How Long Does Methadone Withdrawal Effects Stay?

Posted on Tue, 13 May 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 13 May 2014 Answered on

Mon, 9 Jun 2014 Last reviewed on

Question : Hi. I just started Suboxone today. I have been on methadone for about 11 years. I was at 90mg. for years. I tapered down to 25mg. and held that dose for about 2 years, and today I made the switch. The Dr. started me at 8mg. Every 30-45 minutes I increased by 2mg., until I got to 16mg. total. I feel better than the withdraws, but still not great. My question is how long will it take for me to feel right again?

Answered by Dr. Rohit Gulati (32 minutes later)

Brief Answer:
this takes 2-3 days

Detailed Answer:
Hi,

Thanks for your query.

The " not feeling right" feel comes from the effect of Naloxone, that is a part of this medicine due to the effect at cellular level. This takes usually 2-3 days for the complete effect of naloxone to take away the methadone that is bond at cellular level. But in some patients with hypothyroidism or slow metabolisers this may take some more time say upto 7 days.

Hope this answers your doubt. Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rohit Gulati (23 hours later)

Will I be able to accurately assess my dosage during this few days of adjusting from the methadone to the suboxone? I was at 16 mg. the first day, but my doctor said I could add another 2 mg. if I thought I needed it, which I did today (2nd day). Maybe I should have given the 16 mg. more time. Does there come a time when the larger amount doesn't really make a difference? Is there a "top out" dose for soboxone?

Answered by Dr. Rohit Gulati (3 hours later)

Brief Answer:
yes, usually it settles by third day

Detailed Answer:
Hi, usually the dose adjustment by 2 mg increase settles by third day. The dose that you are taking on the third day if it's sufficient for the pain relief, usually will be dose you ll need for a long time.

Yes, your doubt is correct that there comes a time when increasing dose does not relieve pain any further. This is known as opioid tolerance. To avoid this you need to rotate opioids with non opioid drugs like aceclofenac and acetaminophen.

There is nothing like a 'top up' for suboxane. You need to rotate the drugs after say 6 months of continuous treatment with one drug.

Hope I answered your question.

Regards

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Above answer was peer-reviewed by : Dr. Prasad