Suboxone and Methadone: How Do They Difference?

What is Suboxone?

Suboxone is a prescription medication that treats OUD in adults. It is intended to be used as part of a comprehensive treatment plan that includes counseling and treatment. behavior therapy. Suboxone is a combination medication that contains two active ingredients: buprenorphine and naloxone.

Suboxone comes as a sublingual film or tablet, meaning it dissolves under your tongue. Generic versions are also available. The film should not be cut or swallowed whole. Instead, melt it under your tongue or on the inside of your cheek. Suboxone begins working quickly and reaches its full effect within one to three hours. The usual maintenance dose is 16 mg/4 mg buprenorphine/naloxone per day. It is usually taken long-term or indefinitely.

Zubsolv It is a sublingual tablet that works the same way as Suboxone but with slightly different dosages.

Benefits of Suboxone

Suboxone can be a highly effective treatment for opioid addiction when used as part of a comprehensive plan that includes counseling. Some benefits of Suboxone include:

• Can be used at home
• Lower risk of fatal overdose
• Decreased nausea
• Reduces the risk of premature birth and newborn withdrawal symptoms
• Safe to use during pregnancy

What is Methadone?

Methadone (one brand name is Methadose) is a complete opioid agonist. It works by activating opioid receptors in the brain like other opioids, but in a more controlled manner. It reduces cravings and withdrawal symptoms without causing the intense euphoria (“high”) associated with other opioids.

Methadone is usually taken by mouth as a liquid, but it is also available in tablet and injectable forms. Because of its potency and risk of abuse, methadone is provided under strict supervision, especially in the early stages of treatment.

In addition to opioid use disorder, methadone is also approved by the Food and Drug Administration (FDA) for the treatment of pain. And it is sometimes used off-label to treat neonatal abstinence syndromeA newborn baby bump occurs when the pregnant person experiences withdrawal symptoms from medications such as opioids used during pregnancy.

Benefits of Methadone

Methadone has been the cornerstone of opioid treatment programs for decades and is one of the most studied treatments for opioid use disorder.

Methadone usually requires daily dosing in a clinic. Since the pandemic, some states have allowed new services:

• Take-home doses
• mobile units
• Integrated outpatient treatment programs

This makes it easier for more people, especially in remote areas, to receive necessary treatment. Long-term methadone treatment has proven to be highly effective in reducing the risk of relapse and overdose while improving overall well-being.

Comparison of Suboxone and Methadone for OUD

Research shows that treating opioid use disorder with medication saves lives. Both methadone and buprenorphine (a component of Suboxone) have been proven to reduce the likelihood of death, including death from opioid-related overdose. Methadone and buprenorphine are considered equally effective in reducing opioid use.

Methadone has been shown to be better at reducing appetite, but it comes with a higher risk of overdose (more on this later).

Side Effects of Suboxone and Methadone

Both Suboxone and methadone come with mild to life-threatening side effects.

Because of differences in the way it works, morphine is more likely to cause excessive sedation and respiratory depression (slowed, shallow breathing), especially when taken in the early stages of treatment or in higher doses. Suboxone is less likely to cause excessive sedation, making it a safer option in most cases.

Although not a complete list, the table below compares the most common and potentially serious side effects of Suboxone. and methadone.

Suboxone and Methadone
	Suboxone (Buprenorphine/Naloxone)	methadone
Common Side Effects	Discomfort or irritation in the mouth; redness of the mucous membrane in the mouth; headache; nausea; vomiting; sweating; constipation; insomnia; swelling of the limbs; dizziness	Dizziness; dizziness; sedation; nausea; vomiting; sweating; constipation
Serious and Potentially Life-Threatening Side Effects	Difficulty breathing (respiratory depression); excessive sedation or drowsiness; liver problems; opioid withdrawal; risk of abuse; severe drug interactions; allergic reaction	Difficulty breathing; excessive sedation or drowsiness; heart rhythm problems; serotonin syndrome (symptoms such as diarrhea, seizures, hallucinations and fever); low blood sugar; hypotension; seizures; risk of abuse; severe drug interactions; allergic reaction

Risks of Methadone and Suboxone

When considering Suboxone and methadone for opioid use disorder, it is important to understand the risks and safety concerns associated with both medications. Both drugs can have serious interactions with other substances:

Combining them with Suboxone or methadone can lead to dangerous effects including severe sedation and life-threatening respiratory depression.

Methadone, due to its long half-life (how long does it take for the active ingredients of the drug to decrease by 50%), requires careful dose management to prevent overdose and accumulation of the drug in the body. It is also associated with a potentially fatal heart arrhythmia called QT prolongation, so regular heart monitoring is recommended, especially for people with pre-existing heart conditions. heart conditions.

Suboxone, although safer overall, still carries risks, especially when mixed with alcohol or other central nervous system depressants. Both medications should be used with caution in individuals with liver problems, and it is very important to consult a healthcare professional to ensure safe and effective treatment.

If you become pregnant at any time during treatment, make sure your healthcare provider knows. Although both methadone and Suboxone are sometimes necessary to treat opioid use disorder in pregnant people, it is important to be aware of the risks.

More specifically, taking methadone or Suboxone during pregnancy, neonatal abstinence syndrome. This does not mean that treatment should be stopped, but it does highlight the need for frequent follow-up by healthcare professionals to care for both the birthing person and the newborn.

Summary

Suboxone and methadone are effective options for treating opioid use disorder, but they work differently and have their own pros and cons. Suboxone is generally safer, less likely to be abused, and is generally convenient because you can take it in the privacy of your home. Methadone, on the other hand, requires more medical supervision due to its higher risk of abuse and possible complications, but may be better for those who have not had success with other treatments.

Ultimately, the choice between Suboxone and methadone should be made with your healthcare provider, taking into account your specific situation and needs. Recovery from opioid use disorder is possible with the right support and treatment plan.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts in our articles. Read our editorial process to learn more about how we fact-check our content and keep it accurate, trustworthy and reliable.

1. National Institute on Drug Abuse. Medications used to treat opioid use disorder.

2. Centers for Disease Control and Prevention. Opioid use disorder: Diagnosis.

3. Centers for Disease Control and Prevention. Commonly used terms.

4. DailyMed. Suboxone label.

5. Velander JR. Suboxone: logic, science, misconceptions. Ochsner J.. 2018;18(1):23-29.

6. DailyMed. Methadone label.

7. Patrick SW, Barfield WD, Poindexter BB; Fetus and Newborn Committee, Substance Use and Prevention Committee. Neonatal Opioid Withdrawal Syndrome. Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074

8. Office of Addiction Services and Support. Medications for the Treatment of Opioid Use Disorder.

9. Mattick RP, Breen C, Kimber J, et al.Placebo or methadone maintenance versus buprenorphine maintenance for opioid dependence. Cochrane Database System Rev.

10. DailyMed. Methadone label.

11. Mattick RP, Breen C, Kimber J, et al. Placebo or methadone maintenance versus buprenorphine maintenance for opioid dependence. Cochrane Database System Rev.

With Patricia Weiser, Pharmacist

Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. He has more than 14 years of professional experience.

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