Methadone overdose

Methadone can be poisonous in large amounts.

Medicines with these brand names contain methadone:

• Dolophine
• Methadose
• Physeptone

Other medicines may also contain methadone. The ones above include methadone products that are swallowed or injected into a vein, muscle, or under the skin.

Below are symptoms of a methadone overdose in different parts of the body.

EYES, EARS, NOSE, AND THROAT

• Tiny pupils

STOMACH AND INTESTINES

• Constipation
• Nausea and vomiting
• Spasms of the stomach or intestines

HEART AND BLOOD

• Low blood pressure
• Weak pulse

LUNGS

• Breathing problems, including slow, labored, or shallow breathing
• No breathing

NERVOUS SYSTEM

• Coma (decreased level of consciousness and lack of responsiveness)
• Confusion
• Disorientation
• Dizziness
• Drowsiness
• Fatigue
• Muscle twitches
• Weakness

SKIN

• Blue fingernails and lips
• Cold, clammy skin

Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to.

Naloxone is a life-saving medication that can reverse an overdose from opioids, including methadone, and is often available to the general public without prescription. If Naloxone is available, follow all state and federal guidelines and regulations regarding its use.

If you give someone Naloxone, always seek medical help right away, and always stay with them until emergency help arrives.

Have this information ready:

• Person's age, weight, and condition
• Name of the medicine (strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• CT scan
• Electrocardiogram (ECG)

Treatment may include:

• Fluids through a vein (by IV)
• Medicine to reverse the effects of the methadone (an antidote) and to treat other symptoms
• Activated charcoal
• Laxative
• Breathing support, including tube through the mouth and connected to a breathing machine (ventilator)

How well someone does depends on the amount of poison swallowed and how quickly treatment is received. The faster medical help is given, the better the chance for recovery.

If an antidote can be given, recovery from an overdose begins right away. However, since methadone's effects can last for about a day, the person often stays in the hospital overnight. They may receive several doses of the antidote.

People who take a large overdose may stop breathing. They may have seizures if they do not get the antidote quickly. Complications such as pneumonia, muscle damage from lying on a hard surface for a long time, or brain damage from lack of oxygen may cause permanent disability.

Death can occur in severe cases.

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Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.