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Methadone vs. Suboxone for Opioid Addiction

Suboxone vs. methadone treatment—which is best for opiate addiction?

Both are FDA-approved medications with similarities in how they help manage opioid-related withdrawal symptoms. Yet they also have major differences, meaning the suboxone vs. methadone choice can be quite important for users and prescribers.

Keep reading for an in-depth methadone vs. suboxone comparison.

Opioid Agonists vs. Antagonists

Methadone is administered to treat both severe or chronic pain and substance abuse. It is usually prescribed for treating opioid addiction, or in situations when patients with chronic pain have found other medications intolerable or ineffective.

Methadone is classified as an opioid agonist; this means it attaches itself to the opioid receptors in the brain—specifically the ones that bind with drugs like heroin or fentanyl—to recreate a sensation of being “high.” When used as prescribed, it gives users the desired effect without putting them at risk of an overdose or sanitary complications.

A methadone syringe and prescription bottle

However, methadone has its pros and cons. Its agonist properties mean that it can also become quite addictive and easy to over-use. This is one of the leading arguments in the suboxone vs. methadone debate favouring the latter.

Suboxone, meanwhile, is more complicated. It contains two ingredients: buprenorphine and naloxone, which you may recognize from overdose kits.

Buprenorphine is a partial opioid agonist; it binds to the brain’s opioid receptors without triggering the desired euphoric reaction. Nonetheless, this binding helps reduce cravings and withdrawal symptoms for addicted individuals.

Naloxone is an opioid antagonist—meaning it blocks the effects—and is included in suboxone to reduce the dangers of misuse. If someone were to take too much suboxone, the naloxone would cancel out the effects of the buprenorphine.

Methadone vs. Suboxone: The Benefits

Introduced during the post-WW2 morphine shortages, methadone has been successful in turning people away from harmful drug misuse. Now, it is generally used in harm reduction treatment.

On the other hand, suboxone is specifically used as part of medication-assisted treatment programs designed to help people become sober. As such, suboxone is more commonly used in abstinence-driven approaches to treatment.

Both methadone and suboxone are taken orally and:

  • Reduce cravings to use opioids
  • Limit and improve opioid withdrawal symptoms
  • Significantly reduce the risk of opioid overdose

Methadone’s treatment effects are gradual and mild; it is a safer alternative to dangerous opioids like heroin. This also makes it easier for doctors to slowly wean off patients from methadone treatment until they stop relying on the substance completely.

Suboxone, on the other hand, is less habit-forming than methadone. Its formulation is specifically engineered to have a lower risk of dependency compared to methadone. As such, the risk of becoming addicted to it is much lower.

When comparing suboxone vs. methadone treatment, it’s important to understand both can help patients and be crucial parts of long-term recovery.

a woman pressing her fingers to her temples in a spinning room

Methadone and the Potential for Abuse

When you have too much methadone in your system, it becomes easy to rely on it more, eventually giving way to a new kind of addiction.

Methadone withdrawal is no joke. As mentioned above, the medication interacts with the brain’s opioid receptors to create a chemical reaction similar to strong painkillers like morphine. It can easily become addictive if not used as prescribed.

Doctors often build dosages over time depending on how the patient reacts to the medication. This is because a sudden change in dosage could lead to an overdose. In more serious cases, methadone overdose can lead to comatose or death. Mixing it with other drugs—whether prescribed or not—could lead to serious heart problems such as arrhythmia or heart attack.

Suboxone vs. Methadone Treatment Side Effects

There are some side effects to both treatment methods. These can affect your mind and body health, ranging from mild to severe symptoms.

Some of Methadone’s side effects can include:

  • Headache
  • Weight gain
  • Mood changes
  • Dry mouth
  • Sore tongue

Meanwhile, more serious side effects could include gastrointestinal problems, irregular heartbeat or palpitations, seizures, or depressed respiratory function.

On the other hand, some of suboxone’s side effects can include:

  • Chills
  • Cough
  • Headache
  • Dizziness
  • Sweating

Though rare, some severe symptoms could include agitation, tremors, dilated pupils, and high body temperatures.

Methadone vs. Suboxone: Access to Medication

Different restrictions apply to how you can access both methadone and suboxone medications, which depend on your situation.

Both require a prescription. However, while it is available at some pharmacies, it is generally dispensed at special methadone clinics. Generally, the administering of methadone is a highly controlled and regulated process.

The same can be said for suboxone, minus the designated clinics. It is prescribed by your doctor and picked up at your local pharmacy. However, those taking suboxone should expect to have their usage monitored. In some cases, your doctor may ask you to come in regularly to oversee the ingestion of the suboxone.

When evaluating suboxone vs. methadone, it is also valuable to remember that these are medical drugs and will be treated as such.

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Start Your Journey Towards Recovery Today

Suboxone vs. methadone treatment—which is right for you?

While it’s important to understand their differences, the choice should ultimately be left to your medical practitioner. They’ll know what’s best for you and prescribe a dose that will help treat opioid abuse without putting you or your recovery journey at risk.

Medication is just the first step. At Freedom From Addiction, we offer a holistic approach to addiction treatment. Our state-of-the-art medical detox facility in Ontario allows our patients to get through their withdrawal symptoms in a safe and supervised environment. You can count on us to deliver empathetic, high-quality care.

Contact us today to learn more.


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