Methadone Withdrawals: Methadone Symptoms & Side Effects

Question: Is it possible to have methadone withdrawals after just 6 or 7 hours? please please help!?

(Posted by: on 2010-03-24 13:14:00)

PLEASE, FIRST OF ALL, ONLY EXPERIENCED PEOPLE OR DOCTORS OR COUNSELORS ANSWER MY QUESTION...THE LAST TIME I GOT A BUNCH OF KIDS TELLING ME TO GO THE EMERGENCY ROOM AND IT MADE NO SENSE AT ALL! here is my story...I have been going to a methadone clinic since dec 2, 1009. they started me out on 30mg and every 2 days you can go up 5mg, so I did and when you get to 60mg you can go up every 7- 10 days 10mg. Its now late March and I am on 120mg of LIQUID methadone..(not the Wafers). HERE IS MY QUESTION: Over the past 2 days about 6 or 7 hours after I have dosed I start feeling aches and pains, hot and cold chills and today I have a mild fever. it hurts really bad to go up and down stairs, ...basically it feels like I'm having withdrawals....BUT WHY? I thought with methadone you are suppose to not go through withdrawals for about 24 to 48 hours...I have only had the flu once, so I dont remember really what its like to have the flu ....or a very bad cold for that matter...so do you guys think I am coming down with something or going through withdrawals for some reason? My husband said he quit going to the methadone clinic because thats what was going on with him (this was before we knew each other) but he took alot of amphetamines, so his metabolism was fast...all i know is I've been doing everything right, I AM NOT doing any other opiates or anything..PLEASE ANY INFO WOULD HELP SO MUCH....ive been on 120mg for about 3 weeks and i cannot go up any more because the state law now says if you take benzo's (which i do, i take klonipin) you cannot go any higher than that and that was fine with me anyway. please help! I forgot to mention, and "Thank You " to the girl that responded first to me by the way :) ...actually I didnt mention, I am an addict AND a chronic pain patient. (that is why I am on a high dose)...and I have been persribed my klonipin for over 14 years, so I know alot about them, and I really really wish that could of been the answer to my problems, but actuaally I dont take my klonipin every day...so I dont think that is my reason anyway...BUT, thank you SO much for your advice!! I was addicted to Dilaudid and Oxycontin from surgery after surgery and ER visits from Chronic endometriosis..Last year I had both ovaries and fallopian tubes removed, but I still had alot of pain..and addiction so thats why I started going to the methadone clinic. I have tried Suboxone, but it didnt help for my pain...however if it's the methadone causing me to go into withdrawls after such a short amount of time I WILL go back to the Suboxone! again to the person that wrote to me first, thanks so much!

Posted by: mrmichael on 2010-03-25, 17:17:20

It is absolutely untrue 120mg is a high dose and something that could cause you to od except in the case of an opioid naive person. From what you write, it does sound like you MAY be coming down with something. Prior to the symptoms, how did you feel? Was the dose holding you? Were you craving at all? Sleeping? If it was holding you for a full 24 and you felt comfortable when dosing the next day, then I would be inclined to lean towards it being a cold or something. On the other hand, if you weren't feeling great and really needed your dose come morning the whole time on 120mg, then I would say you are having wd symptoms. Methadone will hold you for as long as you said....24 to 48 hours when you hit your optimal dose. It won't hold you if you don't take enough as related to your tolerance. The therapeutic range is generally 70mg to 120mg, but that is just an average. Of course, some need less and some need more depending on the circumstances. And, pain and addiction together isn't the same as dosing an addict and a pain patient as separate entities. A lot of clinics don't realize pain must be treated as well as the addiction. Pain causes people to take supplemental opioids. That's just a natural survival instinct. So, pain could easily stand in the way of successful methadone treatment for the addict and should be one of the main points of treatment over all. Over the past two days, did you instantly feel better after you dosed? You know, after a half hour to an hour later? If so, then I would point towards wd. In that case, you would need an increase. I am also an addict/ chronic pain patient and am prescribed methadone for my pain at 110mg a day. I used to host a forum and have done a lot of research on the subject and have counseled others through detox and everyday stuff pertaining to the subject.....depression and such. Though I am not a doctor, I do consider myself to be qualified to answer your post. You asked for good info and should get it. I hope my post helps you.

