Methadone is both a treatment for opioid addiction and, for some people, a drug they need help stopping. Whether you are on methadone maintenance and want to come off it, have become dependent on methadone prescribed for pain, or have been misusing methadone from other sources, treatment is available and it works best when it is slow, supervised and paired with support. This guide explains how methadone dependence and addiction are treated, what a taper involves, when inpatient detox makes sense, what it costs and how to choose a program. To start now, verify your insurance or see our treatment centers.
First, an Honest Word About Methadone Maintenance
Methadone maintenance is one of the most effective treatments for opioid use disorder; it reduces illicit opioid use, overdose deaths and infectious disease, and many people stay on it for years with stable lives. Wanting to stop methadone is a legitimate goal, but it should be a decision made with a physician rather than a reaction to stigma. If you are stable on methadone, staying on it is a valid choice. If you want to taper, the safest route is a gradual, medically managed reduction, sometimes with a transition to buprenorphine or naltrexone.
Signs Methadone Use Has Become a Problem
- Using methadone obtained outside a licensed program, or taking more than prescribed
- Combining methadone with benzodiazepines, alcohol or other sedatives, which sharply raises overdose risk
- Sedation, slowed breathing or a previous overdose
- Using methadone for its effect rather than for pain or stabilization
- Withdrawal symptoms when doses are missed and inability to cut back
Our methadone self-assessment can help you organize your thoughts before talking to a professional.
Why Methadone Withdrawal Is Different
Methadone is long-acting, so withdrawal begins later than with other opioids (often 24 to 36 hours or more after the last dose) and lasts longer, sometimes two to three weeks of acute symptoms followed by weeks of lower-grade fatigue, insomnia and cravings. Symptoms include muscle aches, sweating, chills, anxiety, nausea, vomiting, diarrhea and restlessness. Withdrawal is rarely life-threatening, but the length of it, and the drop in tolerance that follows, make unsupervised attempts risky. See the methadone withdrawal timeline.
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How Methadone Dependence Is Treated
Slow, supervised taper
The most common approach for people coming off maintenance is a gradual reduction, typically small decrements every one to two weeks, adjusted to how the person feels. Slower tapers have better completion rates. The taper can happen in the opioid treatment program, in outpatient care, or in an inpatient setting when a faster, more supported reduction is needed.
Medical detox
For people misusing methadone, using it with other substances, or unable to taper as outpatients, inpatient medical detox provides 24-hour monitoring and symptom relief (such as clonidine, anti-nausea and sleep medications) while the dose is reduced. Because of methadone’s long half-life, inpatient detox tends to take longer than detox from other opioids.
Transition to buprenorphine or naltrexone
Some people switch from methadone to buprenorphine, a partial agonist with a better safety profile and more flexible dosing. This requires lowering the methadone dose first and carefully timing the switch to avoid precipitated withdrawal, so it is done under physician supervision. Others complete withdrawal and start extended-release naltrexone, an opioid blocker, after an opioid-free period. Read about medication options for opioid use disorder.
Inpatient or residential rehab
Living at the facility for about 30 to 90 days with daily therapy, medical and psychiatric care and skills work. Recommended when methadone misuse is part of broader polysubstance use, after a previous overdose, or when depression, anxiety or PTSD needs intensive treatment. Compare inpatient vs. outpatient rehab.
Outpatient care and aftercare
Partial hospitalization, intensive outpatient and standard outpatient care with ongoing medication management, alumni support and a written relapse prevention plan.
Therapy Alongside the Taper
Cognitive behavioral therapy, contingency management, motivational interviewing and group and family therapy address the habits, stressors and relationships tied to opioid use. Co-occurring depression, anxiety and PTSD are treated at the same time, and chronic pain, when present, gets a non-opioid plan developed with your medical providers.
How Long Does It Take?
Longer than most people expect. A comfortable methadone taper often takes months, inpatient detox from methadone commonly takes longer than a week, and post-acute symptoms can persist for weeks afterward. The National Institute on Drug Abuse notes that treatment participation of less than 90 days is of limited effectiveness for most people, and ongoing support through the first year matters.
Cost and Insurance
Substance use treatment is an essential health benefit under the Affordable Care Act, and federal parity law requires plans to cover it comparably to medical care. Most commercial plans, Medicaid and Medicare cover detox, medication treatment, inpatient and outpatient care; what you pay depends on your plan and network. Our admissions team will verify your benefits free of charge and explain private-pay options. If you have no insurance, see our guide to rehab without insurance.
How to Choose a Program for Methadone Dependence
- Physicians experienced with methadone tapers and buprenorphine transitions
- 24-hour nursing during inpatient detox
- Willingness to discuss staying on maintenance as an option, not only stopping
- Psychiatric care for co-occurring conditions and a plan for chronic pain
- A full continuum of care within one provider
- Accreditation (Joint Commission or CARF) and state licensure
See our guide to finding the right rehab.
Methadone Treatment at The Recovery Village and Promises
Our centers provide medically supervised methadone detox and tapering, transitions to buprenorphine or naltrexone when appropriate, inpatient and residential rehab, partial hospitalization, intensive outpatient care and aftercare, with psychiatric care for co-occurring conditions. Find a center in Georgia, Florida, Texas, Pennsylvania, Tennessee, Colorado, Washington, Oregon, Missouri, Indiana, Ohio, New Jersey, Maryland or Massachusetts, or see all locations.
Frequently Asked Questions
Is methadone addictive?
Methadone causes physical dependence, which is expected with maintenance treatment and is not the same as addiction. Addiction involves loss of control and use despite harm, which can occur when methadone is misused.
How long does methadone detox take?
Inpatient detox often takes one to three weeks because of methadone’s long half-life; outpatient tapers typically take months.
Can I switch from methadone to Suboxone?
Often, yes, but the methadone dose must be lowered first and the switch timed carefully to avoid precipitated withdrawal. It should be done under physician supervision.
Does insurance cover methadone detox and rehab?
Most plans do. Verify your coverage in minutes.
