Suboxone vs Methadone: Which is the Right Choice?

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Sometimes the struggle to overcome an addiction requires extra help. In the ongoing war against opiate dependence, we have some tools that can provide long-term support. Medical maintenance programs allow long-time or severe substance abusers to remain clean and functional while they continue with their recovery process.

On one side we have methadone, the traditional maintenance protocol. On the other is a relative newcomer, suboxone. There are advantages and drawbacks to each, but is there really a difference between methadone and suboxone? If so, which is better and why?

What Are Medical Maintenance Programs?

Other terms for this type of treatment are opiate replacement therapy (ORT), medically assisted treatment (MAT), and methadone maintenance therapy (MMT). Detractors feel that such programs merely substitute one addiction for another. There are a few maintenance drugs that are used in clinical treatment settings, but methadone and suboxone are the best-known and most widely used.

Opiate replacement therapy offers a highly supervised, medically assisted treatment (MAT) option with the aim of managing withdrawal symptoms and preventing relapse. This is achieved by prescribing lower-risk opioids in a highly regimented way, under doctor’s supervision. MAT is geared toward heavy or long-term users who have already been through multiple programs with little success. Some consider it their last hope for beating the disease of addiction.

Is There a Difference Between Methadone and Suboxone?

The suboxone vs methadone debate began almost as soon as suboxone was introduced as an alternate treatment option. Methadone has been used in public drug treatment programs since 1947. Suboxone came out on the scene in 2002. Both are opioids. The main difference between methadone and suboxone is in their chemical composition. More on that in a minute.

You might ask why an alternative to methadone is needed if it has been around so long and saved so many lives. Methadone and suboxone are very similar. Both act on the brain in the same way as other opioids, and both are addictive. But, neither is as destructive as opiates like heroin or prescription drugs like oxycontin.

Methadone is a full agonist, which means it binds fully to the opioid receptors in the brain like other drugs. But, it’s a slow release opiate that’s taken as a pill or fast-dissolving wafer. It can also be administered as a ready-to-drink liquid. Because it releases slowly into the bloodstream over time and is milder than other opioids, it stops the cravings without the sudden jolt and letdown. However, methadone has a higher risk of abuse than suboxone, and several overdose deaths have been attributed to it over the past few years. That being said, it still has a high rate of success.

Suboxone is a half agonist. It only partially binds to opioid receptors using a two-prong attack. It’s a combination of two other effective opiate treatment drugs, buprenorphine with naloxone. The buprenorphine is a very mild opiate with a low risk of overdose; it makes the connection to fool the brain into thinking you’re taking a full agonist opiate. Naloxone is used to treat opioid overdose and produces very unpleasant side-effects if you try to inject it; naloxone also blocks the high effect of opioids so the brain doesn’t get that reward it seeks when you use. Suboxone is administered as a pill or a thin, dissoluble film. The pills are treated so they can’t be crushed or snorted, and the film can’t be dissolved in a needle for intravenous use. These are two benefits over methadone.

Suboxone vs Methadone Pro and Con

There’s more to the suboxone vs methadone debate than risk or composition. Methadone is a mild opiate that provides the rewards addicts are looking for but in a controlled manner. The goal of this therapy is to manage symptoms while gradually reducing the dosage over time. It has the added benefit of being safe for treating pregnant women who are in long-term programs. Suboxone has not yet been tested and approved as safe for that.

The risk of addiction and overdose is lessened if the drug is administered on-site through an outpatient treatment program (OPT). However, remaining on methadone for an extended period increases the potential for addiction and abuse. The ultimate goal is to wean you off the drugs completely.

The side effects of methadone are:

  • Drowsiness
  • Gastrointestinal problems
  • Impotence
  • Reduced respiratory function
  • Seizures
  • Irregular heartbeat

The main benefit of suboxone is the low potential for abuse, It is still addictive, but the composition of the drug keeps you from getting any pleasure from taking it. The side effects are milder than with methadone. It also has a high rate of success, with a reported 45 percent fewer emergency room visits related to its use than other treatment options.

Side effects of Suboxone include:

  • Numbness in the mouth and throat
  • Dizziness
  • Headaches
  • Insomnia
  • Vomiting
  • Difficulty with concentration

How Long Do You Stay in Methadone or Suboxone Therapy?

Both programs are administered as part of outpatient treatment after you’ve already been through a medical detox and rehabilitation program. Your doctor will assess whether one or the other MAT is right for you given your circumstances and history. Methadone can either be prescribed and taken on a schedule at home or administered as part of the program. Dosages vary according to factors like your weight, maintenance requirements, and doctor recommendation. It’s either given once a day in a time-release formula or in multiple doses. Suboxone is self-administered at home. It’s recommended that you remain in methadone treatment for at least one year after leaving rehab. The length of suboxone maintenance varies on a case by case basis.

Your New Life Begins With a Phone Call

If medical maintenance seems like it may be a good program for you, contact New Life Addiction Treatment Center to learn more. Our 24-hour helpline is open seven days a week. Call (855) 658-0035 for a confidential assessment.