Did you know both Methadone and Suboxone are effective treatments for people who suffer from misuse of opioids such as oxycontin, percocet, hydromorphone, heroin, and fentanyl? They are similar but have some important differences.
Read on to learn more about each and the difference between them.
What is Methadone?
Methadone is a long-acting prescription drug used in methadone maintenance programs. The effects of methadone usually last for 24-36 hrs. In contrast, a person using short-acting opioids typically uses multiple times a day to avoid withdrawal.
Methadone is an opioid agonist, meaning it stimulates opioid receptors in the brain and binds very tightly to them, blocking other opioids from being able to bind to these receptors. It acts on the same parts of the brain without causing the high. This can ease symptoms of withdrawal from opioids.
Due to this reaction, methadone decreases the risk of feeling the effects of other opioids and possibly overdosing. This is key as many people say that painful withdrawal symptoms are the main reason for returning to opioid misuse.
The length of treatment varies from one to two years to 20 years or more. If the person and their doctor agree to end taking methadone the dose is tapered down gradually over many weeks to months, easing the withdrawal process.
What is Suboxone?
Suboxone is the brand name of a medication that eases the symptoms of withdrawal from opioids. It’s made of two different drugs: naloxone and buprenorphine.
Buprenorphine is an opioid partial agonist and also stimulates opioid receptors in the brain. It has a ceiling effect, unlike other opioid medications. Taking more won’t deliver a larger effect. This can help reduce symptoms of opioid cravings and withdrawal, similar to methadone.
Naloxone reduces the ability of opioids to act on the brain’s receptors. When taken appropriately, it has no effects on the body unless someone misuses it, such as by injecting it. As the brand Narcan, it is also used to treat opioid overdoses.
Suboxone acts on the same parts of the brain as methadone but less strongly. It is usually taken under the tongue. Naloxone is added because it can cause painful withdrawal symptoms if injected. This prevents people from misusing it.
Suboxone may be started without a doctor’s prescription. Suboxone’s chemistry makes it less addictive than methadone. And it doesn’t cause as intense a high as methadone.
Side Effects Compared
Side effects can happen during use of methadone and suboxone. They include (from University of Illinois and Healthline.com) [1]:
Common Side Effects |
Methadone | Suboxone |
Lightheadedness |
Y |
Y |
Dizziness |
Y |
Y |
Fainting |
Y |
|
Sleepiness |
Y |
Y |
Nausea and vomiting | Y |
Y |
Sweating | Y |
Y |
Constipation | Y |
Y |
Stomach pain | Y | |
Numbness in mouth |
Y |
|
Swollen or painful tongue |
Y |
|
Redness in mouth |
Y |
|
Trouble paying attention |
Y |
|
Faster or slower heart rate |
Y |
|
Blurry vision |
Y |
Serious side Effects |
Methadone |
Suboxone |
Addiction |
Y |
Y |
Severe breathing problems | Y |
Y |
Heart rhythm problems | Y | |
Problems with coordination |
Y |
|
Severe stomach pain |
Y | |
Seizures |
T |
|
Allergic reaction |
Y |
Y |
Opioid withdrawal |
Y |
|
Low blood pressure |
Y |
|
Liver problems |
Y |
Methadone vs Suboxone
The following table compares methadone with suboxone [2] [3]:
Characteristic |
Methadone |
Suboxone |
Synthetic drugs |
Yes |
Yes |
Bind to opioid receptors in brain |
Yes |
Yes |
Treat opioid addiction |
Yes |
Yes |
Schedule II
Controlled Substance |
Yes |
Yes |
Prescription needed |
Yes From a specialized treatment center |
Yes By any healthcare provider |
Doctor present |
At first |
|
Minimum duration |
1 year |
|
Drug ingredients |
Methadone |
Naloxone and Buprenorphine |
Method of taking the drug |
Flavored drink |
|
How often taken |
Daily |
|
Time to take effect |
Weeks |
Days |
Effects on opiate withdrawal |
Ease withdrawal symptoms by stimulating the brain’s opioid receptors |
Same as methadone |
Potential for addiction |
Yes |
Yes |
Doctor’s supervision required |
Yes |
No |
Taken within a dedicated addiction program |
Yes |
No |
Dosage |
Lower than Suboxone |
Higher than Methadone |
Flexible dosing |
Yes |
No |
Addictiveness |
Greater than Suboxone |
Lesser than Methadone |
Effectiveness for avoiding relapses |
Greater than Suboxone |
Lesser than Methadone |
Side effects |
Possible |
Few |
Overdose risk |
Greater than Suboxone |
Lesser than Methadone due to the “ceiling effect” |
Risk of misuse |
Yes, but lower than other opioids |
Yes, but lower than other opioids |
Effect on body |
Full opioid agonist |
Partial opioid agonist |
Safety |
Yes, for long-term use |
Yes, for long-term use |
Outcomes |
Can increase the likelihood of achieving treatment goals. |
Can increase the likelihood of achieving treatment goals. |
Opioid Addiction Treatment in Michigan
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We offer evidence-based therapies designed to evolve with your individual needs and address the root of your substance abuse. Let our team help you get clean, repair relationships, and equip you with the skills to achieve long-term recovery. Reach out to our Admissions team now.
Sources
[1] University of Illinois. 2019. How Are Methadone and Suboxone Different?. Healthline.com
[2] DerSarkissian, C. 2024. What’s the Difference Between Methadone and Suboxone? WebMD.org.
[3] Villines, Z. 2022. Suboxone vs. methadone: What to know. MedicalNewsToday. Com