Addiction Treatment: What is most promising way for a person to ween himself or herself off of methadone without suffering adverse side effects of methadone withdrawal?

You need to slowly decrease your doses. So, if you're doing 50mg a day, get that down to about 10mg a day gradually. Also, change diet. You're going to need to eat lots of fruits, veggies, and yogurt (with probiotics preferably). And if you're not already taking a daily multivitamin, start taking one. I'm not a doctor or pharmacist or anything, I just speak from experience.

A person could always choose to do what is sometimes called the 'chinese cure'. This requires initial access to a significant quantity of methadone to start with (for instance a weeks 'take home' dose). Day one you take out your normal dose, but then top up the bottle with distilled water. Each day you repeat the process topping up with water. After a couple of weeks the bottle will contain mainly water. Of course the greater the size of the bottle you start off with the more gradual the self detox will be. Please note that you are unlikely to get your prescriber to agree to this being a good idea (they tend not to like people controlling their own dose). Also, and this is the most important part, IF you decide to stop do not return back to your initial dose as your tolerance will be reduced and you may be at risk of overdose.

Methadone is much more difficult to withdraw from than other opioids.  While 10% is the maximum daily reduction for a short half life opioid like morphine, experience has shown me that 2% withdrawal rate is an effective and doable rate .  This is slow enough to not cause problems for most people.  Pain, if present will return and there is nothing that can be done about it.  The rate is figured on the declining balance.  At 100mg that would be a 2% reduction meaning 2mg.  However at 50mg 2% equals 1mg.  At 25mg that is 0.5mg.  At 75mg that is 1.5mg.  During the decades I have helped thousands of people taper.  A diabetes syringe can measure a 1/100 of a ml.  If you are using a concentration of 1mg per ml in the fluid fort instance, an insulin syringe can allow exact enough measurement for drinking the fluid.  I wrote a program that calculated such tapers.

Psychologist PhD . Methadone is as hard to kick as heroin.  It's risky to try vitamin therapy or other home remedies because of the risk of seizures and  rapid decompensation leading to death. The best alternative is to withdraw under a doctors supervision.  He will slowly withhold the methadone while using sedation such as a Benzodiazepine which will reduce some of the side effects of withdrawal. Don't expect a non painful or symptomless withdrawal.  A doctor versed in addictionology has the skill set to get your friend through this.  I have been through withdrawal because of pain medications taken for a badly injured leg, now useless. It might be helpful if he had the support of his former rehab group as an option. It's good he has friends who are standing behind him.  I can't say I envy you, he is extremely lucky. Check the yellow pages for a doctor who practices addictionology.  You will know he has the best interest in getting your friend through this safely.

In short, 10 mg a week until down to 50 mg, then 5 mg per week, although two weeks at the end the last 5 or 10 mg if needed, even 2.5 a week the last 5 or 10. Really, it's the rate they are are comfortable with. Do not (especially if addiction is the reason rather than pain management) be too quick to take sedatives, prescription sleep aids, etc rather than reduce less amount wise or in frequency. If not for addiction, the "jump-off" (the last drop) period your Dr. may if needed prescribe a sleep aid or benzo (benzo's are the worst to get off, so think about that one hard) for a 3-5 day period, as well as clonidine (no risk of dependence with clonidine, NOT klonopin as people confuse the two). Mainly it's just not a race, there is not a "right way" to get off other than the speed you have the least symptoms at. That's what you want, there are no magic pills, and everything taken that has a risk of its own should be well thought out. Kava, an AWFUL tasting root from the pacific got me off (works just like a benzo, but no risk of dependence, I took it 30 days and stopped with no problem. Helped with anxiety, irritability, and sleep issues.

From my experience, one of the best ways to get off the last bit of methadone is to transfer over to suboxone or buprenorphine when you are on a very low dose of methadone. Many people I have spoken to find it easier to withdraw from suboxone and also find they are able to continue working while coming off the final dose. However, this can really depend on each individual and it is vital that this is done with a prescriber's support and assistance. Your friend must be monitored and will need support and medical supervision. Each person is different and will react differently. These are serious medications and must be handled very carefully and under full medical supervision.

