What is the Methadone Detox Protocol?

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Anyone who’s abused opiates for two weeks or longer well knows how these drugs can gradually take over a person’s ability to limit or stop further drug use. These drug effects only grow stronger the longer a person keeps using. By the time a person enters drug treatment, it’s likely addiction has taken hold.

People entering opiate addiction treatment undergo detox as a first stage in the recovery process. Methadone detox exists as one of a handful of detox treatment approaches.

Methadone detox works best for people coming off long-term and/or chronic addiction problems. Long-term addiction leaves the brain and body unable to function normally for months and sometimes years after a person stops using. Likewise, the degree of withdrawal symptoms experienced during detox can be especially severe. Methadone’s therapeutic effects do a good job at relieving withdrawal discomfort.

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methadone uses

Methadone is used during opiate detox to mitigate withdrawal symptoms and prevent cravings.

As methadone exists as a heavily regulated drug, the methadone detox protocol dictates how physicians should administer methadone during detox treatment. According to the U. S. National Library of Medicine, the methadone detox protocol provides guidelines for:

  • Assessing a person’s condition
  • Initial dosing procedures
  • Dosage adjustments
  • Tapering

In effect, methadone detox protocols work to ensure patient safety while giving a person the best chance at making it through the detox withdrawal stage.

Effects from Long-Term Opiate Abuse

Long-term abuse creates both a physical and psychological dependency that makes it all but impossible for a person to stop using on his or her own. For many addicts, the excruciating discomfort associated with withdrawal becomes the number one reason why they keep using. Long-time addicts well know the discomfort that comes with withdrawal as withdrawal effects become an ongoing part of the addiction cycle.

According to the National Center for Biotechnology Information, opiates depress brain and central nervous system activity by interfering with normal brain chemical activities. Over time, these effects alter the chemical processes that regulate brain and central nervous system functions.

Since the brain relies on a delicate balance of neurotransmitter chemicals to function normally, it loses its ability to regulate bodily functions as normal when imbalances take root. Consequently, detox withdrawal effects develop out of these chemical imbalances. Methadone detox protocols help in eliminating the chemical imbalances left behind by long-term opiate abuse.

Withdrawal effects commonly experienced during detox include:

  • Severe depression
  • Nausea
  • Vomiting
  • Intense drug cravings
  • Insomnia
  • Muscle aches and pains
  • Anxiety
  • Irritability

Methadone detox protocols provide step-by-step procedures for administering the drug and monitoring a person’s progress throughout the detox stage.

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Assessment Procedures

As distressing as opiate withdrawal detox can be, it’s actually quite predictable in terms of the types of symptoms experienced and the duration of the withdrawal period. While some variation does exist as far as severity of addiction and a person’s overall physical and psychological condition goes, opiate withdrawal still follows a set sequence of events.

Methadone detox protocols require a comprehensive assessment of a patient’s condition at the start of treatment. According to the National Institute on Drug Abuse, physicians use what’s known as the Clinical Opiate Withdrawal Scale to determine withdrawal symptom severity, which in turn dictates which types of treatment approaches to use. Methadone detox protocols also require repeated assessments throughout the detox period to ensure a person isn’t being under- or overmedicated.

Risk Factors Considered

Methadone detox protocols rely heavily on the assessment process as a means for identifying the risk factors that most hamper a person’s progress in recovery. In effect, any identified risk factors will only aggravate withdrawal symptoms and make it that much more difficult for a person to stay the course.

According to the Academy of Managed Care Pharmacy, factors posing the greatest threat to a person’s progress include:

  • Drug abuse history Severity of withdrawal symptoms
  • Any co-occurring medical conditions
  • Any co-occurring mental health issues, such as depression or anxiety disorders
  • A person’s motivation to get well
  • Whether a person has an existing support system, such as friends and/or family
  • A person’s potential for relapse

Methadone’s Effects

Methadone’s overall effect works to stabilize brain chemical processes and restore normal brain and central nervous system functioning. The guidelines provided by methadone detox protocols provide doctors with procedures for determining the drug’s effectiveness at each stage in the detox treatment process.

Methadone, a synthetic opiate medication, mimics the effects of addictive opiate drugs, which accounts for its ability to alleviate withdrawal and drug cravings effects. Methadone detox protocols work towards weaning addicts off the effects of addictive opiates by replacing these drug effects with methadone’s effects.

Methadone Dosing Procedures

Once a physician determines the level of treatment a person needs, methadone detox protocols lay out the dosing procedures for administering the drug. In general, the more severe the addiction the higher the dosage level needed to relieve withdrawal discomfort.

Finding the right dosage level is essential to ensuring patients experience the therapeutic benefits of the drug. Methadone detox protocols caution against under- as well as overmedicating as too low a dose leaves addicts susceptible to relapse, while too high a dose can result in overdose.

Dosage Adjustments

Considering how the brain and body rely on a delicate balance of neurotransmitter chemicals to function normally, it’s not uncommon for doctors to have to make multiple dosage adjustments before finding the right dosage level. In cases of severe opiate dependence, methadone detox protocols recommend doses of 30 to 40 milligrams a day.

If withdrawal symptoms persist, doctors can administer an additional 10 milligrams and reassess a person’s condition two hours thereafter. This practice, known as “challenge dosing,” helps doctors better pinpoint the dosage level needed to produce methadone’s intended therapeutic benefits.

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Considerations

While methadone dosing protocols go a long way towards ensuring the safety and overall well-being of the patient, as an opiate-based drug, methadone carries its own risk of physical dependence. For this reason, methadone detox protocols include a tapering phase as part of the methadone detox process. Once patients experience ongoing relief from withdrawal symptoms, dosage levels can be gradually reduced until a person no longer requires the drug’s effects.


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