A very clear sign of an addiction is the inability to stop using the substance. However, we can suggest that a detailed discussion on suboxone vs. methadone is relevant for a better understanding of the two. Suboxone vs methadone is an extremely common topic that often sparks debate among medical practitioners!
We know that medications prescribed by doctors to relieve pain are known as opioids. At first, the person has a choice about how much to use. But, failure to follow the doctor’s instructions makes the person want to keep using it. The continuous use of opioids, including medications and illicit drugs like heroin, leads to addiction.
Several medications can assist in recovery from addiction and suboxone and methadone are the two of the most common medications that are used in addiction treatment.
These medications come with their fair share of benefits and side effects and comparisons are often drawn between them tallying which works better than the other.
1. Suboxone VS Methadone
Methadone is an opioid agonist, and it is manufactured in labs. Hence, it is known as a synthetic opioid. When it is administered by a professional, it subsides the need for wanting to take the substance in larger amounts. However, methadone can be addictive as well, and it is important to take it in the quantities prescribed by a medical professional.
Suboxone is a brand name for the combination of two drugs buprenorphine and naloxone. It helps to treat severe opioid withdrawal symptoms and opioid dependence. Naloxone opposes the effects of opioids on the body during an overdose. Therefore, it is an opioid antagonist.
In contrast, buprenorphine partially acts as an opioid agonist. It acts by blocking opioid receptors, thereby reducing a person’s urge to overuse them. Though it works like an opioid, its effects are less strong compared to full agonists like heroin and methadone. Just like any other heavy medication, suboxone, and methadone come with various benefits and disadvantages.
Several controversies surrounding suboxone vs methadone are debated in the medical sector.
Methadone and Suboxone are both opioids, and the following sections of the article will discuss what an addiction is, along with the various arguable pros and cons of the suboxone vs methadone treatment methods.
2. What Is An Opioid Addiction Disorder?
An addiction is an intense craving to do something. Therefore, a strong craving for opioids suggests the possibility of addiction. It is a disease that affects a person’s brain and behavior. Some common opioid drugs are fentanyl, codeine, heroin, and morphine.
Signs and symptoms of opioid abuse can be physical or psychological. Common symptoms include shallow breathing, mood swings, irritability, abandoning responsibilities, and poor decision-making.
In case of an overdose, signs like erratic pulse, irregular heartbeat or cardiac arrest, vomiting, and small pupils of the eyes are considered very serious and require immediate medical attention.
However, a person can be tolerant and dependent on a drug but not be addicted to it. There is a difference between drug tolerance, drug dependence, and addiction.
Opioid addiction disorder is diagnosed with the help of a medical examination that often includes a test for mental health disorders. Methadone and suboxone are two of the most common medications used to treat opioid addiction and opioid use disorder.
One of the most highly addictive substances is heroin. The risk of overdosing and contracting communicable diseases increases with the abuse of illicit drugs like heroin or prescription drugs. A point that distinguishes suboxone vs methadone further is that suboxone is a Schedule iii controlled substance, a pharmaceutical drug that is widely used for opioid addiction treatment, mainly opioid dependence.
3.1. Benefits Of Suboxone
To address the colloquies surrounding suboxone vs methadone, an explanation of how suboxone works must be done first.
When suboxone is taken according to the prescription, it allows the addicted person to stop abusing the drug without any potential withdrawal symptoms. Usually, it is not needed for the person to go to a clinic for suboxone. Their doctor will provide a prescription and the initial intake must be monitored very closely. With time, the doctor will allow the person to monitor their own intake.
Suboxone is a new drug that was created for the treatment of opioid addiction. It was developed to be less addictive with a lower number of side effects than methadone. However, the use of suboxone is associated with risk factors as well. Owing to this reason, it has a higher success rate compared to other alternatives, and it doesn’t produce the “euphoric effects” in the person taking the medication.
3.2. Risks Associated With Suboxone
Suboxone is a combination of an opioid agonist named buprenorphine and an opioid antagonist named naloxone. Although suboxone has been ranked to be the least likely drug to be misused, potential risks of physical dependence seem to exist. Several studies suggest that the abuse of suboxone occurs when people try to self-treat their withdrawal symptoms.
