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

6-8

Days Per Week:

5

Outpatient Intensive Day Treatment Extensive services of an inpatient program but patients return home each day following treatment. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-4 months Hours Per Day:

2-4

Days Per Week:

3

Counseling Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medication-assisted treatment is not available. As long as desired Hours Per Day:

1-2

Days Per Week:

1-3

Support Groups Support groups center on maintaining abstinence after another form of treatment. Typically meet one day a week for 1-2 hours. As long as desired Hours Per Day:

1-2

Days Per Week:

1

Behavioral and Medication-Assisted Therapies

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to use and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and, thus, unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

Behavioral Therapies for Methadone Addiction
Type of Therapy Definition
Cognitive Behavioral Therapy

 

Further reading:

Cognitive behavioral therapy can be combined with many other approaches, including motivational incentives, abstinence, and medical-assisted therapy. It works by leading people to explore the root causes — emotional, environmental, and otherwise — behind drug abuse so they can identify the thought processes and habits that contribute to substance use. These are known as triggers.

 

CBT also works to help individuals develop healthier coping mechanisms and practice using them so they can respond to triggers in positive ways that support sobriety.

Contingency Management Interventions/Motivational Incentives

 

Further reading:

Contingency management provides positive motivations for abstinent behaviors, rewarding individuals for staying clean and maintaining treatment, such as attending therapy sessions as scheduled. These work best in inpatient or residential settings, where individuals can be rewarded with prizes or privileges.
12-Step Facilitation Therapy

 

Further reading:

Because someone may have become dependent on methadone while being treated for another addiction, abstinence-based programs might be a good option to consider. Abstinence-based programs are often based on 12-step program models and place an emphasis on staying clean of all substances.
Medication-Assisted Therapies for Methadone Addiction
Type of Therapy Definition
Buprenorphine

 

Further reading:

Buprenorphine is a medication approved by the FDA to treat opioid misuse disorder. It helps reduce withdrawal symptoms and counteracts the impact of opioids on the system.
Naltrexone

 

Further reading:

Naltrexone doesn’t treat withdrawal symptoms, but it does counteract the impact of opioids in the system. It’s typically used more often as a maintenance medication to help someone stay off opioids than as an immediate treatment option during the withdrawal period.

V. How to Find Help

Finding a Rehabilitation Center for Methadone Addiction

When looking for a rehab center for methadone addiction, consider looking for one that offers a detoxification program. Even if your providers determine that you shouldn’t remain on detox medications such as methadone or buprenorphine long-term, they may be able to offer you assistance in tapering off the drugs. Having clinical professionals on hand also makes it possible for addicts to treat various symptoms of withdrawal, such as nausea, to make the process less uncomfortable.

Rehab centers that combine medical approaches with options such as cognitive behavioral therapy help you address a holistic recovery and develop plans and skills to support your sobriety in the future. Methadone addiction may be treated in either inpatient or outpatient settings, and which one is right for you will depend on individual factors. However, continuing with treatment such as individual therapy or support group meetings after you’re discharged from any rehab can ensure you’re provided with ongoing support during long-term recovery.

Our Directory

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.