Methadone is a laboratory-manufactured opioid that is one of the most widely used all over the world. It is primarily prescribed as an opioid pain relief drug to treat chronic pain and opioid use disorder (OUD). 

The drug is effective in countering withdrawal symptoms, craving, and dependence in users who have been addicted to the consumption of heroin or opioids, and aids in post-rehabilitation. It is similar in intensity to them, and a high risk due to its great capacity and the long half-life (it occupies up to 60 hours in the body).

The symptoms of methadone overdose can slowly progress – early signs of such a condition can appear and be easy to control. However, these symptoms may turn fatal in the long term. This blog post shows the signs of overdose of methadone, the physiological factors that have led individuals to the overdose, and the response or immediate treatment that should be given.

What Causes Methadone Overdose?

Overdosing on methadone can result from several situations, including:

1. Increasing the dose above the recommendation.
2. Combining it with other depressants of the central nervous system, such as alcohol, benzodiazepines, or other opioids.
3. Diminished drug tolerance, especially during detox or following a phase of abstinence.
4. Methadone accumulates in the body since it has a long half-life.

Methadone stays in the body longer than its pain-relieving effects last. This may cause someone to take more, increasing the risk of an overdose. Slow accumulation causes overdose to be hazardous since its symptoms can take hours to appear even after it has been consumed.

Recognizing Respiratory Depression and Its Risks

Respiratory depression is one of the most severe and life-threatening methadone overdose symptoms. As a derivative of opioids, methadone constricts the respiratory centers of the brain that control automatic breathing. An excess of methadone in the system can cause severe breathing complications, as the brain won’t be able to communicate effectively with the lungs so that it can respond appropriately.

What to Look For in Respiratory Depression:

• Breathing rate drops to 12 breaths per minute.
• Gasping breaths.
• Prolonged pauses between breaths.
• Cyanosis.
• Gurgling sounds.
• Snoring. 

The leading cause of mortality in opioid-related overdose is respiratory depression. Consider calling emergency services if the symptoms mentioned earlier are suspected in this vital issue.

The Impact of Pinpoint Pupils in Overdose Scenarios

Pinpoint pupils, also medically known as miosis, is another clear sign of opioid toxicity. They constitute an essential diagnostic hint in the case of methadone overdose, particularly in combination with other signs such as drowsiness and respiratory depression. 

Methadone influences the parasympathetic nervous system, which causes pupil constriction. When an individual’s pupils grow very small and nonresponsive to light, the chances are high that the individual is subjected to opioid stress in the central nervous system.

Pinpoint pupils are not dangerous, but can confirm a diagnosis in the presence of other symptoms. They are a visual indicator that first responders and health professionals use to assess suspected overdoses. Medline states the common and unique symptoms of opioid overdose, which you can read more about for better insight.

Identifying Drowsiness, Nausea, and Vomiting

Drowsiness may also be caused by the sedative effect of methadone, as well as the gastrointestinal effects, such as those related to nausea and vomiting. These can be considered common side effects, but in the case of overdosing, they tend to be more potent and life-threatening.

Drowsiness

In such cases of opioid overload, the excess opioids stimulate the shutdown of non-essential body functions. This is followed by:

• Slurred speech.
• Trouble with keeping the eyes open.
• Individuals can’t stay alert or awake.
• Development into losing consciousness or being in a coma.

Nausea and Vomiting

All these symptoms indicate the body’s efforts to eliminate excess toxins. However, they are still capable of causing new threats:

• Possibility of aspiration (inhaling vomit into the lungs).
• Fluid or electrolyte imbalance.
• Choking hazards.

Although early symptoms such as drowsiness, nausea, and vomiting are possible without overdose, when combined with other symptoms, they can increase the risk of the condition.

Confusion and Cognitive Effects of Overdose

Methadone depresses normal brain activities, which leads to cognitive changes, including confusion, disorientation, and poor judgment. These are some of the symptoms that can be used as early neurological warning signs of methadone overdose.

Common Signs of Confusion

• Inability to recognize familiar people or surroundings.
• Difficulty forming coherent sentences.
• Wandering or repeating words.
• Hallucinations or paranoia in extreme cases.

This confusion may result in accidents or getting lost in dangerous situations. It may undermine the capacity of the individual to request assistance, which makes the occurrence of an overdose even more dangerous.

Monitoring for Low Blood Pressure and Weak Pulse

The above recommended doses of methadone may result in cardiovascular depression, which will result in low blood pressure (hypotension) and a weak pulse. This poses a significant threat since it limits the supply of oxygen and nutrients to the body, including the heart and brain.

Indicators of Low Blood Pressure:

• Feeling faint 
• Dizzy
• Pale
• Sweating without physical activity

Weak Pulse:

• Irregular heartbeat
• Rapid or slow heart rate

Weak pulse rate and low blood pressure are the last indicators before a cardiovascular collapse occurs. These symptoms indicate that the overdose is at a dangerous level, and the individual has to be taken to the hospital. The National Library of Medicine NLM stated hypotension and bradycardia/weak pulse, associated with opioid overdose.

Urgent Actions to Take During a Suspected Overdose: Guidance from Touch Stone Recovery

It is essential to understand the symptoms of overdose with methadone, but choosing the right approach when such a situation occurs can potentially save a life. An individual who shows signs of respiratory depression, pinpoint pupils, confusion, or a low pulse is in danger.

Emergency Steps to Follow:

• Call 911 Immediately.
• Administer Naloxone (Narcan).
• Perform Rescue Breathing.
• Put Them in Recovery / Rest Position.

Once stabilization is complete, the patient must then proceed to professional treatment to deal with underlying substance use. Touch Stone Recovery is a facility that focuses on the safe detoxification process of opioid users, such as methadone, and assists them in a complete continuum of care.

Get Help at Touch Stone Recovery for Methadone Overdose.

Understanding the methods of using methadone for pain relief and treatment helps recognize the signs of potential overdose. However, the possible side effects include low pulse, vomiting, confusion, and respiratory depression. These symptoms do not indicate the use of methadone, but also a fatal overdose.

Touch Stone Recovery is dedicated to a fully defined care model that maximizes overdose prevention and recovery. No one should go through a crisis alone. Contact Touch Stone Recovery so that we can assist you or your family member in taking the initial steps towards long-lasting well-being.

FAQs

What are the early signs of methadone overdose that include respiratory depression and pinpoint pupils?  

The most common symptoms will start with respiratory depression, which is indicated by seriously slow, shallow, or no breathing, for air and pinpoint pupils, known as a hallmark of opioid toxicity, that necessitates immediate treatment.

How does drowsiness, nausea, and vomiting indicate a potential methadone overdose?  

When the symptoms have attained an extreme level or remained constant, they are accompanied by slow breathing or confusion. The symptoms indicate that the body system is overwhelmed with the effects of methadone.

Why is confusion a critical symptom to watch for in methadone overdose situations?

Confusion denotes that the brain is affected by a deficiency of oxygen or the toxicity of opioids. It is a clear indication that the overdose is developing toward unconsciousness or coma.

In what ways do low blood pressure and a weak pulse contribute to the dangers of methadone overdose?  

Both symptoms suggest cardiovascular suppression, which means organs are not receiving enough oxygen. If untreated, this can lead to cardiac arrest or multi-organ failure.

What immediate steps should be taken if respiratory depression and other overdose symptoms like a weak pulse occur?

Call emergency services, administer naloxone if available, monitor vital signs, and keep the individual safe until help arrives.