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Suboxone vs. Methadone: Which Works Best for Treatment

Overturned bottle of prescription pills
Methadone has been an opioid addiction treatment for decades. How does it compare to Suboxone? Here’s what you should know about Suboxone vs. methadone.

If you struggle with an opioid dependency, medication-assisted treatment might be an excellent recovery strategy. Currently, the only FDA-approved medication-assisted treatments for opioid use disorder are Suboxone, methadone and Vivitrol. While Vivitrol and Suboxone are comparatively new treatments for substance use disorder, methadone has been used for more than 60 years as an opioid addiction therapy.

Whether methadone or Suboxone treatment is the best option will depend upon multiple factors relating to your substance use disorder. Here is a breakdown of the two treatment modalities.

Methadone: The First Opioid Addiction Treatment Medication

Methadone was first introduced as an analgesic (pain-relief), synthetic alternative to opium. Though originally envisioned and used for pain management, the drug began to gain recognition as an effective opioid misuse remediation tool in the 1950s. By the early 1970s, in large part facilitated by a federal program that allowed certified treatment clinics to administer methadone, approximately 25,000 people were receiving methadone treatment for opioid addiction in the United States.

Methadone is a synthetic opioid agonist; it attaches to the brain’s opioid receptors, which inhibits the ability of other opioids (heroin, codeine, oxycodone) to cause a euphoric response. Administration of methadone allows opioid-dependent people to cease opioid use without experiencing severe withdrawal symptoms. For people with opioid dependency, methadone does not cause intoxication.

Because methadone has been in use for decades, we have abundant studies and research on long-term treatment and methadone efficacy. It is a highly effective treatment when combined with dedicated addiction intervention.

However, methadone is a Schedule II drug with minor potential addiction and abuse. Nevertheless, because methadone can only be administered by a registered narcotic treatment program as a substance use disorder therapy, the likelihood of illicit use or adverse reactions is relatively low.

Methadone is administered daily and under supervision. It is given as a liquid solution, tablet or tablet dissolved in a liquid.

Suboxone: A New Generation of Medication-Assisted Recovery

Suboxone has become the most commonly prescribed medication for opioid use disorder treatment, surpassing even methadone.

Like methadone, buprenorphine — the active drug in Suboxone — was originally intended for the treatment of pain. As its potential for opioid addiction treatment became recognized, it also became clear that buprenorphine could pose addiction risks. The National Institute on Drug Abuse (NIDA) launched an effort to develop a new drug: one that uses buprenorphine’s ability to mitigate withdrawal symptoms but mutes the euphoric effect. Suboxone was the result.

Suboxone is a targeted opioid use disorder treatment that effectively neutralizes the brain’s opioid receptors and manages withdrawal symptoms. It combines two drugs, buprenorphine and naloxone, that simultaneously inhibit opioid intoxication while minimizing cravings.

Like methadone, Suboxone helps reduce the severity of withdrawal from opioid dependency. Buprenorphine is a partial opioid receptor agonist, and while it can cause a mild euphoric response, its effects are limited because of the interaction with naloxone.

In some cases, Suboxone might be a more appropriate treatment than methadone. Suboxone has less potential for addiction than methadone.

Medication-Assisted Treatment at The Raleigh House

Ultimately, whether methadone or suboxone treatment is best for your needs will depend upon your unique set of circumstances. While both options offer significant benefits for people struggling with opioid dependency, there might be drawbacks in individual cases for each medication.

At The Raleigh House, we offer comprehensive substance use disorder treatment programs to address the core factors contributing to addiction. We conduct a comprehensive evaluation of your history of substance use and misuse, your co-occurring disorders, family history, medical history and other factors to determine the most effective treatment plan for your needs.

If you think medication-assisted treatment could help you break free from substance use disorder, please don’t hesitate to contact the team at The Raleigh House.

When you’re ready to heal, we’re ready for you.

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