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A study of positive and negative factors associated with tapering off methadone maintenance treatment

Kishor Kumar1, Bharat S Shekhawat1, Sandhya Yadav1

  • 1Department of Psychiatry, Government Medical College, Kota, Rajasthan, India.

Indian Journal of Psychiatry
|July 24, 2026
PubMed
Abstract

Insights

Successful methadone tapering in India is linked to lower doses, less severe withdrawal, and higher motivation. Avoiding tobacco use also aids successful tapering, while faster taper rates increase relapse risk.

Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Public Health

Background:

  • Limited evidence exists on factors influencing successful methadone tapering in India.
  • Methadone maintenance treatment (MMT) is a key intervention for opioid use disorder.
  • Understanding tapering success factors is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To identify positive and negative factors associated with successful methadone tapering.
  • To analyze demographic, clinical, withdrawal, motivational, and treatment-related factors.
  • To provide insights for improving MMT tapering protocols in India.

Main Methods:

  • Retrospective study of 88 patients undergoing MMT tapering.
  • Data collected from a tertiary care drug treatment clinic.
  • Analysis of factors including demographics, clinical status, withdrawal severity, motivation, and treatment parameters.

Main Results:

  • 19.3% of participants successfully completed tapering without relapse.
  • Successful tapering correlated with lower baseline methadone dose, reduced withdrawal severity, increased motivation, and absence of tobacco use.
  • Higher taper rates were significantly associated with relapse (6.4 vs. 3.3 mg/week).

Conclusions:

  • Lower baseline methadone dose, slower taper rate, reduced withdrawal severity, greater motivation, and tobacco abstinence are key to successful tapering.
  • Barriers include fear of relapse, withdrawal symptoms, and socio-economic instability.
  • These findings can inform clinical practice and policy for MMT tapering.
Keywords:
Methadonemethadone taperingopiate substitution treatmentopioid-related disorderstreatment outcome

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