Methadone Vs. Suboxone | Which Is Better For Treating Opioid Addiction?

The opioid epidemic has been a crisis in the United States for the past three decades, which brought about the use of methadone and suboxone as treatment options. According to the National Institute on Drug Abuse, both medications are effective in treating opioid addiction.

Medication-assisted treatment (MAT) uses medications like methadone and Suboxone along with behavioral therapy as an effective approach to addiction treatment. MAT medications can be started during detoxification and continued as part of your aftercare.

How Does Methadone Treatment Work?

Methadone is a long-acting opioid agonist, meaning it activates the same opioid receptors as prescription pain medications like oxycodone and morphine. Activating these receptors reduces withdrawal symptoms and eliminates drug cravings.

Can You Get High On Methadone?

You may experience some side effects when you take methadone, especially at higher doses. 

Side effects may include:

• weight gain
• dry mouth
• decreased reaction time
• drowsiness
• sedation

However, if you’re opiate dependent you may not experience the same euphoric effects that other opioid medications produce. This is because your doctor will create a dosing schedule that is enough to prevent opioid withdrawal without producing a euphoric high.

Methadone Maintenance

Despite its addictive qualities, methadone is considered a much safer alternative to other opioids because it is administered in a highly controlled environment.  

Your methadone must be dispensed to you from an opioid treatment program every day. This is a limiting treatment if you have a job or other responsibilities that require travel or maximum flexibility.

Methadone maintenance can help prevent:

• drug overdose and death 
• relapse
• criminal activity
• health problems associated with drug injecting

What is Suboxone?

Suboxone is a maintenance medication that contains two active ingredients, buprenorphine and naloxone. 

Buprenorphine is a partial opioid agonist, which means it activates opioid receptors to a lesser extent than full opioid agonists. 

Buprenorphine suppresses withdrawal symptoms and cravings but it has a ceiling effect. If you are already opioid dependent, you will likely not experience a high when you take Suboxone. It can be administered on its own or in combination with naloxone.

Naloxone is an opioid antagonist, which means it blocks opioid receptors and induces withdrawal if taken with opioids. When taken as a combination with buprenorphine, it does not produce withdrawal unless you try to abuse it by snorting or injecting it.

How To Take Suboxone

Suboxone comes as film strips that are dissolved sublingually (under the tongue). The combination of buprenorphine-naloxone is also sold as sublingual tablets under the brand name Zubsolv. 

Although it is a milder opioid than methadone, you may still experience some side effects when you take buprenorphine.

Common side effects of buprenorphine include:

• stomach pain
• tongue pain (it is taken sublingually)
• back pain
• blurred vision
• difficulty falling asleep
• constipation

Buprenorphine Treatment

Suboxone and buprenorphine can only be obtained from physicians who have been authorized to prescribe these medications for opiate addiction. 

Suboxone is more convenient than methadone because you can take the medication at home with a prescription. You will still have mandatory appointments to attend with a counselor in an outpatient setting. 

Benefits Of Maintenance Treatment

Both drugs are approved by the Food and Drug Administration (FDA) to be used to treat opioid use disorders. Since the 1960s, they have reduced the amount of opioid-related overdose fatalities in the United States. 

Other benefits of maintenance treatment include:

• the blocker in Suboxone discourages illicit drug use
• reducing criminal activity associated with substance use disorders
• reducing risk of overdose
• dosing is monitored 

While both medications are addictive, they are significantly different from addiction to other opioids. In combination with counseling, you will be more likely to hold a job and maintain relationships which is something that becomes problematic in substance abuse and addiction. 

Can I Switch From Methadone To Suboxone?

While methadone is a highly effective treatment, there may be several reasons why you want to make the switch to Suboxone. 

Benefits of switching to Suboxone include:

• convenience of taking your medication anywhere
• less intense side effects 
• lower risk of abuse because it has a ceiling effect

Even though the transition is slow and difficult, it’s beneficial and can be done with the help of your healthcare provider. 

You must be in a mild state of withdrawal to begin taking Suboxone, which means your first step will be lowering your methadone dose to 30 milligrams or less. Depending on your dose, this can take several weeks or more because you must lower your dose gradually to avoid severe withdrawal symptoms.

Once you reach your doctor’s preferred dose to transition, you will stop taking the medication and wait for withdrawal symptoms to appear. This is the most challenging part of the process but you should be ready to start taking Suboxone within 72 hours of stopping methadone.

Risk Of Overdose & Abuse

Methadone is a Schedule II controlled substance, which means it has a high potential for addiction and overdose. Suboxone is a Schedule III controlled substance and has a lower risk of opioid dependence than methadone.

Both medications have the potential for overdose if you abuse them by:

• taking them when you are not currently opioid dependent
• mixing them with other depressants (such as illicit opioids, benzodiazepines, or alcohol)
• taking more than your prescribed dose

If you or a loved one would like more information about medications used to treat opioid addiction, please contact Ark Behavioral Health.