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Suboxone vs. Methadone: What’s the Difference?

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Suboxone vs. methadone: What’s the Difference? Is one drug more effective than the other? What are their side effects? Here is everything you should know about the critical differences between these FDA-approved opioid agonist treatment drugs.  

Both Suboxone and methadone are potent opioids (narcotics) used to treat opioid addiction and dependence. Dependence is when you develop tolerance to an addictive substance after long term substance abuse. Consequently, your body needs more of it to get the effects you used to get with a lower dose. 

Opioid Addiction has emerged as a significant public health crisis in the U.S. According to the National Institute on Drug Abuse (NIDA), opioid-involved overdoses caused about 50,000 deaths in the U.S. in 2019. 

While both are used in Medication-Assisted Treatment (MAT) related to opioid abuse, methadone is also used to treat common withdrawal symptoms (such as severe pain relief), and Suboxone is limited to treating opioid dependence. Read on to learn more about the other differences. 

 

Suboxone vs. Methadone: Understanding the Fundamental Differences

Suboxone is a brand of a combination product that contains buprenorphine and naloxone. Other brands of buprenorphine-naloxone combination are Zubsolv, Cassipa, and Bunavail. 

Suboxone is available as a sublingual film or oral film for:

  • Sublingual use: Placing the film under the tongue. 
  • Buccal use: Placing the film in the area between your gums and the inner lining of the cheek.

You can also get sublingual prescription drug tablets of Suboxone. 

Methadone is a generic prescription drug. Brands that contain methadone are Dolophine, Methadone HCl Intensol, and Methadose. Methadone is available as:

  • Oral tablet, solution, and concentrate
  • Injectable solution
  • Oral dispersible tablet (you should dissolve dispersible tablets in water before taking)

 

Suboxone vs. Methadone: Are they Controlled Substances?

Suboxone and methadone are both controlled substances; although, they belong to different drug schedules

Methadone is a Schedule II controlled substance, while Suboxone (buprenorphine) is a Schedule III narcotic. 

Schedule II drugs have a higher potential for abuse than Schedule III drugs. Thus, Suboxone abuse is likely to cause moderate or low physical dependence. On the other hand, methadone abuse can cause severe psychological or physical dependence. 

 

Suboxone vs. Methadone: Comparing their Effectiveness

The NIDA states that both methadone and buprenorphine (Suboxone) are equally effective at medium-to-high doses when reducing heroin or prescription drug abuse. 

However, lower doses of buprenorphine (6 mg or less) appear to be less effective at keeping patients in treatment. 

When choosing between Suboxone and methadone, your doctor will most likely consider the following:

 

The Severity of Opioid Addiction

If you have mild-moderate dependence, Suboxone is the better treatment option. However, methadone can be used in patients with mild, moderate, or severe dependence. 

 

Divergence Risk

In people with a higher risk of deviating from standard treatment, methadone is considered a better option. It is because supervision of buprenorphine use is more challenging. 

 

Risk of Precipitated Withdrawal

If you are already using methadone, you should avoid switching to buprenorphine. To do so increases the risk of precipitated withdrawal. The symptoms of withdrawal include stomach pain, nausea, excessive vomiting, and severe muscle pain. 

Nonetheless, withdrawal does not typically occur when transitioning from buprenorphine to methadone. 

 

Use in Pregnancy

Suboxone appears to be safe for use in pregnant women with opioid use disorders; in such women, switching to methadone might not be necessary. 

 

Suboxone vs. Methadone: Does the Accessibility Differ?

Methadone is available only in certified opioid treatment programs (OTPs), such as methadone maintenance clinics. 

During the initial treatment, you have to visit the clinic and receive each dose under observation (on-site administration). Once you become stable, your doctor may allow you to take home doses for self-administration. 

For buprenorphine, you can receive treatment in an office-based setting or get it with a doctor’s prescription. During the initial treatment, your doctor may ask you to come to their office to get the medication. 

If you have received take-home medication, you will likely get only a few doses at a time. 

