Suboxone Vs Methadone for Opioid Recovery: Who Wins? | AspenRidge

Suboxone and Methadone – Both are Used to Treat Opioid Addiction

For decades, the only treatment option available to people struggling with an addiction to opioids was a trip to the Methadone clinic. Now, there’s a drug called Suboxone that has been proven effective for helping those who are trying to overcome an addiction to opioids.

Just like anything else in life, Suboxone and Methadone both have their benefits and their drawbacks. This article will provide useful information about both medications and offer a brief side-by-side comparison of the two.

If you’re considering Methadone or Suboxone for treatment of your addiction to opioids – and you’re not sure which one would work better – you will be better informed to make a decision by the time you’re finished reading this article.

What Happens When You’re Addicted to Opioids  

Opioids are highly addictive pain-killing drugs that work on opioid receptor sites in the brain. Before long, the body builds a tolerance to opioids, which means you need more and more of the stuff to get the same effect. This is how addiction happens. You become physically dependent on opioids and your body needs them to function.

Once your body is addicted to opioids, it is almost impossible to stop using them without a medically supervised withdrawal or medication replacement therapy. This is where Suboxone and Methadone come in.

Opioid Replacement Therapy (ORT) – How It Works to Treat Opioid Addiction

Methadone and Suboxone are drug replacement therapies (also known as medication replacements therapy or ORT which means Opioid Replacement Therapy) prescribed to people who are battling an addiction to street heroin or legal prescription opioids.

It is important to understand that the only notable difference between heroin and legal opioids like Hydrocodone, Oxycodone, Fentanyl, or Percocet is that heroin is illegal. Heroin and prescription opioids both work on the brain the same way, cause the same kind of euphoria, and bring on the same painful withdrawal symptoms.

If you’re addicted to opioids, you’ve probably tried to stop using them countless times on your own only to be unsuccessful time and time again. Why? Because opioids are one of the hardest addictions to kick.

If you try to stop taking opioids, your body will get sick without them and go into withdrawal. You will also experience overwhelming cravings that you simply can’t overcome with willpower.  

Drug replacement therapies like Methadone and Suboxone are given to opioid addicts instead of opioids. These medications work to eliminate cravings, reduce painful withdrawal symptoms, and decrease the risk for abuse and misuse.

Let’s talk about Methadone and Suboxone in depth, and then provide a side-by-side comparison of the two ORTs so you can make an informed decision about which medication is right for you.

Helpful Information About Methadone – a Treatment Option for Opioid Addiction

What is Methadone?

Methadone is an opioid that is prescribed for pain, but it is most commonly prescribed for the treatment of opioid dependence. It was invented in the 1930s by a German chemist who was looking for a synthetic opium-based painkiller that could address the shortage of medical narcotics in Germany at the time. It was approved for use in the United States in 1947.

When heroin use spiked in the United States in the 1960s, diseases were being spread from the use of dirty needles. This became a major problem. Methadone was introduced as an alternative to intravenously injected heroin. Clinics offering tablet or liquid forms of Methadone began to crop up across the U.S., which greatly reduced the spread of diseases like Hepatitis. By 1998, there were 79,000 Methadone clinics across America.

Methadone was the first medication approved by the U.S. Food and Drug Administration to treat opioid addiction. Until Suboxone was introduced in 2002, Methadone remained the number one treatment for heroin addiction in the United States.

If You Choose to Take Methadone, You’ll Have to Make a Daily Trip to Get Your Medication….at Least For Awhile

Methadone is taken once daily and is usually distributed at a Methadone clinic, although it can also be prescribed by a private doctor. This means that every day, you will have to physically go to the clinic or doctor to get your medication – at least for a while.

This can be problematic for people who don’t have transportation. Furthermore, in rural areas, there aren’t many Methadone clinics or methadone doctors available so you might have to travel a great distance to get your medication.

After demonstrating a continued commitment to the medication regime, however; you may be able to take a limited supply of Methadone home with you so that you do not have to go to the clinic or visit the doctor daily. This is called “medical maintenance program treatment.” This usually doesn’t happen until several months after you start taking Methadone. You first have to demonstrate a commitment to abstinence from opioids and usually have to work some kind of 12-step recovery program in addition to drug replacement therapy.    

Getting Treatment with Methadone – How it Works

Methadone is an opioid. But, remember – Methadone works as a medication replacement therapy. You take Methadone instead of heroin or whatever prescription opioid you happen to be addicted to. Methadone replaces your drug of choice.

Methadone can be administered by tablet, liquid, or wafer form. The idea with Methadone is that you slowly taper off the medication, or “step down” from it. This means you slowly reduce the amount of Methadone you are taking over a period of time. Usually, the Methadone program is six months to a year. That means you take Methadone once a day every day for as long as your doctor thinks you need it. During that time, your dosage will slowly become less and less until you are off the drug altogether.

