Switching from methadone to Suboxone is possible, but it requires careful planning and medical supervision.
Both medications are widely used in medication-assisted treatment (MAT) for opioid use disorder, and while they share some similarities, they work differently in the brain.
To ensure safety, the transition usually involves tapering methadone to a lower dose before introducing Suboxone, which helps reduce the risk of severe withdrawal symptoms.
Learning how each medication works, the benefits and drawbacks of both, and what to expect during the transition can help clients and families feel more confident about making this important treatment decision.
Methadone: the first opioid addiction treatment medication
Methadone has been used for decades as one of the earliest medications to support opioid addiction treatment. It has helped countless individuals stabilize their lives and reduce the harms of opioid misuse.
How methadone works for opioid addiction
Methadone is a full opioid agonist that binds to opioid receptors in the brain, preventing withdrawal symptoms and blocking the euphoric effects of other opioids.
This allows individuals to stop using heroin, fentanyl, or prescription painkillers without experiencing intense withdrawal.
Limitations and risks of long-term methadone use
While methadone is effective, long-term use carries certain drawbacks.
Clients often need to visit a clinic daily for supervised dosing, which can make treatment less flexible. Methadone may also cause sedation or cognitive slowing, and some people report challenges with tapering.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), methadone must be carefully managed because it can cause heart rhythm problems and carries a higher risk of overdose compared to newer medications like Suboxone.
Suboxone: a new generation of medication-assisted recovery
Suboxone has become one of the most common treatments for opioid use disorder and is often preferred for its safety profile and convenience.
How suboxone works in the brain
Suboxone combines two medications: buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist.
Buprenorphine reduces cravings and withdrawal symptoms while producing only limited euphoric effects.
Naloxone discourages misuse by blocking intoxication if the medication is injected.
Benefits of suboxone compared to methadone
Compared to methadone, Suboxone offers several advantages:
- Can be prescribed for home use, reducing the need for daily clinic visits
- Has a lower risk of overdose and fewer cardiac side effects
- Provides more flexibility, with options like Sublocade (a monthly injectable form)
According to the National Institute on Drug Abuse (NIDA), buprenorphine-based medications such as Suboxone are highly effective for opioid addiction treatment and present fewer safety risks than methadone.
Methadone vs. Suboxone: Why are people switching treatments?
Many clients consider switching from methadone to Suboxone to improve daily functioning and long-term recovery.
Methadone vs. Suboxone withdrawal symptoms
Methadone withdrawal can be prolonged and more intense than Suboxone withdrawal, often lasting weeks.
Suboxone withdrawal tends to be milder and shorter, though it can still include symptoms such as anxiety, insomnia, and cravings.
Safety concerns: Can you take Suboxone with methadone?
Suboxone and methadone should not be taken together. Because buprenorphine binds more strongly to opioid receptors, starting Suboxone while methadone is still in the system can trigger precipitated withdrawal—a sudden and severe onset of withdrawal symptoms.
Suboxone vs. methadone for long-term recovery
Both medications can support long-term recovery, but Suboxone is often favored for its lower overdose risk, convenience, and flexibility.
Methadone may still be appropriate for clients with higher opioid tolerance or who need the structure of daily clinic visits.
How to switch from methadone to Suboxone
Transitioning from methadone to Suboxone requires tapering and close medical guidance. Attempting to make the switch without supervision can be dangerous.
The best way to transition safely
Clients are typically advised to taper their methadone dose to 30 milligrams per day or less before beginning Suboxone. Reducing methadone gradually, no more than 5 milligrams per week, is generally considered safest.
How long after methadone can you take Suboxone?
Most people need to wait 24 to 48 hours after their last methadone dose before taking Suboxone. Waiting too little time can result in precipitated withdrawal.
Risks of taking methadone and Suboxone together
Combining methadone and Suboxone is unsafe because the medications compete for the same brain receptors. This can trigger withdrawal or reduce the effectiveness of treatment.
The role of medical supervision during conversion
Because each client’s body responds differently, medical supervision is critical during the transition. A licensed provider can adjust timing, dosage, and support therapies to ensure safety and comfort.
Personalized medication-assisted treatment near Denver
At The Raleigh House, we understand that medication is just one part of recovery.
Clients benefit most when treatment combines MAT with therapy, nutrition, family involvement, and experiential activities.
Our team develops individualized treatment plans that address substance use, co-occurring disorders, and long-term recovery goals. We provide care at two Colorado locations:
- The Ranch at The Raleigh House:Located in the Colorado countryside, The Ranch offers a calm and restorative environment with nature-based therapies and a supportive community.
- The Center for Integrative Behavioral Health: Situated in the Denver Tech Center, The Center delivers advanced clinical care in a modern, accessible setting, ideal for clients seeking convenience and comprehensive treatment.
Both locations provide safe, welcoming spaces where clients can find lasting recovery.
Contact us today to learn more about our medication-assisted treatment options and take the first step toward healing.
Frequently asked questions about switching from methadone to Suboxone
Many clients and families have questions about transitioning from methadone to Suboxone. Below are answers to some of the most common concerns.
What is the safest way to switch from methadone to Suboxone?
The safest way is to taper methadone under medical supervision until the dose is around 30 milligrams or less, then transition to Suboxone when withdrawal symptoms begin.
Can you take methadone and Suboxone together?
No. Taking both at the same time is unsafe and can trigger sudden withdrawal symptoms.
What withdrawal symptoms should I expect during the switch?
Some clients experience anxiety, sweating, insomnia, nausea, or cravings during the transition. These symptoms are typically manageable with medical support.
Can you switch from Suboxone back to methadone?
Yes, some clients may switch back if Suboxone is not effective for their needs. This should only be done under a provider’s supervision.
Is the methadone to Suboxone transition permanent?
Not always. Some clients remain on Suboxone long-term, while others taper off over time. The best approach depends on individual treatment goals.
Who should avoid switching to Suboxone?
Clients with certain medical conditions or those who cannot tolerate withdrawal may not be good candidates. A provider can help determine the safest option.