What are the Most Difficult Drugs to Detox From?

What are the most difficult drugs to detox from? The top contenders in the hardest-to-quit group are crack cocaine, crystal meth, heroin and methadone. Heroin and methadone are both opioids, but heroin is semi-synthetic, prepared from morphine, while methadone is completely synthetic and made in a lab. Heroin is short-acting; methadone is long-acting. Heroin creates a powerful reinforcing compulsion to use it again and again in susceptible individuals but certainly not in everyone. Intravenous use produces a rush, an exquisite feeling of euphoria that users covet. Methadone is too slow-acting to produce much euphoria, but it’s an excellent analgesic and MAT agent. MAT stands for medication-assisted treatment.


People typically become physically dependent on methadone when they enter a methadone MAT program. These programs are administered in specially licensed clinics distributed throughout the United States. Most states have limits on how much methadone can be dispensed to one person in one day. Average doses probably range from about 60 milligrams up to around 120 milligrams. Amounts exceeding this are usually either forbidden or require a special waiver. Methadone causes little to no euphoria in someone with a high opioid tolerance such as those seen in heroin abusers. It simply eliminates withdrawal symptoms and stops drug cravings. This it does very, very well.

Methadone can allow a former heroin abuser to return to a normal life. They get their dose every day and are free of debilitating withdrawal symptoms. Drug cravings are virtually erased, so the person can concentrate on other things. There is no need to commit crimes, and the person can tend to family and work responsibiities. However, methadone is highly addictive. Taken orally, milligram for milligram, methadone is at least as strong as heroin, and it’s far longer-acting. It’s every bit as addictive, if not more. People on methadone MAT find this out the hard way when they try to quit the methadone. Methadone withdrawal typically lasts at least a month to six weeks. The worst of heroin withdrawal is generally over in about seven to 10 days.

It’s always best to stop methadone gradually. If you want to stop, let your clinic staff know. They’re required to detox you if you ask. Make sure they do this very, very slowly. No more than 5 milligrams a week at most. It’s not a contest to see how fast you can stop taking methadone. If it takes a year or more, then it does. The slower you detox, the less discomfort you will feel and the more likely you will stick with your plan. If you find life without methadone to be bleak, it’s not your fault. Changes caused by the drug in the brain can cause depression if the drug is absent, even after a very slow taper. If you need methadone to feel normal, then you do. Opioid use changes both brain chemistry and structure. It is not known if these changes are permanent or not, but they could be.


When heroin is injected, it produces an intense euphoric high called a rush that users pursue relentlessly. It’s this feeling that keeps users addicted and also creates a craving long after the last dose. People trying to quit the drug cannot forget the rush. This makes it very hard to quit. MAT in the form of methadone or Suboxone is available.

Crystal Meth

If you think methadone withdrawal sounds bad, crystal meth is far, far worse. It causes the brain to change so profoundly that the person experiences constant urges to use the drug again and again. Withdrawal symptoms include:

  • Anxiety
  • Fever and chills
  • Nausea and vomiting
  • Heart palpitations
  • Tremors and shaking

Withdrawal has three separate stages that last for at least a month. Cravings are constant and there is no MAT to help with this drug. Profound depression typically sets in after the physical symptoms have abated. This can last for six weeks up to three months and longer.

Crack Cocaine

This is a smokable form of cocaine that affects the brain in much the same way that crystal meth does. Smoking cocaine provides a far more euphoric experience than snorting it does. Crack doesn’t last very long, perhaps some 15 minutes per use. The person must use it again and again to get the effect. This creates a powerful psychological dependence and irrestible urge to continue crack use. Drug cravings can persist for years, and there is no MAT for crack. Support groups and holistic treatments have helped some former crack users to stay sober.

If you’re struggling with substance abuse of any kind, call us for help anytime at 844-639-8371. Our group of trained drug counselors will be happy to help you find your way back to a brighter future.

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