When you are taking Methadone, you will be routinely and randomly drug-tested to make sure you don’t have any other drugs in your body – specifically, other opioids. You have to be committed to getting off opioids to stay in a Methadone program. If you fail a drug test, you will no longer be administered Methadone and will be excused from the program. You will be asked to come back when you are ready to get serious about kicking your habit, but there is usually a time requirement of six months before you can return.

Only Certain Doctors Can Prescribe Methadone

Defined as a Schedule II drug, Methadone is one of the most safely guarded medications available in the U.S. marketplace. The Narcotic Addiction Treatment Act of 1974 and the Drug Addiction Treatment Act of 2000  determine which doctors can prescribe drugs like Methadone.

Methadone doctors are bound by federal guidelines laid out by the U. S. Drug Enforcement Administration and they must undergo strict licensing requirements in order to prescribe Methadone for opioid addiction treatment.

If you want to be prescribed Methadone, you are going to have to go to a certified, licensed methadone clinic or see an addiction specialist who is licensed to administer the medication for opioid dependence.

Does Methadone Get You High?

Methadone is an opioid just like Oxycodone, Morphine, and Codeine. It does create a euphoric effect. In no uncertain terms, you can catch a buzz off Methadone. That being said, you need to keep in mind that Methadone is addictive and can be habit-forming.

But – you’re not going to be taking Methadone to get high, remember? You’d be taking it because you don’t want to get high anymore. You would start taking Methadone because you want to stop the insane cycle of opioid addiction. Methadone is a treatment for opioid addiction. It is not a drug you want to start taking because you want to trade one habit for another.  

Information About Methadone Dosage

There are different dosages for Methadone. You will work with a doctor to determine how much Methadone you will take daily. This depends on how what kind of opioids you have been taking, how much you have been taking, and for how long. Usually, the average initial dose starts out at 20 to 30 mg daily and it tapers down from there. The maximum daily dose is usually 40 mg per day.

Methadone Side Effects

Here are some of the side effects you can expect with Methadone:

  • Mood swings
  • Insomnia
  • Depression
  • Anxiety
  • Drowsiness
  • Nausea
  • Vomiting
  • Dry Mouth
  • Diarrhea
  • Constipation

Learn more about the potential harmful effects of prolonged use of methadone.

How Much Does Methadone Cost?

If you’re worried about how much Methadone costs, don’t be. If you have health insurance, your insurance will probably cover Methadone treatment and your out-of-pocket expenses will be minimal. If you don’t have health insurance, most methadone doctors and clinics work on a sliding scale – which means they will charge you based on your income and ask you to pay only what you can afford. If you’re not working, there are options available so you can get Methadone for free.

Everything You Need to Know About Suboxone

We’ve given you some important information about Methadone, which is used for the treatment of opioid dependence. Now, let’s talk about the alternative – Suboxone.

What is Suboxone?

Suboxone is prescribed to treat opioid addiction. Like Methadone, it is also prescribed for chronic pain. However; the primary purpose of Suboxone is to treat opioid dependence. Because Methadone proved to have its limitations in treating heroin and prescription opioid addiction, Suboxone was introduced to the world in 2002. Since then, it has helped tens of thousands of opioid addicts get clean and stay clean.

There are two different types of Suboxone – there is the Suboxone film and there are Suboxone tablets. The Suboxone film is a strip of medication that is dissolved under the tongue. Suboxone tablets are pills that are taken orally.

How Does Suboxone Work?

Like Methadone, Suboxone is an ORT/Opioid Replacement Therapy or drug replacement therapy that is given to people who are suffering from an addiction to opioids. Suboxone is given to opioid addicts instead of their drug of choice – whether it’s heroin or prescription opioids. However; it works much differently than Methadone.

Here is a simple explanation to a very complicated process. Suboxone is a combination of two different medications, Buprenorphine and Naloxone. These two medications work together to stop the cycle of opioid abuse. Buprenorphine is a narcotic opioid medication that treats pain. Naloxone is an opioid antagonist that binds to opioid receptors in the brain and blocks the brain from experiencing the high caused by opioids.

How Suboxone Curbs Cravings and Lessens Withdrawal Symptoms

Opioid abuse happens because of several different factors – tolerance, craving, and withdrawal.

As we’ve explained, once you begin to take opioids, your body builds a tolerance to the medication. This means you need more and more to get the same effect, which causes your body to crave more opioids. If you try to stop taking opioids, your body will go into withdrawal and experience extreme pain. This will cause you to take more opioids to avoid the withdrawal symptoms. As you know, it’s exhausting.

Buprenorphine and Naloxone, the two active medications in Suboxone, works together to stop the addictive cycle opioids inevitably produce. These medications treat opioid addiction by reducing the painful withdrawal symptoms caused by opioids and lessen the cravings they cause. They also prevent misuse and abuse because they don’t bring about the same kind of buzz you experience with heroin or medications like Percocet. This takes away the craving for more.

