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Methadone Rehab Treatment: What Should I Expect?

The synthetic opiate methadone, created in Germany in 1939, has been widely used in medical heroin detox since the 1970s. Because a dose of methadone satisfies opiate-effects cravings for 24–36 hours, with less risk of overdose or dangerous behavior, it’s still widely considered a safe substitute. Taking just one small geographic area as an example, a Google search for “Riverside treatment center methadone,” “Riverside rehabilitation center methadone” or “Riverside recovery methadone” yields thousands of results.

However, those results also comprise services for people trying to get off methadone. While the drug is considered less dangerous than heroin, it’s hardly harmless. Known cases of addiction existed half a century before the current prescription-opioid epidemic. And since 2001, fatalities from overdose, withdrawal and tainted illicit doses have soared. When it comes to withdrawal, methadone can be more dangerous than heroin: of the common opiates, methadone is the most likely to cause seizures, heart failure or stoppage of breathing when quit “cold turkey” after being taken in high doses for long periods. (Alongside benzodiazepines and alcohol, detox program experts rank methadone among the most dangerous substances to “just stop.”)

Fortunately, professional methadone detox centers are available, including several Riverside treatment centers and many others throughout southern California. With proper care, it’s possible to withdraw with minimal risk and go on to live a life free from methadone and other opioids.

(Note to any readers looking into heroin rehab: while you don’t necessarily have to discount a program because it uses methadone in treatment, do take time to thoroughly question the center on its methadone philosophy. As with many a prescription drug, fewer addictions would develop if patients and doctors took time to explore the original problem and plan ways to use the drug temporarily in conjunction with other options, rather than just “throwing a pill at it.”)

If you’re ready, here’s a summary of what you can expect in methadone rehab:

1. Expect to provide full details on your drug-use history and overall health.

Yes, it can be embarrassing to admit you “quit” heroin cold turkey four times, relapsed four times, and then went outside official prescription instructions with methadone treatment—but that information may be essential for the treatment center to plan not only how they’ll care for you during physical detox, but how they’ll counsel you during the long-term recovery period. And remember you’re speaking confidentially in a medical setting, not announcing anything on national television or social media.

Don’t think the conversation has to be one-sided, either. Interview detox centers before committing yourself, and ask them what treatment approach they use, who you’ll be working with, what withdrawal symptoms you may experience and what follow-up will be like.

 2. Expect to be kept under medical observation.

During initial withdrawal, center staff will check on you regularly, and a medical professional will stay ready to respond in case of dangerous symptoms. If you feel extremely nauseated, experience difficulty breathing or notice potential indicators of an oncoming seizure (sudden intense headache, seeing lights before your eyes, disorientation, uncontrollable stiffening of muscles), don’t wait for your care providers to notice—call for help immediately.

Depending on your detox center’s treatment approach, a doctor may also measure gradually reduced methadone doses to wean your body off dependence, or may give you a sedative to ease the first round of withdrawal symptoms. Understand and discuss such possibilities—and their alternatives—before agreeing to be admitted to the center. Especially if your methadone addiction developed from treatment for another addiction, you may prefer a clinic that does not use drugs to treat drugs. Best bet in any case: an emphasis on treatment plans structured according to specific individual needs.

3. Expect physical detox to take longer than for many addictive drugs.

Despite potential life-threatening dangers as noted above, it’s quite possible you will get no sicker than with a moderate case of the flu—but that it will seem to last forever. The dark side of methadone’s longer-lasting physical effects (which, in heroin detox, make it easier to space doses so heroin cravings won’t get the chance to return) is that the acute-withdrawal period is also extended—it can literally take weeks before cravings subside completely, though thankfully the worst of withdrawal lasts for a much shorter period. The period of intense initial symptoms usually takes 8­–10 days (vs. 4–7 days for heroin).

Besides the serious symptoms already noted, you may experience chills, fever, pounding heart, muscle pains, runny nose, mental confusion, hallucinations or unprovoked fear and anger. After the acute period subsides, an overshadowing depression, combined with emotional longing for methadone, can persist for a week or two before becoming intermittent and eventually fading.

4. Expect a long post-physical-detox period of intensive coaching and therapy.

Many longtime users report that while methadone may not make you walk around in a perpetual daze, it “numbs” you and diminishes initiative and self-respect. Once you’ve gotten out of practice, it takes some work to rediscover the skill of paying attention to your dreams and planning for your future. Responsible methadone detox centers provide licensed therapists who work with you there and also help uncover preexisting self-esteem/confidence issues that may have contributed to your becoming addicted.

5. Expect to stay in treatment a while before transitioning back to everyday life.

Typically, full preparation to return to the “real world” takes several months. Make good use of that time by cooperating with treatment staff, letting your body recuperate and getting to know your real self.

If you doubt that inpatient treatment would be practical in your financial or work situation, consider that since the recurrent-cravings period is particularly long for methadone, you’ll be at special risk of relapse without ongoing supervision. If you still think outpatient treatment would be your best option, look for a program specifically labeled “intensive outpatient,” enlist every possible means of constant support from friends and family, and plan on at least taking a couple of weeks off work and getting extra bed rest. (Your local Narcotics Anonymous chapter can provide additional tips.)

If you developed methadone addiction as the result of an earlier addiction treatment, you already know that demanding quick solutions can generate new problems. So, here are two final “what to expect” tips: expect real recovery to require hard work and determination. And expect that as your self-confidence grows, you’ll be glad you chose that path!

Inland Detox is the top Los Angeles/Riverside rehabilitation center and also serves the rest of southern California. (We’re less than 50 miles south from Riverside, with recovery facilities in the scenic Temecula Valley.) If you or a loved one are struggling with methadone addiction—or need a heroin, general-opiate, benzodiazepine, cocaine, methamphetamine or alcohol detox program—please call (888) 739-8296 to learn how we can help.