Methadone is a powerful medication used to help people overcome addiction to opioids. While it can be effective when taken under a doctor’s guidance, it can be dangerous if misused or taken in too high a dose. Accidental overdoses can happen, especially when methadone is mixed with other drugs or alcohol [1].
This page explains what overdose is, the most common methadone overdose signs and symptoms, and steps to take if someone is overdosing on this controlled substance. You will also learn how to get compassionate and effective treatment for opioid addiction with methadone therapy.
Methadone Overdose Symptoms
Symptoms of methadone overdose can range from mild discomfort to life-threatening reactions. Understanding these symptoms can help people identify an overdose and seek timely assistance before the situation worsens. Methadone overdose symptoms can affect different systems in the body, like the respiratory, cardiovascular, and central nervous systems.
Like other opioids, methadone slows the respiratory system, making it hard for the body to get enough oxygen. Respiratory methadone overdose symptoms include:
- Slow or shallow breathing: The person may struggle to take deep breaths or experience labored, uneven breathing.
- Difficulty breathing: Breaths may sound wheezy or strained.
- Gasping for air: Breathing may become so weak that the person appears to be gasping.
Methadone overdose can also affect the brain and central nervous system, causing changes in alertness and physical control. Nervous system methadone overdose symptoms include:
- Fatigue or drowsiness: The person may appear overly tired or unable to stay awake.
- Confusion or disorientation: Someone overdosing may have trouble understanding their surroundings or answering questions.
- Loss of consciousness: In severe cases, the person may become unresponsive or pass out.
Methadone can also slow the heart rate and lower blood pressure, which can bring about additional dangers. Cardiovascular methadone overdose symptoms include:
- Low blood pressure: Low blood pressure can make the person feel weak, dizzy, or lightheaded.
- Weak or irregular pulse: The heart may beat unevenly, or the pulse may feel faint.
- Pale or blue skin: Reduced blood flow may cause the skin, lips, or nails to take on a bluish or grayish color. [2]
The digestive system is also affected by methadone overdose. Gastrointestinal methadone overdose symptoms include:
- Nausea and vomiting: The person may feel sick or vomit frequently.
- Severe stomach pain or constipation: Pain or bloating may occur as the digestive system slows down.
Recognizing these symptoms early can make a difference in getting help quickly. Methadone overdose is a medical emergency that requires immediate action [3].
Signs of a Methadone Overdose
Identifying methadone overdose signs can help save a life. Signs of overdoses are the visible clues that show someone may be in danger. These may include behavioral and physical signs that become more obvious as the overdose progresses. These include:
- Pinpoint pupils: A classic sign of opioid overdose is pinpoint pupils—when the pupils become unusually small, even in bright light. This symptom is common in opioid overdoses and should be a strong indicator that medical attention is needed.
- Unresponsiveness or extreme drowsiness: People experiencing a methadone overdose may become extremely drowsy and difficult to wake up. They might slur their words, appear confused, or not respond when spoken to. If someone is unresponsive or cannot stay awake, call for emergency help.
- Slow or shallow breathing: One of the most dangerous methadone overdose symptoms is slow or shallow breathing. Breathing may become so slow it’s barely noticeable, and this can quickly lead to a lack of oxygen in the body, causing brain damage or death [4].
- Discoloration of skin and lips: Another visible sign of methadone overdose is a change in skin color. If someone’s lips, fingernails, or skin appear blue, gray, or pale, it may indicate they are not getting enough oxygen. This discoloration is a serious warning sign of methadone overdose.
- Cold or clammy skin: In many cases, someone experiencing an overdose will have cold, clammy skin. Their skin might feel sweaty or unusually cool to the touch. This can happen when blood circulation slows down during an overdose.
- Weak or faint pulse: A methadone overdose can cause a weak or irregular pulse. If you check their pulse and find it’s faint or inconsistent, it strongly indicates that they need immediate help.
- Gurgling or snoring sounds: Sometimes, a person overdosing on opioids may make strange gurgling or snoring sounds. These noises are due to relaxed airway muscles, which can make it difficult to breathe properly. These sounds can be a red flag that they are not getting enough oxygen.
