If you are experiencing a medical emergency due to opioid withdrawal, you should call 911 right away. You may need to be transported to a hospital for treatment. If appropriate, emergency methadone can be administered as determined by a healthcare provider for acute withdrawal.
Buprenorphine is another medication option often used in the emergency treatment of sudden opioid withdrawal symptoms. Your doctor can also administer additional medicines as needed for nausea and vomiting, acute diarrhea, severe anxiety, or muscle cramping.
You may also experience withdrawal if you have received an opioid overdose antidote like naloxone (brand names: Narcan, Kloxxado, Zimhi), but methadone is not typically administered in these cases. Your doctor may provide different medications like clonidine.
In addition, starting March 2022, practitioners working in hospitals, clinics, and emergency rooms will be able to make a special request to dispense a 3-day supply of medication-assisted treatments, including buprenorphine and methadone, to treat patients experiencing acute opioid withdrawal symptoms.
Can I get emergency methadone in the mail?
No. The Controlled Substances Act and the DEA have special regulations for some drugs used in Opioid Treatment Programs (OTP). Methadone is a Schedule II narcotic medication with a high risk for diversion and abuse. Because of this, methadone must be dispensed directly to the person for whom it is intended for the purpose of a maintenance or detoxification treatment. It cannot be delivered by the U.S. Postal Service.
However, due to the COVID-19 public health emergency, if you are not able to travel to the narcotic treatment program (NTP) facility, employees of the NTP, the National Guard or law enforcement may be able to directly deliver the medication to you. Speak with your program facility or healthcare provider.
Can I get emergency methadone via telehealth or phone?
If you are an existing patient being treated for opioid use disorder (OUD), you may be able to receive methadone via telehealth and in accordance with SAMHSA’s Opioid Treatment Program (OTP) guidance. For new OTP patients that are treated with methadone, the requirements of an in-person medical evaluation will remain in force.
In addition, the DEA notes that providers can prescribe buprenorphine to new and existing patients with OUD via telephone by authorized practitioners without requiring such practitioners to first conduct an examination of the patient in person or via telemedicine.
Under the current national COVID-19 health emergency, OTPs can provide up to 14 doses for clinically less stable patients and 28 doses for clinically stable patients, as determined and documented by the clinical team.
Can I get emergency methadone if I am in jail?
Healthcare provider employed at the jail may order emergency methadone for use in a jail setting. These providers can use the DEA “72-Hour Emergency Rule” to continue these essential medications for opioid use disorder (OUD) without interruption for 3 days.
During this period, the jail will make a longer term plan for continuation of the OUD treatment. This may be especially useful over weekends or holidays and is essential to help maintain abstinence from opioid use and prevent relapse or fatal overdose. Opioid withdrawal can start as soon as 24 to 48 hours after the last dose of methadone.
What are the signs of opioid withdrawal?
Opioid withdrawal can be dangerous and life-threatening, and may begin within 4 to 48 hours, or sooner, after you stop taking opioids, dependent upon the opioid.
Regular use of opioids can lead to tolerance and withdrawal if opioids are abruptly stopped. Opioids are narcotics, which includes drugs like heroin, fentanyl, methadone, hydrocodone or oxycodone.
Withdrawal from opioids can lead to common symptoms such as:
- dilated pupils (mydriasis)
- yawning
- sweating
- bowels sounds
- goosebumps
Other symptoms may include:
- high blood pressure
- low blood pressure (if you’ve lost a lot of fluids)
- heart rate increased
- rapid breathing
- nausea / vomiting
- diarrhea
- watery eyes
- mood changes, irritation
- restlessness
- muscle or joint pain
- runny nose
- seizures (in infants)
- stomach pain
- tremor
- yawning
How long does opioid withdrawal usually last?
- Withdrawal symptoms from opioids usually reach their peak 24 to 48 hours after they begin, but may be slower with longer acting agents.
- These symptoms can persist for several days with shorter-acting narcotics or up to several weeks with methadone.
This is not all the information you need to know about methadone, opioid withdrawal or any opioid for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.