Methadone vs. Suboxone

Key Takeaways

• Both are medications to help with opioid addiction; Suboxone also contains naloxone - Jump to Section
• Methadone is for severe cases; Suboxone includes naloxone to prevent misuse - Jump to Section
• Choose between Methadone or Suboxone based on health, addiction severity, and past treatments - Jump to Section
• Methadone reduces cravings and can manage pain without causing euphoria - Jump to Section
• Suboxone eases withdrawal and prevents misuse through naloxone and buprenorphine - Jump to Section

What are Methadone and Suboxone?

Methadone and suboxone are prescription medications used to treat opioid dependence and addiction. Both medications are key players in addiction medicine and are FDA-approved for medication-assisted treatment (MAT).

Methadone is a synthetic opioid analgesic, it’s similar to other prescription opioids like hydrocodone and morphine. On the other hand, Suboxone is a combination of two medications called Buprenorphine and Naloxone.

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How are Methadone and Suboxone Different?

Although they both treat opioid addiction, they have distinct mechanisms. Suboxone is only approved for treating opioid use disorder, on the other hand, Methadone treats chronic pain and OUD.

Other differences between Methadone and Suboxone include:¹

• Methadone is a full opioid agonist which stimulates the brain’s opioid receptors completely, while Suboxone is a partial opioid agonist which stimulates these receptors to a lesser extent
• Methadone is taken orally in liquid or tablet form, while Suboxone is available as a tablet or sublingual film
• Methadone is more effective for severe cases of addiction and better at managing cravings to avoid relapses

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Is Methadone or Suboxone Right for You?

There is enough evidence to show that both Suboxone and Methadone effectively treat opioid addictions. Talk to your doctor to ensure you’re making an informed decision.

Methadone is the most effective treatment option because it prevents cravings and other withdrawal symptoms while managing pain. Meanwhile, Suboxone is effective at reducing cravings and preventing relapse.

However, as part of a comprehensive treatment plan, the choice between Methadone and Suboxone should be made after considering the following factors:

• Overall health status
• Severity of addiction
• Treatment history
• Personal preference

It’s also important to consider the opioid treatment cost, which may vary depending on your insurance and specific treatment program.

How Does Methadone Work?

Methadone is a long-acting opioid agonist which prevents cravings by acting on the opioid receptors in the brain. It can also relieve pain by affecting the pain receptors in the central nervous system.

Although it’s similar to other opioids, it activates the opioid receptors in an opioid-dependent person without triggering euphoria or pleasure.³ Because of this, Methadone is considered a component of holistic treatment approaches that involves counseling and other behavioral treatments.

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Methadone Dosage & Administration

Methadone dosage differs from person to person.⁴ Follow your doctor’s directions to ensure you take the correct dose for your condition.

Methadone can only be legally dispensed through a certified opioid treatment program (OTP).⁵ Additionally, you should only receive this drug under the supervision of a mental healthcare professional.

If you’ve been taking Methadone for over a few weeks, don’t stop taking it without consulting your doctor first. They will help you gradually taper off the drug to avoid Methadone withdrawals.

Benefits of Methadone

In addition to opiate addiction treatment and chronic pain management. It’s also effective for opioid replacement therapy.

Other benefits of Methadone treatment include:

• Lowers the risk of infectious diseases such as HIV/AIDS and hepatitis spread through sharing opioid injection needles
• Improves a person’s overall quality of life 
• Improves social functioning
• Allows for better participation in treatment programs by eliminating opioid withdrawals
• Prevents relapse by controlling cravings

Side Effects & Risks of Methadone

Alongside the benefits, Methadone has the following side effects:

• Irritability
• Anxiety
• Restlessness
• Disturbed color perception
• Constipation
• Confusion 
• Missed or irregular menstrual periods
• Weight changes
• Decreased sexual drive
• Night blindness
• Weakness
• Itching

Note that this is not a complete list of Methadone’s side effects. However, if you notice any unusual changes or severe side effects, contact your healthcare provider immediately.

