Substance Use

Methadone vs. Suboxone: Positives and Negatives

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Suboxone Versus Methadone: Which Drug Is Best for Treating Opioid Addiction?

Methadone and Suboxone are two commonly prescribed substances for opioid dependence. Both medications are FDA-approved and classified as long-acting opioids used to treat narcotic addictions. One must have a valid doctor’s prescription to obtain methadone or Suboxone legally. Methadone requires daily trips to a regulated facility.

These drugs are usually prescribed as part of a larger addiction treatment plan. Your opioid addiction treatment plan may include behavioral therapy, counseling, and other supportive methods.

Over 4.5 million Americans struggle with opioid abuse, and nearly two million report an opioid addiction. Because opioid drug abuse is such a large problem in the United States, recovery centers are eager to help people who struggle with narcotic addiction.

Learn more about methadone and Suboxone to determine which may benefit you the most.

If you or a loved one struggles with opioid dependence, call Zinnia Health at (855) 430-9439.

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Methadone and Suboxone for Opioid Dependence

Opioids are typically prescribed for pain relief. Sometimes, they are also used for anesthesia. Less often, they are prescribed as remedies for diarrhea or cough. Somewhat ironically, some opioids are also effective at reversing opioid overdose or for opioid use disorder.

Because opioids are commonly prescribed for a variety of diseases or injuries, many Americans have used these drugs at some point. They are commonly prescribed for moderate-to-severe pain, including post-surgery or for injuries like broken bones. When taken as prescribed, opioids have fewer risks. However, these medications are sometimes habit-forming and often addictive.

Side effects of opioid use include a pleasant or contented sensation, which may tempt patients to take more of the medicine than prescribed. Taking too much of an opioid may lead to euphoria (or a “high”). This sensation may be addictive. That’s why opioid abuse is so common.

Suboxone and methadone are both regulated substances used to treat opioid abuse or addiction. While methadone is more commonly abused, Suboxone may also be addictive.

However, when taken as prescribed, these medications can help. Most doctors prescribe Suboxone or methadone as part of a larger treatment plan. If you’re advised to take Suboxone or methadone for opioid use disorder, it’s important to review the risks and side effects first.

How Can You Access Methadone?

Methadone is only legally available through a certified treatment program. You must first take methadone while supervised. If you’re compliant and stable, you may then take methadone at home.

How Long Does Methadone Treatment Last?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), most methadone treatments last at least 12 months, and some last much longer. Your dose of methadone will gradually be reduced to limit withdrawal symptoms.

How Does Methadone Work?

You can feel the effects of methadone much longer than other opioids. Heroin, fentanyl, hydrocodone, and oxycodone are all metabolized more quickly than methadone. This makes it an effective treatment to help you wean off other drugs. It also helps reduce your withdrawal symptoms and cravings.

If you’re taking opioids for pain relief, your doctor may recommend methadone as a replacement option.

Is Methadone Addictive?

If you take methadone as it is prescribed, it is usually not addictive. However, it is an opioid with the potential for abuse. It also has a risk of dependency.

If you abuse methadone, you may experience physical symptoms or possibly even addiction.

Is Methadone Safe?

Generally, yes; methadone is safe. There are risks if you use or abuse any medication, though.

Because methadone has the potential for abuse, the dosage is adjusted for each patient. Your dose may be adjusted numerous times throughout your treatment. Make sure you tell your doctor your entire medical history so they can prescribe the best treatment. 

You should never share methadone with anyone else. Methadone may also interact with other medications. Share all the medications you take (including vitamins, supplements, prescriptions, and street drugs) with your doctor.

Remember to take methadone exactly as prescribed to avoid overdose or addiction. Avoid alcohol while you are on methadone and keep the medicine away from pets and children.

What Are the Side Effects of Methadone?

There are side effects associated with methadone. Most of these are mild and can include:

  • Agitation or a restless feeling
  • Stomach problems like nausea, vomiting, or constipation
  • Slow breathing
  • Itchiness
  • Sweating
  • Sexual issues
  • Weight gain

More serious side effects include:

  • Shallow or labored breathing
  • Faintness or lightheaded feelings
  • Hives or a rash
  • Swelling on your face, lips, tongue, or throat
  • Chest pain
  • Fast or pounding heartbeat
  • Hallucinations or confusion

If you have any of these more serious side effects, stop taking methadone and seek immediate medical attention. Your doctor may change your medication or provide alternative treatment options.

Can Pregnant and Breastfeeding Women Take Methadone?

Methadone is usually safe for pregnant or breastfeeding women. You can discuss your medical history with your doctor. If you’re prescribed methadone during pregnancy, your treatment plan should include prenatal care.

Opioid withdrawal may cause problems during pregnancy, and methadone treatment doesn’t cause birth defects. However, your baby may experience methadone withdrawal symptoms. You can discuss this risk with your doctor.

Most doctors recommend you continue breastfeeding while you’re on methadone. Only a small amount of methadone passes through to your baby, and the benefits of breastfeeding outweigh the methadone effects.

How Can You Access Suboxone?

Suboxone is available via prescription from your doctor. Unlike methadone, it does not require treatment through a regulated clinic.