Illegal use of suboxone is dangerous, especially when it is injected into the bloodstream. Several other diseases are also associated with the unauthorized use of suboxone, like the development of abscesses and contracting blood-borne diseases like HIV and hepatitis. Therefore, further treatment may be provided for suboxone addiction in an individual.
3.3. Withdrawal Symptoms With Suboxone
As an opioid, suboxone has the potential of being illicitly abused. Some of the most common withdrawal symptoms linked with suboxone are fever, nausea, chills, digestive problems, depression, anxiety, drug cravings, and difficulty concentrating.
Methadone is an opioid used for pain relief and drug detoxification. In contrast to suboxone, a person can acquire methadone through certified opioid treatment programs, such as a certified methadone maintenance clinic. Methadone is a Schedule II controlled substance, and it is used to treat chronic pain and opioid addiction.
4.1. Benefits of Methadone
Methadone works by relieving pain in individuals who cannot be treated with any other pain medications. In addition to relieving pain, it prevents cravings and withdrawal symptoms in those diagnosed with opioid use disorder. The euphoric feelings associated with the intake of opioids are absent.
A patient undergoes overall improvement with methadone treatment. The doctor might also change the treatment plan and start decreasing the intake with time. Maximizing the required dosage is strongly discouraged without medical consultation. However, research undertaken by healthcare professionals assessing the hazards of suboxone vs methadone shows that the risks and side effects of methadone are higher than suboxone.
4.2. Risks Associated With Methadone
To understand the difference between suboxone vs methadone, we must know that the biggest risk linked with methadone is that this medication leads to abuse as well. Several unwanted effects occur with the misuse of methadone. Some critics have argued that methadone is as bad as any other substance in terms of addiction and dependence.
4.3. Withdrawal Symptoms With Methadone
As with any opiate, methadone includes withdrawal symptoms like loss of appetite, sexual dysfunction, insomnia, nausea, and irregular heartbeat. Methadone and suboxone are opiates used to treat opioid addiction.
Several facilities have been developed to help individuals who are trying to recover from drug abuse. These include OTPs (opioid treatment programs) like medicated assisted treatment.
5. Opioid Treatment Program
Medicated assisted treatment (MAT) is provided by OTPs (opioid treatment programs) for people diagnosed with opioid use disorder. SAMHSA (Substance Abuse and Mental Health Services Administration) must provide certification for OTPs, and it must also be accredited by an independent SAMHSA-approved accrediting system.
Opioid treatment programs are also known as highly modulated and synchronized methadone clinics, which means that OTPs have permission to distribute methadone. Most of these clinics offer different types of treatment options in addition to medicated-assisted treatment.
5.1. Medicated Assisted Treatment
This treatment method combines medications and behavioral therapy in addition to counseling to provide a “whole patient” approach to the treatment for opioid use disorders and other substance abuse disorders. MAT programs are clinically driven and tailored to meet every individual patient’s needs.
According to information gathered by research, MAT has the potential to prevent and reduce opioid overdose. These medications and therapies can also reduce the risk of contracting HIV and hepatitis by reducing the chances of relapse.
Medicated assisted treatment aims towards the complete recovery of the individual who abuses opioids. The FDA approves several medications to treat opioid abuse disorder. These MAT medications reduce the chances of developing withdrawal symptoms and psychological dependence caused by chemical imbalances in the body.
Buprenorphine, methadone, and naltrexone are drugs used for the treatment of opioid dependence. It focuses on addictions related to short-acting opioids and semi-synthetic opioids. These medications are considered safe for long-term use. Naloxone is used to prevent the toxic effects of an opioid overdose by reversing the consequences.
Several health centers aid in overcoming opioid addiction. In these centers, the doctor will take on the “whole patient” approach to treat patients and help them with their recovery. The use of medication might be incorporated as well in the treatment plan.
