From the FDA Drug Label
Methadone's plasma elimination half-life is substantially longer than that of morphine (typically 8 to 59 hours vs 1 to 5 hours). For Short-term Detoxification ... The dose of methadone should be gradually decreased. The rate at which methadone is decreased should be determined separately for each patient.
The duration of methadone withdrawal is not explicitly stated, but the plasma elimination half-life of methadone is typically 8 to 59 hours. The withdrawal process for methadone can take several days to a week or more, as the dose is gradually decreased to minimize withdrawal symptoms. The exact duration of withdrawal can vary depending on individual factors, such as the dose and duration of methadone treatment, as well as the rate of dose reduction 1.
From the Research
Methadone withdrawal typically lasts between 2 to 4 weeks, but can extend up to several months in some cases, especially for those on high doses or long-term maintenance therapy. The withdrawal process occurs in two phases: an initial acute phase lasting about 1-2 weeks where symptoms peak in intensity, followed by a protracted phase that can last for weeks or months with gradually diminishing symptoms. Withdrawal symptoms begin slowly, usually 24-36 hours after the last dose due to methadone's long half-life (24-36 hours), unlike shorter-acting opioids which cause withdrawal symptoms more quickly. The severity and duration of withdrawal depend on several factors including the dose (higher doses lead to longer withdrawal), duration of use, individual metabolism, and whether tapering is implemented. Common withdrawal symptoms include muscle aches, anxiety, insomnia, nausea, diarrhea, sweating, and drug cravings. Medically supervised tapering, where the dose is gradually reduced over time, can significantly reduce the severity of withdrawal symptoms and increase the chances of successful discontinuation. This extended withdrawal timeline reflects methadone's pharmacological properties as a long-acting synthetic opioid that accumulates in tissues, requiring more time to be eliminated from the body compared to other opioids.
Some studies have investigated the use of clonidine in methadone withdrawal, showing that it can rapidly suppress withdrawal symptoms 2, 3. However, the most recent and highest quality study on methadone withdrawal is from 2025, which highlights the challenges of transitioning from methadone to buprenorphine in patients with acute liver failure 4. This study suggests that a buprenorphine low-dose induction strategy may reduce the risk and severity of precipitated withdrawal.
Key factors influencing the duration of methadone withdrawal include:
- Dose: Higher doses lead to longer withdrawal periods
- Duration of use: Longer use results in more prolonged withdrawal
- Individual metabolism: Variations in metabolism can affect the speed of withdrawal
- Tapering: Medically supervised tapering can reduce the severity of withdrawal symptoms
Overall, the duration of methadone withdrawal can vary significantly depending on individual factors, and medically supervised tapering is recommended to minimize the severity of withdrawal symptoms.