Methadone Addiction: What to Know

Medically Reviewed by Jennifer Casarella, MD on April 18, 2022
4 min read

If you or a loved one is in recovery for an opioid use disorder, methadone is one of a couple of medicines that can help you get through it without many withdrawal symptoms and cravings. Sometimes people think this means you’re trading one addiction for another. But that’s a misconception that can get in the way of recovery.

Addiction, or substance use disorder, is defined by a lack of control over the use of that substance. People being treated for opioid use disorder take methadone under close supervision to ensure their safety.

At the same time, methadone is an opioid painkiller that comes with its own risks for misuse, dependence, and overdose. Methadone is a Schedule II narcotic under the Controlled Substances Act. That means it has a high potential for misuse that could lead to serious psychological or physical dependence. It’s not legal to use methadone unless a doctor prescribes it for you.

Some common street names for methadone are amidone, chocolate chip cookies, fizzies with MDMA, and wafer.

It depends. If you don’t have an opioid use disorder and you take methadone, it can make you high. But methadone doesn’t give you the same fast, intense high that other opioids like heroin do. That’s why it’s used to treat opioid use disorders.

When you take it at the right dose to treat opioid use disorder, methadone won’t make you feel high. But it does work on the same receptors in your brain that other opioids like heroin or oxycodone do. It can stay in your body for 1-3 days and will actually block the “high” of other opioids.

Because methadone stays in your system for a long time compared to other opioids, you can overdose on it. Methadone can build up in your body quickly. If a doctor has prescribed methadone for you to take at home, make sure you take it only as prescribed.

Signs of a methadone overdose are the same as those for overdoses of other opioids. They include:

  • Slow and shallow breathing
  • Blue fingernails or lips
  • Stomach spasms
  • Clammy skin
  • Convulsions
  • Weak pulse

Methadone can cause death, and this typically happens to people who are taking large doses of prescription methadone for pain relief. Most overdose deaths linked to methadone are in people who take it at home, whether for pain relief or recreationally.

Opioid treatment programs usually require you to go in for treatment each time you need it and carefully monitor any doses you take home. This makes it less likely you’ll take too much.

It’s not safe to mix methadone with other opioid drugs. Taking it with heroin makes an overdose more likely. That’s partly because methadone stays in your system for a long time and blunts the effects of other opioids. You may take more to try and get high and overdose.

Mixing methadone with alcohol or benzodiazepines raises your risk for an overdose. Don’t take methadone with any other substance that depresses your central nervous system.

If you’re taking methadone, be careful about medicines that make you sleepy, including:

  • Other pain medicines
  • Sleeping pills
  • Anxiety medicines, especially benzodiazepines
  • Allergy medicines (antihistamines)
  • Sedatives

Other medicines to be careful about include:

  • Diuretics
  • Antibiotics
  • Heart or blood pressure medicines
  • HIV medicines
  • MAO inhibitors, a type of antidepressant
  • Medicines that could change your heart rhythm

If your doctor prescribes methadone, tell them about any other medicines or supplements you take. Your doctor should also know about any health conditions you have, including a substance use disorder. If you’re older or have certain health conditions, you could be more sensitive to methadone.

Methadone comes in different forms. It may be a tablet, oral dispersible tablet (disket), or liquid. To take it correctly, you take it by mouth. You shouldn’t inject, snort, or smoke it. If a doctor prescribes methadone for you, make sure you take it exactly as they say you should.

Other tips to take methadone safely and avoid addiction or overdose include:

  • Take the amount of methadone your doctor prescribes, on schedule.
  • If you miss a dose or think it’s not working, don’t take an extra dose.
  • Don’t take methadone with alcohol or other drugs.
  • Call 911 if you think you’ve taken too much methadone or have signs of an overdose.
  • Keep methadone away from kids and pets.
  • Don’t share your methadone with anyone.
  • Get rid of any methadone you don’t need.

If you’re taking methadone or any opioid, ask your doctor if they can prescribe you naloxone. Naloxone can reverse an overdose from opioids, including methadone. It’s a good idea to carry it if you have an opioid use disorder or fear you may take too much of any opioid. Make sure your friends and loved ones know the signs of an overdose and how to use naloxone.

If you take prescription methadone more often or in larger amounts than your doctor advises, or if you often use it recreationally, you may have a substance use disorder. When your body is dependent on methadone and you try to stop all at once, you can have signs of withdrawal similar to those you get with other opioids. Withdrawal symptoms include:

  • Watery eyes and runny nose
  • Sweating, chills, or fever
  • Shaking
  • Muscle aches
  • Diarrhea, nausea, or vomiting
  • Appetite loss
  • Depression
  • Trouble sleeping

Treatment for methadone use disorder usually includes medical detox and therapy. Your doctor may suggest that you taper off methadone. They may put you on another medicine to help you stop taking methadone.

Many people who develop a methadone use disorder have other disorders, like:

  • Depression
  • Posttraumatic stress disorder (PTSD)
  • Schizophrenia
  • Bipolar disorder
  • Other substance use disorders

Getting help for any other mental health condition you have may also help your recovery. can help you to find health providers around the country who specialize in treating substance use disorders of all kinds.