Severe Side Effects of Methadone Use

Abusing Methadone in any way can lead to severe side effects. These include:

• Blurred or loss of vision
• Nausea or vomiting
• Bleeding gums
• Changes in skin color
• Convulsions
• Extreme fatigue
• Cough with a frothy pink sputum
• Difficult or troubled breathing
• Difficulty with swallowing
• Noisy breathing or wheezing
• Dizziness, faintness, or lightheadedness
• Dry mouth
• Double vision
• Puffiness or swelling around the eyes
• Muscle pains
• Hives or skin rash
• Addiction 
• Methadone Overdose

The likelihood of experiencing severe side effects increases when you mix Methadone with other medications or alcohol. Methadone can also dangerously interact with depressants and sedatives, leading to:

• Slowed breathing
• Unconsciousness
• Coma
• Death

Methadone Addiction Potential 

While Methadone has beneficial uses, it also carries a high risk of drug abuse. Because of this, Methadone is classified as a Schedule II drug.⁷

Because of this, the non-medical use of Methadone is prohibited. contact a healthcare professional if you or someone you know has become addicted to Methadone.

Opioid Withdrawal Symptoms

Both Methadone and Suboxone are helpful in managing harmful withdrawal symptoms, which include:

• Watery eyes, runny nose, and sneezing
• Problems with sleeping
• Changes in body temperature
• Anxiety
• Sweating
• Tremors
• Nausea or vomiting
• Diarrhea
• Intense cravings for opioids

How Does Suboxone Work?

As a mixture of naloxone and buprenorphine, Suboxone acts on the brain’s opioid receptors to prevent cravings.⁸ It can also interact with these receptors to ease withdrawal symptoms.

Buprenorphine acts like other opioid drugs to a much lesser extent, hence the name partial agonist. On the other hand, Naloxone blocks the brain’s receptors from the euphoric effects of buprenorphine, which prevents Suboxone misuse.

When Suboxone is taken properly, these two substances effectively manage withdrawal. This helps you recover with minimal pain and discomfort.

Suboxone Dosage & Administration

Generally, the recommended starting dosage of Suboxone is 8 mg/2 mg.⁹ Eight milligrams (mg) represents buprenorphine, and two milligrams (2 mg) represents naloxone.

The maintenance dose for Suboxone is 16 mg/4 mg, which is taken once a day. The Suboxone sublingual film shouldn’t be cut, chewed, or swallowed because it’ll affect absorption and lessen its effects.

However, Suboxone does have flexible dosing. This means healthcare providers can adjust the dosage depending on your response to the medication.

Benefits of Suboxone

In regard to treating opioid use disorders, Suboxone has the following benefits:

• Increases the chances of survival in cases of severe opioid dependence
• Prevents unpleasant withdrawal symptoms, allowing you to focus on treatment
• Enhances the success of other holistic approaches, such as behavioral therapy and support services, when used together
• Decreases criminal activities related to drug use
• Improves outcomes in pregnant women with OUD
• Improves a person’s overall quality of life
• Aids in limiting illicit opioid use

Side Effects & Risks of Suboxone

Mild side effects include:

• Drowsiness
• Anxiety
• Depression
• Problems with concentration
• Sweating
• Headache
• Constipation
• Blurry vision
• Trouble sleeping (Insomnia)

Severe Side Effects of Suboxone Use

Severe side effects include:

• Problems breathing due to respiratory depression
• Painful tongue
• Back pain
• Numb or tingling mouth
• Fast or irregular heartbeat
• Nausea and vomiting
• Dizziness and fainting
• Liver damage
• Dependence
• Coma

The main risk associated with Suboxone is respiratory depression. This condition causes slow or shallow breathing, depriving the body of oxygen. If you experience any of these symptoms, seek immediate medical assistance.

Suboxone Addiction Potential 

Suboxone is classified as a Schedule III drug under the Controlled Substance Act (CSA).¹⁰ Although these drugs aren’t as potent as Schedule I or II substances, prolonged use can still lead to physical and psychological dependence.

If you suddenly stop using suboxone after using it for an extended period of time, you may experience severe opioid withdrawal symptoms. If you want to avoid these symptoms, talk to your doctor. They’ll be able to assist you in tapering and quitting the drug.

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