Methadone VS Suboxone: What is the Difference?

There’s no doubt that opioid addiction has been increasing year over year and can now be considered one of the most important matters facing our generation.  As this epidemic worsens, companies are continuing to expand their medications to help combat the continued use of opioids and provide some relief to the symptoms of withdrawal.  Two of the most widely used medications on the market at this time are Methadone and Suboxone.  Whether it’s for yourself or a loved one, it can be useful to know what is the difference between Methadone and Suboxone if you are seriously considering either of these two drugs.

How Opiates Work

To better understand how these drugs work, it’s useful to know how opiates affect the brain.   Every person has a number of opiate receptors in the brain that provide feelings of increased pleasure and relaxation all while decreasing pain and discomfort.  Opiates mimic chemicals naturally created in the body and are used to tell the brain when something is pleasurable and thus enticing the person to repeat something that feels good. When opiates enter the body, they bind to the receptors and stimulate these feelings.  The more opiates entering the blood, the more intense these feelings become. Due to our natural drive to repeat pleasurable activities, these substances are very addictive. Users are prone to want to repeat the action of using over and over, and when opiate drugs are used continuously, they create both a mental and physical addiction which often requires medications to detox from.

Quick History of Methadone

Methadone was first synthesized in 1939 in Germany.  After World War II, the already existing patent for Methadone was obtained by the US Department of Commerce Intelligence and approved as a painkiller.  In the middle of the 1960’s, Methadone uses were expanded to treat heroin addicts with ongoing doses to prevent withdrawal symptoms from setting in, there by deterring the use of heroin- a treatment commonly referred to as a Methadone Maintenance Treatment.  This reduced the transmission of diseases caused by intravenous drug use and a decrease in the local crime rate.  Over time, Methadone Clinics started gaining momentum throughout the US and even in other countries as well.

Quick History of Suboxone

In 1966 Buprenorphine was discovered as an alternative treatment to morphine, and branded under the name Subutex. Subutex was a sublingual- meaning a medication dissolved under the tongue- form of Buprenorphine that preceded Suboxone. The significance of Buprenorphine was that it was as effective as a painkiller but without some of the serious side effects that come with most painkillers such as abuse risk potential.  However, Buprenorphine diversion still allowed the drug to be abused to a certain extent and so it was enhanced to include an ingredient called Naloxone that helped prevent and deter users from abusing the drug to get high. Thus, Buprenorphine plus Naloxone created Suboxone. Subutex is no longer in production, and Suboxone is the most common form of the drug used to treat opiate withdrawals today.

Methadone vs Suboxone

Now, the most important question: What is the difference between Methadone and Suboxone?  To start, Methadone and Suboxone are both synthetic opioids and both are used to treat patients with a dependency on opioids.  Though they both have the same intended uses, there are some very major differences between the two drugs.  Due to the Naloxone in Suboxone, it is much harder to abuse, has a much lower risk of a fatal overdose, and is less addictive than methadone.  Suboxone produces less euphoric effects compared to Methadone and has a higher half-life, meaning that it stays in the body longer versus methadone which is consider a short-acting withdrawal drug.

Drugs.com states that “Naloxone blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse”.  According to Medlineplus.gov “Methadone may be habit forming” and that “there is a greater risk that you will overuse methadone” if the patient has a history of alcoholism, drug addiction, depression, or mental illness.  On the opposing side, Methadone is much stronger than Suboxone and may provide more relief to an individual with more severe withdrawal symptoms.  Methadone dosages are closely monitored by a clinic because of the strength whereas Suboxone can be prescribed and taken home with an individual.  The initial stages of starting Methadone will require a trip to a local Methadone clinic where the dosage must be monitored and taken in front of a witness.  Lastly, there are generic forms of Methadone available that, depending on insurance, offer much cheaper options than suboxone.  Each drug has comparable side effects but some additional researched should be utilized prior to taking either.

Finally, because of the Naloxone component in Suboxone, any opiates currently bound to an opiate receptor in the brain will be pushed off when the drug takes effect, meaning that if it is taken prior to the onset of withdrawal symptoms, it can lead to an instant and severe onset of symptoms known as precipitated withdrawal. For this reason, it is recommended to take your first dose of suboxone 24 hours after your last use of opiate drugs. Methadone, on the other hand, will not cause the onset of withdrawal symptoms. It is, however, recommended to be very honest with your doctor about your last use time and amount, to avoid the possibility of overdose.

Choosing the Right Medication for You

Regardless of your choice, both options are generally seen as a safer alternative to street heroin.  Heroin users are not taking prescribed dosages and have no idea what chemicals have been added or cut into the heroin making each use a considerable gamble.  If the only option available to you is between either heroin and Suboxone or Methadone, then the Suboxone and Methadone should be an obvious answer.   However, if you are fortunate to be in the situation to choose between Methadone and Suboxone then being informed and knowing the benefits and drawbacks will certainly assist in coming to an informed decision.  Remember, a physician or doctor should be always be consulted before taking either drug as they can help with reviewing each drug in much more detail and assessing the benefits and risks for an individual.