When you use Suboxone, you are still able to treat your pain – without getting a significant high. You won’t crave the stuff as much, you won’t have the terrible withdraw symptoms, and you’ll be able to manage your own life again. However; Suboxone can be habit-forming and should only be taken for less than a year.

You Have to Get Suboxone From a Qualified Doctor

You have to get Suboxone from a doctor, but the medication is not nearly as restrictive as Methadone. It is important to recognize, however; that not every doctor can prescribe Suboxone. You probably won’t be able to go to your primary care physician and get a prescription for Suboxone. A doctor has to meet federal guidelines and be licensed to administer this medication.

You can go to and perform a search by zip code to find a doctor near you who prescribes this drug replacement therapy.

Suboxone Treatment and Dosages – What to Expect

Like Methadone, the idea behind Suboxone is that you will take it temporarily and be tapered off the medication over time. Your dosage will be determined by what kind if opioid you have been taking, how much, and for how long. Your doctor will determine the dosage and slowly lower that dosage over a period of time. Generally, most people start with 8 – 16 mg per day.    

One of the major differences between Suboxone and Methadone is that you don’t have to go to a clinic or doctor every day to get Suboxone. You can manage your Suboxone intake on your own without daily supervision and are allowed to have the medication in your possession. You are trusted to take it as prescribed.

This can be dangerous because Suboxone can be habit-forming and can be misused. Unlike Methadone, where you are forced to be accountable to a doctor, you are only accountable to yourself when you take Suboxone.

Short-term and Long-term Suboxone Medication Therapy

There is short-term Suboxone medication therapy and there is long-term Suboxone medication therapy.

Short-term Suboxone treatment happens over the course of three to seven days. During this period, someone will be given Suboxone and quickly tapered off the medication. This often happens with a supervised medical detoxification that happens at a medical facility or an in-patient rehabilitation center. Sometimes, a doctor will administer this to someone who comes to them for outpatient treatment under closely supervised care.

The problem with going this route is that someone who has an addiction to opioids has a high probability for relapse. Unless someone has only been on opioids for a few short months and hasn’t been taking high doses off the stuff, this is not the way to go.

Long-term Suboxone treatment is the more common – and more effective – approach for treating opioid addiction. In this case, Suboxone will be administered for six months to a year. During this time, someone who is recovering from opioid addiction will be given less and less of the medication until they are taking no medication at all. This is how the cycle of opioid addiction is ultimately broken completely without the pain of withdrawal.  

Suboxone is Designed to Reduce the Effects of Opioids, but it Can Create a Low-Grade Buzz

Although Suboxone contains Naloxone, which is designed to block the brain from experiencing the high caused by opioids, this medication can give you a low-grade buzz. Many people who take Suboxone say they do get high off the stuff – though not to the degree that they do when they take heroin or Oxycodone.

It is important to recognize that, like Methadone, Suboxone can be habit-forming. You can become dependent on this drug just like prescription opioids such as Codeine or Morphine. You have to be careful when taking Suboxone. You must follow doctor’s orders and take it exactly as prescribed.  

Common Side Effects You Should Expect from Suboxone

Here are some of the common side effects that you can expect with Suboxone:

  • Abdominal/stomach pain
  • Constipation
  • Nausea/vomiting
  • Drowsiness
  • Insomnia
  • Light headedness
  • Dizziness
  • Fever or chills
  • Headaches
  • Lower back pain
  • Sweating
  • Difficulty urinating

How Much Does Suboxone Cost?

Suboxone is not an inexpensive medication. The price depends on the dosage, which pharmacy you get it from, whether your insurance covers it, and if you have discounts. Suboxone can cost as much as eight dollars a pill, but the average cost is about $144 a month without insurance. With insurance, the average cost is $18.50.

Methadone Vs. Suboxone – Who Wins?

So! We’ve talked about Methadone. We’ve talked about Suboxone. Let’s do a quick side-by-side comparison of the two.

  • Methadone has been treating opioid addiction for more than 50 years. Suboxone has been treating this condition for only 15. We have a lot more research available on the long-term effects of Methadone.
  • You have to go to the doctor/clinic daily to get Methadone. You can be given a prescription of Suboxone and manage it yourself.
  • By going to a Methadone doctor daily, you have to stay accountable. By managing your own script of Suboxone, there is a greater potential for misuse.
  • Both medications are habit-forming.
  • There may be less stigma around taking Suboxone
  • Both medications are designed to slowly remove opioids from your body.
  • Methadone gets you high. Suboxone is designed to block the opioid high.
  • Both medications treat pain. However; Methadone is an opioid. Although Suboxone contains opioids for pain, it also has a medication that blocks opioids.
  • You can get Methadone for free. Suboxone can be costly.
  • Suboxone has been developed to help you fight cravings. Because it is an opioid Methadone can cause cravings.
  • Both medications have been proven to help fight opioid withdrawal.

So, when it comes to which medication is better for opioid recovery – Methadone or Suboxone – who wins? You be the judge.      

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