Editing Methadone (section)

=== Overdose ===
Most people who overdose on methadone show some of the following symptoms:
* [[Miosis]] (constricted pupils)<ref name=medline-methadone>{{cite web | url = https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682134.html | title = Methadone (meth' a done) | publisher = National Institutes of Health | work = MedlinePlus | date = 1 February 2009 | access-date = 23 October 2013 | url-status = live | archive-url = https://web.archive.org/web/20131017172738/http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682134.html | archive-date = 17 October 2013 }}</ref>
* Vomiting<ref name=MedlinePlusOverdose>{{cite web|title=Methadone overdose|url=https://medlineplus.gov/ency/article/002679.htm|website=MedlinePlus|date=3 October 2017}}</ref>
*[[Spasm]]s of the stomach and intestines<ref name="medlineplus.gov">{{cite web|title=Methadone overdose: MedlinePlus Medical Encyclopedia|url=https://medlineplus.gov/ency/article/002679.htm|access-date=13 November 2021|website=medlineplus.gov|language=en}}</ref>
* [[Hypoventilation]] (breathing that is too slow/shallow)<ref name=medline-methadone/>
* [[Drowsiness]],<ref name=medline-methadone/> sleepiness, disorientation, sedation, unresponsiveness
* Skin that is cool, clammy (damp), and pale<ref name=medline-methadone/>
*Blue fingernails and lips<ref name="medlineplus.gov"/>
* Limp muscles,<ref name=medline-methadone/> trouble staying awake, nausea
* [[Unconsciousness]]<ref name=medline-methadone/> and [[coma]]<ref name=medline-methadone/>

The respiratory depression of an overdose can be treated with [[naloxone]].<ref name=sadovsky>{{cite journal | url = http://www.aafp.org/afp/2000/0715/p428.html | title = Tips from Other Journals – Public Health Issue: Methadone Maintenance Therapy | vauthors = Sadovsky R | journal = American Family Physician | date = 15 July 2000 | volume = 62 | pages = 428–432 | issue = 2 | url-status = live | archive-url = https://web.archive.org/web/20150904004312/http://www.aafp.org/afp/2000/0715/p428.html | archive-date = 4 September 2015 }}</ref> Naloxone is preferred to the newer, longer-acting antagonist [[naltrexone]]. Despite methadone's much longer duration of action compared to heroin and other shorter-acting agonists and the need for repeat doses of the antagonist naloxone, it is still used for overdose therapy. As naltrexone has a longer half-life, it is more difficult to titrate. If too large a dose of the opioid antagonist is given to a dependent person, it will result in withdrawal symptoms (possibly severe). When using naloxone, the naloxone will be quickly eliminated and the withdrawal will be short-lived. Doses of naltrexone take longer to be eliminated from the person's system. A common problem in treating methadone overdoses is that given the short action of naloxone (versus the extremely longer-acting methadone), a dosage of naloxone given to a methadone-overdosed person will initially work to bring the person out of overdose, but once the naloxone wears off, if no further naloxone is administered, the person can go right back into overdose (based upon time and dosage of the methadone ingested).