Opioid addiction is a biopsychosocial issue. Since there are biological, psychological, and social components, the choice to slowly get out of a medication assisted therapy is complex and individualized.
In this post, we’ll look at the separate aspects of tapering off of methadone (medically supervised withdrawal) and examine the best way to get off of methadone without relapsing.
The Biology of Addiction
When we talk about the biological component of addiction, it’s more accurate to use the term dependence. Why? Because we’re primarily talking about the physiological response to abstaining from opioids, which is called withdrawal, rather than the other aspects of what we would call addiction.
For example, a person with diabetes depends on insulin, but we wouldn’t say they were addicted to insulin.
Physical withdrawal is one of the most common reasons for continued use of opioids or relapse.
The Psychological & Social Components of Addiction
In a nutshell, the psychological aspect of addiction has to do with how we process and respond to the world around us. Before getting off of methadone, we want to make sure you have:
- Healthy coping skills or responses in processing of the world around you
- Purpose and meaning in life
- Self efficacy to follow through with a workable program of recovery.
You may have heard the adage, “If you hang out in a barbershop long enough, you’re gonna get a haircut.”
It sounds silly, but it’s true more often than not. If your social circle is primarily made up of people who use drugs, it’s even more difficult to abstain from drug use and lead a recovery-oriented lifestyle.
Are You Prepared to Get Off of Methadone?
The decision of getting off of methadone is largely up to you, but the best way to ensure success is to wait at least nine months to work on the psychosocial aspects of recovery. You’re much better positioned for success when you have a stable home environment, a support system, healthy coping skills, and employment, or another way of engaging with the world in a way that serves you.
Being open and honest with your counselor about your real life challenges will be a great help with more than just relapse prevention. Your counselor can help bring objectivity to the issue. Also, your counselor can also help you break down challenges into smaller, more manageable goals that may help you feel less overwhelmed and increase your chances for success.
How Long Does It Take to Get Off Methadone?
In short, the amount of time for getting off of methadone depends on how:
- Your body responds to reductions in dosage
- Conducive your environment is to the process of recovery
- You respond psychologically to those changes
From a more technical standpoint, it’s recommended to taper off of methadone at a rate no greater than 5-10% every 2 weeks.
That being said, it’s important to keep an open mind and go at the rate that works for you.
It can seem like a moving target as the process is not always uniform from beginning to the end. However, it’s important to remember that you’re a human being and not a piece of machinery, and you need to go at the rate that works best for your body.
What Are the Side Effects of Tapering Off of Methadone?
If tapering off of methadone happens too quickly, craving and withdrawal symptoms are typical.
It’s important to communicate with nursing staff and your counselor at least once a week for the best chance of success. It’s better to take a small break from tapering, or hold until you feel stable, than to relapse or have withdrawal symptoms that make you fearful of the process.
Tapering off of methadone too quickly is like working out so vigorously that you don’t return to exercise for six months because of the soreness. You stand to lose valuable time that could have been used to make slow and steady progress.
Tapering off too quickly also affects your sense of self efficacy. At that point, lack of progress becomes a self-fulfilling prophecy.
The Best Way to Get Off Of Methadone Without Relapsing
One of the biggest misconceptions about addiction is that drugs are the problem. However, drugs are not so much of a “problem” as they are an unworkable “solution” to life’s other problems.
Let’s try a thought experiment. For 10 seconds, try NOT to think of a hippopotamus.
Were you successful or did you picture a hippopotamus almost as soon as you read the word?
The brain generates images and language, and that part of your brain doesn’t respond particularly well to the word “NOT.” This is the reason that, sometimes, the more you try to avoid doing something, the more difficult it is to stop thinking about it.
This is important because it’s often less productive to dedicating your time to NOT doing something than it is to find other, more satisfying and life affirming things to fill your time.
Surround yourself with a healthy support system of people, living a drug-free lifestyle, who support your recovery efforts. Social interaction is a fundamental need for us as humans. It’s indispensable, though often overlooked, in helping you recover from opioid addiction and living life to the fullest.
Additionally, it’s important to work with your counselor to develop a relapse prevention plan that will help you navigate life’s difficulties without resorting to drug use. A good relapse prevention plan will include knowing your particular triggers to use, knowing the people that you can rely on in your support system, and having recovery-oriented coping skills to help when times are tough.
Lastly, when getting off of methadone, an open mind with a willingness to learn new skills is crucial, because the thinking that got you into this won’t be the same thinking that gets you out.