I have read the answers to this question and agree with most and also have learned some new information. I would like to add some great advice and info that was given to me when I was struggling with Opioid addiction. When you are decreasing your dose, whether it be by 10% or 50%, your body will give you reasons to stop decreasing  i.e suddenly you have pain that wasn't present before, this is a response to the decrease of opioid in your system. You will also notice an increase in your anxiety level. The use of opioids often blocks these physical and mental feelings it is your brains natural response is to alleviate these symptoms. If the only "tool" you have in your "tool box" to alleviate the pain is drugs  that most often will be your automatic remedy. Having other healthy "tools" to use  such as counselling meditation, physical activity, will give the person other  options  when uncomfortable or panicked. The more you use these new found "tools" the more natural it will feel to use them as a response to mental or physical pain. Often when a person decreases their Opioid intake theses symptoms occur and sometimes the response is to go back up in their dose and sometimes increase even higher. This is one of the reason's why a person could be on a high dose, they decrease by 10ml and then increase by 20ml. It is recommended that you maintain a steady dose until you no longer crave increasing your opiod intake and have stability in other areas of your life. A practice that I have seen some doctors use is to decrease dosage every other week to give the patient a "rest" period, this helps to alleviate the anxiety felt. It was described to me in a simple way once, there was also a picture drawn that I'm unable to add, "To get from point A (addiction) to point B (Opioid Free) the easiest way is to move in a straight line, better to take the train than the rollercoaster. Your mind and body will thank you for it." I had a very smart doctor that explained information in simple ways while I was "broken" so that I could process it without too much thinking, giving me less chances of rejecting the advice he gave me due to not understanding. I am six years clean from all Opioid use, prescribed or otherwise, and have him to thank for the positive results I acheived  while under his care, and  also my understanding of addiction itself. I hope passing his wise words on will help someone with their experience with Opioid addiction. I was prescribed a medicine  and it helped me beat the disease that is Opioid addiction.

Getting high is more fun than "getting low"; if it were easy to wean off narcotics there would probably be no narcotic-addicts.  That being said, it's a matter of willpower and direction.  People stop narcotics all the time on their own; they just need proper incentive(s). Slowly tapering the dose is probably the best way to do it.  Methadone clinics are reluctant to lower doses very much or very frequently.  If your methadone dosing is in the context of a methadone-clinic, be firm about wanting to get off/away from methadone.  Many attempts will be made by clinicians to keep the present dose or even increase it (with a common response from methadone treatment's being: "if you want to get off methadone so much, that probably means you are gearing up for drug-usage, thus we should raise the methadone dose").  Of course, this reasoning allows for no exit for methadone-usage. Narcotic-withdrawal is a harrowing but not life-threatening experience.  Probably when you come right down to it is akin to a severe case of the flu: extremely uncomfortable, but survivable.  That's if you do it all at once.  Those who do it more gradually will have fewer symptoms, but over a longer period of time.  Some people can't maintain the attention and focus to continue the detoxification process all the way down to the end. Professional medical or psychological help may be needed to maintain the willpower-quotient, forward-direction of getting off narcotics; however, the reward will be well worth it. Humans don't need to continue narcotics indefinitely.  Once detoxified from narcotics, the key then is to avoid restarting them, something far more common than would be expected given the severe problems that accrue during times of addiction, and the presumption that people remember those. Suboxone is probably easier to wean from then methadone, but both are narcotics.  I perform gentle Suboxone tapering over a period of a few months in the context of an outpatient treatment plan. http://WWW.your1MD.com

I agree with most that has been said but I have a few other ideas that would help alleviate symptoms. 1: clonidine aka catapres; in Australia small amounts of this drug are given to cause slight sedation and relieve anxiety temporarily. Risk can raise blood pressure with long term use. 2: to reduce anxiety I would recommend ashwaganda a herb that acts as a paradox on the central nervous system for example raising or lowering alertness/drowsiness depending what your body needs. Also provides protection to myelinated axons and promotes healthy brain cells. 3: scullcap tea; a natural tea that acts as a relaxant on the cns. Even if sleeps an issue this will alleviate the stress that follows. 4: vitamin b6+12 will help energy levels if feeling really flat. Avoid caffeine and guarana stimulates. 5: light swimming/spa and very short sauna periods may benefit some. 6:Dopamine powder from a herb shop can help to reduce the craving sensation by lifting dopamine levels in the brain. Use recommended dose from naturopath 7: as a last resort I would suggest vallum; but only for the first few nights if able to sleep ok after the first night try avoid taking vallum on the second and if you need to take a final dose on the 3rd. Warning Benzos can be very addictive try not to go from one addiction to the other. Clomazepam for ex. Can affect peoples sleep for short to long durations when trying to stop. Depending on the anxiety the person had sleep may not occur at all for a few days if not tapered correctly. Never stop any medication abruptly the body secretes hormones In discretion to the pharmaceutical tablet/liquid etc. It's great to get off these types of drugs but don't rush it will be harder and isn't worth the extra effort even if you can go cold turkey. Allow regulation of hormones and neurotransmitters to occur it's better to be smart than tough. Namaste ✴✴