 

Suboxone vs. Methadone: Cost and Insurance Coverage

According to NIDA, the costs of buprenorphine vs. methadone treatment are as follows:

  • Methadone treatment (daily visits including medication and psychosocial and medical support services): $126.00 per week or $6,552.00 per year. 
  • Buprenorphine for a stable patient provided in a certified OTP(medication and twice-weekly visits): $115.00 per week or $5,980.00 per year. 

“The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care.” 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES September 1, 2020. 

If you get buprenorphine or methadone treatment from an opioid treatment program enrolled in Medicare, Medicare will pay doctors and other providers for office-based opioid use disorder treatment. 

Medicare covers the cost of your medication (methadone and buprenorphine), counseling, drug testing, and individual and group therapy. 

 

Suboxone vs. Methadone: Common Side Effects

The same way opioid drugs and opioid withdrawal symptoms both have common side effects, There are also some similar side effects of Suboxone and Methadone, even if they are medical treatments for opiate addictions. These side effects may include:

  • Lightheadedness
  • Dizziness
  • Sleepiness
  • Nausea 
  • Vomiting
  • Sweating
  • Constipation
  • High Blood Pressure
  • Runny Nose

Suboxone side effects may also include:

  • Numbness in the mouth
  • Swollen or painful tongue
  • Redness inside the mouth
  • Problems with focus
  • Faster or slower heart rate
  • Blurry vision
  • Muscle Aches
  • Stomach Pain

Both Suboxone and Methadone can cause serious side effects, including:

  • Addiction
  • Severe breathing difficulty

To lower the risk of side effects and possible overdose, use Suboxone or methadone only as prescribed by your doctor. 

The manufacturer’s label contains a boxed warning for methadone, which states, 

Accidental ingestion of even one dose of Methadone, especially by children, can result in a fatal overdose.

 

Key Takeaways

  • The United States FDA has Suboxone and methadone for the treatment of opioid dependence. 
  • Suboxone is a brand of a combination product (buprenorphine + naloxone). Methadone is a generic drug. 
  • Suboxone (Schedule III) has a lower abuse potential than methadone (Schedule II). 
  • Both these medications have comparable effectiveness. Yet, under certain conditions, one drug might fare better than another. 
  • The cost of methadone treatment appears to be higher than that of buprenorphine treatment. 
  • Methadone is available only in certified opioid treatment programs (OTPs). However, you can receive buprenorphine treatment in an office-based setting. 
  • These are potent medications, and misuse or abuse can lead to potentially fatal consequences. 

 

FAQs

Is Suboxone the same as methadone?

No. Suboxone is a brand of a combination product that contains buprenorphine and naloxone. Methadone is a generic drug. That said, both these drugs belong to the same class of medications called opioids. 

Is it safe to switch from methadone to Suboxone?

Doctors do not usually recommend switching from methadone because of the significant risk of precipitated withdrawal. That said, it may be an option in those transferring from methadone doses less than 50 mg. As always, consult your physician for proper medical advice. 

Is naloxone similar to methadone?

No. Naloxone is a medicine used in opioid overdose. It is in a class of drugs called opioid antagonists. It blocks the effects of opioids. Methadone is an opioid (narcotic) used in the treatment of severe pain and opioid dependence. 

Does Suboxone help with pain?

The US FDA has not approved Suboxone for the treatment of pain. Therefore, the only FDA-approved use of Suboxone is the treatment of opioid dependence. 

Can I take Suboxone 24 hours after taking methadone?

Methadone has a long half-life. It means methadone stays in your body for a longer duration. You may take Suboxone at least 36 hours (or up to 72 hours) after stopping methadone. As always, consult your physician for proper medical advice. 

Getting Addiction Treatment

If you, or someone you love, are struggling with heroin or prescription opiate addiction. Pacific Sands Recovery Center has all of the tools you need, such as Medically Assisted Treatment or Detox, to help them take their first steps towards sobriety. Call today for a free consultation with one of our care coordinators. 

 

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