Stopping methadone can take some time and precision, but never stop your medication abruptly.
Abruptly stopping methadone treatment can lead to significant withdrawal symptoms that result in intense mental and physical discomfort. It is best to taper slowly from a methadone maintenance program to minimize the side effects and potential for relapse.
Your medical provider can provide safe tapering plans for methadone treatment and can help you get started. The process can take weeks and, for some, several months to complete. However, if stopping methadone treatment is your ultimate goal, this tapering process will help.
Why are Safe Tapering Plans for Methadone Treatment Necessary?
Whether you want to end your medication-assisted treatment (MAT) program or switch to a different medication, tapering is important. Safe tapering plans for methadone treatment are highly encouraged due to the nature of the medication. Because methadone is a full opioid agonist, it will cause symptoms of withdrawal when stopped.
Dose reduction is vital for reducing uncomfortable feelings in patients undergoing methadone treatment. Some treatment centers refer to this process as “methadone detox,” but it does not happen like most drug detox procedures. Medical providers who have experience with methadone for over forty years recommend this process.
The gradual medication-assisted tapering of methadone allows patients to continue their recovery planning while they experience safe withdrawal. This dissuades patients from relapsing and prepares them for the next step of their recovery journey.
Best Practices for Methadone Dose Reduction
Determine Dependence
The first thing to determine before creating a tapering program is your level of dependence. This gives your provider a way to gauge how to lessen the amount of methadone you use over time gradually. It is strongly recommended you undergo this process with your medical team.
How dependent or not a person is on methadone is affected by several factors. Not only does the exact amount play a role, but so does the length of time you have been in treatment. If you have been taking methadone for an extended period, you will likely need a longer tapering schedule. Someone who has recently started taking methadone will go through the taper process more quickly.
It is also important to consider how you are taking methadone. There are two different forms — liquid or sublingual or buccal film. Patients ingest methadone orally so the body can metabolize it through the gastrointestinal system.
If methadone enters your bloodstream in a different way, such as through an injection, the medication will metabolize differently. Injecting or misusing methadone can increase your dependence. Be honest with your provider if you are misusing methadone so they can adjust your treatment schedule.
Decrease the Amount
Everybody is different, and factors ranging from genetics to gender will affect how quickly or not methadone leaves the body. Therefore, it is important to talk to your provider about decreasing the amount of methadone you take.
Your tolerance to opioids will also affect how long the tapering process will take. For example, if you are already tolerant to opioids, methadone will likely leave your body quickly. Compared to someone with a much lower tolerance, you have much more opioid resistance built up. In such cases, providers will adjust the amount of methadone accordingly.
Once your provider settles all of these factors, they will lower your dose of methadone at a very controlled rate. This process may take several weeks or even months. Be patient as they decrease the amount of methadone by small percentages depending on how you feel and react. While you may wish to taper more quickly, it is crucial to do so slowly and carefully to monitor any possible side effects.
Reduce Withdrawal Symptoms
The goal of managing methadone withdrawal is to minimize withdrawal symptoms. Whether physical or emotional, uncomfortable withdrawal symptoms during the tapering process can occur. Some symptoms include:
- Anxiety
- Depression
- Insomnia
- Headache
- Nausea
- Muscle aches
Keeping these symptoms to a minimum during tapering will help you remain comfortable. However, it will also help to prevent relapse. Many people who experience withdrawal symptoms will seek out any form of opioid to find comfort.
While careful monitoring will help reduce these symptoms, other wellness factors can help. Try to maintain a balanced diet, exercise regularly and drink plenty of water. Communicate openly with your recovery team about how you are feeling.
Sample Methadone Taper Schedule
If you are ready to taper off of methadone, speak with your provider. Customized tapering schedules are always a priority. This is a general example of what your dosage taper schedule may look like if you are taking 60mg regularly. This general protocol will help prevent the discomfort of withdrawal and make the transition smooth and painless.
- Most commonly, your dose will decrease by 10mg every one to three weeks, as long as you are comfortable.
- This decrease in dosage will continue until your rate is at 40mg.
- Once you feel comfortable at 40mg of methadone, your dose will drop by two to five milligrams.
- This continues over the following weeks until you are comfortable at a baseline of zero milligrams of methadone.
Some people take 120mg regularly, which means this process can take upwards of three months to complete. However, this sample is only an example; your provider will give you more insight into your specific case and dosage.
If you are preparing to stop all medication-assisted treatment, it is vital to make plans for the longevity of your recovery. Continue with substance use treatment and use all of the tools you have learned to deal with potential triggers and hardships. If you decide that you are not quite ready to graduate from your MAT program, contact your provider immediately.
There is no shame in continuing your medication-assisted treatment. If you are not quite ready to be without medication, you can try something other than methadone. Your provider can speak with you about the options available.
Talk to a specialist at BAART Programs about our Safe Tapering Plans for Methadone Treatment
BAART Programs offers MAT withdrawal strategies for patients looking to end their treatment or switch medications. Our specialized team understands the nature of addiction and how to treat substance use disorder.
To learn more about BAART’s MAT programs with methadone, contact our team with questions.
