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What's the Difference Between Methadone and Suboxone?

Medically Reviewed by Jabeen Begum, MD on October 26, 2021

Methadone and Suboxone are medications that treat opioid addiction. Opioids are a type of drug that includes painkillers, heroin, and fentanyl. These drugs can reduce pain, especially from injuries or surgery. They can also cause feelings of being high.

Treatment for opioid addiction may take place in a recovery center or with a professional’s help. People in recovery often use methadone and Suboxone during treatment. These drugs can help ease withdrawal symptoms and block the high that makes opioids so addictive. 

What is Methadone?

‌Methadone is a prescription medication that helps reduce the pain of opioid withdrawal. It acts on the same parts of the brain as other opioids, without causing the high. 

German scientists created methadone during World War II during a shortage of morphine (another powerful opioid painkiller). Doctors in the U.S. began using methadone as a painkiller in 1947. 

At first, a doctor needs to be present while a person starts methadone treatment. Later in treatment, people may be allowed to take methadone alone. The drug is taken for at least 12 months.

What is Suboxone?

‌Used like methadone, Suboxone is a brand of medication that eases the symptoms of opioid withdrawal. It’s made of two different drugs, naloxone and buprenorphine. Suboxone acts less strongly on the same parts of the brain as methadone. 

Doctors began prescribing Suboxone in the U.S. in 2002. Suboxone can come in the form of a pill or strip of film that melts under your tongue, or an implant under the skin of the arm that lasts for 6 months.

What Are the Benefits of Methadone vs. Suboxone?

Both methadone and Suboxone are successful addiction treatments (although they can become addictive, as well). ‌

As for ease of use, Suboxone may be started without a doctor’s supervision. Most doctors can prescribe it within or outside a dedicated drug addiction program. However, it requires a higher dose than methadone for treatment and it is less effective for avoiding opioid relapses.

Methadone is also easier to use in flexible dosing. Flexible and take-home dosing can make it easier for patients to stay on their treatment plan and avoid relapse.

What Are the Risks of Methadone vs. Suboxone?

Methadone is more addictive than Suboxone. Withdrawal symptoms from methadone can increase dependence on the medication. Some people stay on methadone for life in order to stay away from opioids. 

Suboxone’s chemistry makes it less addictive. It doesn’t cause as intense a high as methadone, either.

Suboxone overdose is also less common than methadone overdose. Unlike methadone, its effects taper off after a certain dosage amount (called the ceiling effect). The ceiling effect helps to prevent someone from taking too much Suboxone.

But Suboxone addiction and overdose are still possible. People who are new to opioids and people who mix medications are at higher risk of overdose from Suboxone.

What Are the Side Effects of Methadone and Suboxone?

Side effects can happen during short- and long-term use of methadone and Suboxone. They can include:

  • Constipation
  • Nausea or vomiting
  • Dizziness
  • Trouble concentrating
  • Drowsiness
  • Shallow breathing
  • Sexual problems

Medications like methadone and Suboxone are often only one part of a larger treatment plan for opioid addiction. They can help people stop using opioids initially. Staying away from opioids after addiction often involves therapy, family support, and lifestyle changes.

Show Sources

SOURCES:

Addiction: “Yes, people can die from opiate withdrawal.”

American Addiction Centers:  "Can You Overdose on Suboxone?," “How Does Suboxone Compare to Methadone?," "Suboxone Side Effects: What Are They & Is It Worth It?"

American Society of Addiction Medicine: “Opioid Addiction Treatment.”

Centers for Disease Control and Prevention: “What You Need to Know About Treatment and Recovery.”

Department of Justice/Drug Enforcement Association: “Drug Fact Sheet: Methadone.”

Indian Health Service: “Buprenorphine for the Treatment of Opioid Use Disorders.”

Mount Sinai: “Methadone overdose.”

National Institute on Drug Abuse: “How do medications to treat opioid use disorder work?," "How much does opioid treatment cost?"

Pediatrics: “Prescription Opioid Misuse and Risky Adolescent Behavior.”

The Pew Charitable Trusts: “More Flexible Methadone Access Should Continue Post-Pandemic.”

Recovery Care: “What Is Suboxone?”

Recovery Research Institute: “Tried-and-true methadone shows superiority over buprenorphine.”

Substance Abuse and Mental Health Services Administration: “Methadone.”

UAMS Psychiatric Research Institute: “What is Methadone?”

U.S. Drug Enforcement Administration: “BUPRENORPHINE.”

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