If you notice any of these signs of methadone overdose, act immediately. Even if you’re unsure whether it’s an overdose, it’s safer to seek medical assistance than to wait.
Methadone Overdose
Methadone overdose is a serious risk, especially when the medication is not taken as directed. Methadone has a long-lasting effect on the body, and taking too much can cause it to build up to dangerous levels. This makes overdose a risk even when someone doesn’t intend to misuse the drug. Here are some situations commonly associated with methadone overdose:
- Accidental overdoses: Methadone breaks down slowly, meaning it stays in the body much longer than other opioids [5]. People who take additional doses before the first dose wears off risk accumulating too much methadone in their system, triggering overdose.
- Mixing methadone with other substances: Combining methadone with other substances like alcohol or benzodiazepines increases the risk of overdose significantly. These substances slow the CNS (central nervous system) just like methadone, and they can dangerously lower heart rate and breathing when used together.
- Using methadone illicitly: Some people may misuse methadone by taking higher doses than prescribed or obtaining it illegally. Taking methadone without a doctor’s supervision can lead to serious health risks, as dosages must be carefully controlled based on a person’s health and tolerance.
- Increased risk in those new to the medication: People new to methadone treatment are often at a higher risk of overdose. Their bodies are not yet accustomed to the drug’s effects, and even small increases in dosage can lead to dangerous consequences. For this reason, doctors usually start individuals on low doses.
The more you know about how methadone overdose happens and the risks involved, the safer choices you can make with the medication—avoiding potentially fatal situations.
Methadone Overdose Treatment
Methadone overdose treatment must begin immediately to prevent severe adverse outcomes. In an overdose, emergency responders or medical professionals will follow specific steps to help the person recover.
- Call for emergency help: If someone shows methadone overdose symptoms, call 911 right away—overdoses can quickly become life-threatening. The emergency operator may guide you through some initial steps to assist the person until help arrives.
- Administer naloxone (Narcan): Naloxone—Narcan—is a medication that can reverse an opioid overdose by blocking methadone’s effects on the brain [6]. Naloxone is available in nasal spray or injection form, and it can restore breathing and consciousness if administered in time.
- Perform rescue breathing (CPR) if necessary: If the person has stopped breathing, you may need to perform rescue breathing and chest compressions. Emergency operators can guide you through the CPR process until professional help arrives.
- Hospital treatment and monitoring: Once at the hospital, the person will receive further treatment. This may include IV fluids to keep them hydrated and activated charcoal to prevent the body from absorbing more methadone. In severe cases, doctors might use a ventilator to help the person breathe if their respiratory function is severely impaired.
- Additional doses of naloxone: In some cases, a single dose of naloxone may not be enough to reverse the effects of overdose. Methadone’s effects are long-lasting, so hospital staff may need to administer multiple doses of naloxone to keep the person stable. They will monitor vital signs like breathing, heart rate, and blood pressure until the person is out of danger.
- Follow-up care: After the immediate crisis is resolved and methadone overdose symptoms have subsided, follow-up care may include counseling, mental health support, and adjusting the methadone dosage to a safer level.
If you encounter this emergency, call 911 immediately—you could save a life.
Get Treatment for Opioid Addiction at a Premier California Rehab
If you require help recalibrating your life from opioid addiction, reach out to California Detox for compassionate and evidence-based treatment.
During medical detox at our luxury beachside facility, you can access methadone (under careful supervision) and other FDA-approved medications to streamline withdrawal and prepare for ongoing inpatient treatment.
You will also have access tp the following therapies during inpatient rehab at California Detox:
- Motivational therapy
- Counseling
- Talk therapy
- Family therapy
- Group therapy
- Holistic treatment
- Aftercare
Begin your recovery from opioid addiction by calling 888-995-4208.
Sources
[1] https://pubmed.ncbi.nlm.nih.gov/36516551/
[2] https://journals.lww.com/nursing/citation/2004/11000/methadone_overdose.56.aspx
[3] https://pubmed.ncbi.nlm.nih.gov/24991620/
[4] https://www.ncbi.nlm.nih.gov/books/NBK470415/
[5] https://www.ncbi.nlm.nih.gov/books/NBK310658/
[6] https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/opioid-overdose-reversal-medications