Posted by: Peaches (The Original) on 2010-03-24, 14:10:28

OK. I have experience with Methadone, although it was used for Pain Management. First of all, 120 mg's per day is EXTREMELY high! I can not believe that a doctor would put you at risk of an overdose by allowing you to take this much medication. It is very potent and, as you said before, has a very long half life. For these two reasons, most people who are using this to remain off other opiates never exceed 60 mg's per day, and that is usually reserved for hard core heroin addicts. But, I do have a pretty good idea why you are experiencing withdrawal symptoms. Benzo's act on the same receptors as opiates. When you take a benzo, it knocks the opiate off and takes its place, sending you into withdrawal symptoms. Also, not sure why your doctor has you on benzo's in addition to the methadone. These two medications are contra-indicated. They both severely depress the Central Nervous System which controls breathing and heart rate. Used together, it is not unheard of for a patient's heart rate to drop into the 30's at night! Or stop all together. I respect your desire to remain off what ever other drugs you were using prior to seeking treatment with methadone. If you have insurance, you should check into seeing a doctor that has the ability to prescribe Suboxone for the management of cravings and withdrawal. It works well, has a long half life, and if you have insurance, it is a cheap drug. There is also very little possibility for addiction or abuse. This is because there is a 2nd drug in the Suboxone called Naloxone. It is ineffective when dissolved under the tongue, but when it is crushed and snorted or injected, the naloxone kicks in, sends the person into withdrawals and effectively blocks the high that straight Subutex allows. Please, if you can, see another doctor. Or at least find another Methadone clinic. Also, there are other medications that can be used for anxiety that are not in the benzo family that are just as effective and do not interact with methadone. You need to do some research and start asking a lot of questions. ***First of all, to the second poster, the maximum daily dose of methadone is 325 mg's. 1,000 mg's would kill an elephant. This is per the Journal of the American Medical Association. To the poster, since you are not taking the Klonipin daily, that is definitely not the issue. I doubt you are having withdrawals from the methadone, even if you have developed a tolerance to the drug. You may just be getting sick and should see your primary care doctor to have some blood drawn for a white blood cell count. A sinus infection, the flu, or a bad spring cold could be the culprit. And if this is the case, a round of antibiotics should fix the problem. Of course if he says you are not sick you should contact the clinic and let them know what your symptoms are. I know that Suboxone is no good for pain! Some studies say it is, but my PM doc said it was ineffective, and I experienced a huge increase in pain when I used this to come off my opiate regimen. I only used it for a 14 day taper, but I still experienced pain and some moderate physical withdrawals that lasted about 2 weeks. After that, all I had was pain in my cervical spine caused from a car accident which herniated my C5-C6 and C6-C7. These herniated discs have also caused degeneration to start at C7-C8 from the pressure of the other two injuries. I will have it fixed via surgery as soon as I can save up the money to pay 20% of the surgical bill and the hospital stay co-pay! My insurance sucks! I do feel for you. I know how hard it is to have chronic pain. When I used the Methadone it worked great. The problem for me was I had an allergic reaction and within a week was swelled up larger than the Good Year Blimp in my legs, arms, and face! It took more than a week for that to go away. The only other thing I can tell you is that if you should ever decide to come off the methadone, it has some very nasty and long lasting withdrawals. You can do some research online and find more information about this. This is because the drug builds up in your system with each dose you take since it has a 24-36 hour half life. So basically if you are taking 120 mg's, and then take 120 the next day, you effectively have 180 mg's in your system. Make sense? If you can, try seeing a PM doctor since they can prescribe methadone and know so much more about it! They can make sure you are on a safe and effective dosage. I hope this additional info has been helpful.

Posted by: emmeline on 2010-03-25, 00:00:12

It is UTTERLY untrue that your dose is "extremely high ". I don't mean to be rude to the other poster but this is dangerously false misinformation she is giving out. The average dose for most methadone pts is 80-120 mgs per day, with many needing even more. It all depends on your tolerance, your metabolism, and other factors as well. People taking methadone for addiction can be on doses from 20 mgs to 1,000 mgs and you would never know the difference between them if you spent an hour in the room with them both, due to tolerance. The fact that you are feeling the way you do indicates you may need a dose increase or that you may require a split dose ( half in the am and half in the PM). The clinic can do a peak and trough test to see if you are a rapid metabolizer. You should feel comfortable for a full 24 hours on your medication.

Posted by: ruthiepoo on 2010-03-26, 02:25:31

I am a methadone pt and have been for over 10 years. I also work at and help run several methadone advocate/ methadone info websites and forums. I am also a certified methadone advocate so I do know quite a bit about methadone. 120mg is not a high dose for an opiate tolerant person. Each person metablolizes methadone differently. I agree with the poster that you need to speak to your clinic and that split dosing may help. ALSO, something to think about, people with liver probs such a hepatitis and people who take certain other medications like anti seizure meds and some anti anxiety meds will cause you to metabolize the methadone faster. You may want to check and make sure you don't have some underlying illness that you don't know about and evaluate all medications you are taking in addiction to methadone. One other thing too, I don't know HOW much real truth there is to this, but I know alot of people say they feel they go through their dose faster if they are on the liquid versus the wafers that are dissolved in water. I do know that the different fillers and binders in each med can have an effect on how you metabolize it and that the liquid does seem to act quicker, but not last as long and the wafers take a little longer to act but last a little longer. You definately need to speak to your clinic about this. They are the ones that ulitmately have the contol over increasing your dose so it's important to have them document what is going on with you and there may be other things they can try first without increasing your dose (again, split dosing and such) What state do you live in? I have never heard of a law that says you can't go over 120mg if you are on benzos, and again, I stay up to date on the laws and the changes in the law where methadone is concerned because of our website. I know they are less likely to go up on the dose if you are on benzos (because it can be toxic and cause death )and may require you to do a peak and trough test before increasing, but there is no such "law " that prohibits them from increasing over 120mg if you are on benzos. It is also very dangerous to take benzos and methadone and a lot of clinics say no benzos at all. I know this isn't what benzo users want to hear, but I agree with the no benzos at all rule. I feel like if you take benzos and are on MMT, then you could transfer your addiction to the benzos. The whole purpose of MMT is to get us to be stable and not use medications to mask our emotions and feelings and that is exactly what benzos do. They help ease stress when you are upset and "stressing " about something, therefore you take a medication to mask your feelings. IMO true recovery is going through those feelings, emotions and stresses without any medicinal help, but that is just my opinion so those who disagree please don't start bashing me about my opinion. Again, SPEAK TO YOUR CLINIC and let them know what is going on with you and your dose. Don't take this into your own hands and try to fix it.