Methadone is a very strong painkiller. It is also used to treat heroin addiction. Methadone overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.
Methadone overdose can also occur if a person takes methadone with certain painkillers, such as oxycontin, hydrocodone (Vicodin), or morphine.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
Note: This list may not include all sources of methadone, and includes preparations that are taken by mouth (orally) or injected into veins, muscle, or under the skin.
Eyes, ears, nose, and throat:
- Pinpoint pupils
Heart and blood:
- Low blood pressure
- Weak pulse
- Breathing difficulty
- Breathing - slow and labored
- Breathing - shallow
- No breathing
- Coma (decreased level of consciousness and lack of responsiveness)
- Muscle twitches (spasticity)
- Blue fingernails and lips
- Cold, clammy skin
Seek immediate medical help. Do NOT make a person throw up unless told to do so by Poison Control or a health care professional.
Before Calling Emergency
Determine the following information:
- Patient's age, weight, and condition
- Name of the product (ingredients and strengths, if known)
- Time it was swallowed
- Amount swallowed
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number 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.
What to Expect at the Emergency Room
The health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. You may receive:
- Activated charcoal
- Breathing support, including tube through the mouth and breathing machine (ventilator)
- Chest x-ray
- EKG (heart tracing)
- Fluids through a vein (by IV)
- Medicine (narcotic antagonist) to reverse the effect of the medication
- Tube from the mouth into the stomach to empty the stomach (gastric lavage)
How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better chance for recovery.
If an antidote can be given, recovery from an acute overdose begins immediately. However, since methadone's effects can last for about a day, the patient is usually kept in the hospital overnight and may receive several doses of the antidote.
Persons who took a large overdose may not be breathing (respiratory arrest) and may have seizures if they do not get this medicine quickly. Complications, such as pneumonia, muscle damage from lying on a hard surface for a prolonged period of time, or brain damage from lack of oxygen, may result in permanent disability.
Yip L, Megarbane B, Borron SW. Opioids. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 33.
Bardsley CH. Opioids. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 162.