The choice between the use of suboxone vs methadone is equal, meaning both opiates are equally used for treatment. Eleanor Health and Right Path Addiction Treatment Center are two great examples of centers where medication and behavioral therapy are provided at the same time to the person.
5.2. What About Treatment Costs?
Federal and state-funded health insurance programs like Medicaid and Medicare will ensure that the treatment program a person is opting for is either free or provided at a lower cost.
The argument that distinguishes the efficiencies of suboxone vs methadone is explained by a study conducted to observe how people reacted to buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). Before further analysis of suboxone vs methadone, it is important to note that Suboxone contains buprenorphine and naloxone, but Subutex only contains buprenorphine.
6. The Cochrane Review
This study was conducted to evaluate buprenorphine maintenance with a placebo and methadone maintenance in the treatment for opioid dependence, along with its ability to retain people in treatment, reduce mortality, and illicit drug abuse. The method of data collection used for this study was the Cochrane Collaboration methodology.
The Cochrane Review included 31 participants, and the results suggested that the buprenorphine treatment led to better retention by suppressing illegal drug abuse. Compared to the methadone treatment, BMT tends to retain fewer individuals when administered flexibly at low doses. Other critics of the suboxone vs methadone argument discovered that methadone treatment and BMT do not vary in effectiveness when administered in fixed high or medium doses.
6.1. Limitations Of The Study
This study differentiates between flexible and fixed doses. In a clinical setting, doses are prescribed by the doctor in response to the patient’s needs. Furthermore, the results indicated that methadone treatment retained participants better than the BMT approach with flexible doses. There was also no evidence that if one of the treatment methods repressed the urge to use heroin more than the other.
There are several other limitations in this study that require further research by scientists and doctors. As mentioned earlier, suboxone vs methadone is a topic subject to controversies. Though both of the medications are used in addiction treatment, they have the potential to be abused. A person who reduces their intake might begin to experience opioid withdrawal.
The long-term dangers and side effects associated with methadone and suboxone have gained more attention in the 20th and 21st centuries. Challengers who oppose the use of methadone have suggested that this drug treatment is just another replacement for an opioid. Patients are often left struggling with their addiction to methadone, which prolongs the treatment.
In addition, methadone is a Schedule II drug, which indicates that the chances of experiencing side effects of being addicted to it are higher than other drugs. When distinguishing between suboxone vs methadone, we have learned that suboxone is a form of buprenorphine with added naloxone, and it has been gaining popularity as a drug for treating addiction disorders. However, the use of the medication suboxone is a dubious topic among certain doctors.
According to them, taking suboxone has devastating effects if used for a long time, and it is as good as an addiction starter. However, on the other hand, researchers see suboxone as a better alternative for addiction treatment. The special concoction of buprenorphine and naloxone causes lesser withdrawal symptoms and discourages misuse by encouraging recovery compared to only buprenorphine.
The difference between suboxone vs methadone lies in the fact that suboxone has been garnering rapid approval for the treatment of opioid addiction. It is easier for a person to discontinue Suboxone than methadone as the “high” caused by buprenorphine is less intense. The NIDA has endorsed suboxone as a safer alternative than methadone for the treatment of heroin addiction.
To finally address the controversial situation between suboxone vs methadone, support from NIDA and SAMHSA gives suboxone the upper hand in the future of drug treatment.
1. How do Suboxone and Methadone differ in their mechanisms of action?
A. Suboxone contains both an opioid agonist (buprenorphine) and an antagonist (naloxone). Buprenorphine activates opioid receptors but has a ceiling effect, limiting the euphoric effects and risk of overdose. Naloxone is added to deter misuse.
Methadone is a full opioid agonist, meaning it activates opioid receptors fully. It helps reduce cravings and withdrawal symptoms by providing a long-acting opioid effect.
2. Can Suboxone and Methadone be used during pregnancy?
A. Both medications can be used during pregnancy, but the choice depends on individual circumstances and should be discussed with a healthcare provider.
3. Can someone switch from Methadone to Suboxone or vice versa?
A. Switching between medications should be done under medical supervision and depends on factors like the individual’s current dose, the length of time in treatment, and their specific needs and goals.