How Does Suboxone Work?

Suboxone doesn’t work the same as other opioids. It includes two medications. Buprenorphine is a partial opioid agonist, which limits the potential for abuse. If you take more than a certain amount, you won’t feel any additional effects.

Naloxone is a medication that blocks opioids in the brain. You usually won’t experience any of the effects of naloxone unless you attempt to abuse Suboxone. If you try to inject it, the naloxone activates and keeps you from feeling the effects of the opioid.

Is Suboxone Addictive?

Suboxone is less addictive than methadone. The naloxone creates a plateau that won’t let you feel euphoria or other opioid effects. This makes it harder to abuse Suboxone, though the potential is still there.

Is Suboxone Safe?

Yes, Suboxone is usually safe when taken as prescribed.

What Are the Side Effects of Suboxone?

Suboxone side effects are similar to those of other opioids and include mild symptoms like:

  • Constipation, nausea, or vomiting
  • Headache
  • Dizziness
  • Drowsiness
  • Fatigue
  • Sweating
  • Muscle aches
  • Muscle cramps
  • Insomnia
  • Dry mouth
  • Fever
  • Blurred vision
  • Dilated pupils
  • Heart palpitations
  • Agitation
  • Tremors

More serious side effects include:

  • Shallow or labored breathing
  • Faintness or lightheaded feelings
  • Hives or a rash
  • Swelling on your face, lips, tongue, or throat
  • Chest pain
  • Fast or pounding heartbeat
  • Hallucinations or confusion

Can Pregnant and Breastfeeding Women Take Suboxone?

Suboxone is generally considered safe during pregnancy or while breastfeeding. You can discuss your treatment options with your doctor.

Methadone and Suboxone Abuse

Both methadone and Suboxone are used for opioid dependence, abuse, or addiction. However, only methadone is also prescribed for chronic pain.

Methadone is abused more often than Suboxone because of the opioid-blocking effects of Suboxone. However, it’s possible to abuse either drug.

What Are the Symptoms of Opioid Withdrawal?

Suboxone and methadone are prescribed to help prevent opioid withdrawal. Usually, methadone is prescribed first, then Suboxone is prescribed later. That’s because Suboxone may create opioid withdrawal if you aren’t weaned off stronger opioids first.

With opioid abuse or addiction, your brain’s chemicals are altered. Once your body is rid of these drugs, you may feel withdrawal symptoms.

Opioid withdrawal usually isn’t life-threatening, but it may be very uncomfortable. Sometimes, it’s even painful.

You may feel like you have the flu, and your emotions may be affected, too. You may feel anxious or depressed. You may have insomnia or trouble focusing. Some patients are irritable or angry.

If you’re taking Suboxone, it may be tempting to misuse your medication when you’re experiencing opioid withdrawals. Remember that Suboxone blocks opioids in the brain, so you may worsen your withdrawals if you take more Suboxone than prescribed.

Suboxone abuse may also create withdrawal symptoms that you wouldn’t experience if you took the medication as prescribed.

Is Methadone More Addictive Than Suboxone?

Methadone is more addictive than Suboxone because it is a full agonist rather than a partial agonist. In other words, you can feel the effects of methadone more than the effects of Suboxone.

However, both medications can be abused, and they both have a risk of dependence or addiction.

If you take methadone or Suboxone too long or abuse either drug, you may become physically dependent. Remember, though, that dependence isn’t the same as addiction. You can discuss any symptoms with your doctor or treatment center.

What Are the Signs of Methadone or Suboxone Abuse?

The signs of methadone or Suboxone abuse are the same as the potential side effects. However, if you are abusing your medication, you’re more likely to experience these effects. You may also feel the effects more severely.

Signs of abuse include:

  • Constipation, nausea, or vomiting
  • Sweating
  • Memory issues or blurry thoughts
  • Inability to focus
  • Headache
  • Lack of coordination

More severe signs include:

  • Irregular heartbeat
  • High or low blood pressure
  • Trouble breathing
  • Liver or kidney issues
  • Sedative effects

What Are the Cons of Methadone and Suboxone Use?

The biggest downside to methadone and Suboxone use is the potential for abuse, addiction, and even fatal overdose.

According to the Centers for Disease Control and Prevention (CDC), annual opioid overdose deaths topped 100,000 in 2021—the highest annual overdose rate in history. Methadone is closely monitored, which helps limit the potential for abuse. Suboxone deaths are much less common, but the potential is still there.

While methadone has a long half-life, you may only feel its pain relief effects for four to eight hours. Some people take more methadone to relieve the pain, which leads to an overdose.

Signs of an overdose include trouble breathing, sleepiness, sedation, heart problems, coma and, sometimes, death.

Are Methadone and Suboxone Safe and Effective Options for Opioid Dependence?

In general, yes; methadone and Suboxone are safe and effective options for opioid dependence or abuse. However, you must use the drugs as intended. Take your medication exactly as prescribed and discuss any side effects with a medical professional.

Most treatment plans first prescribe methadone to help your body wean off of other opioids (e.g. heroin, oxycodone). Methadone helps control your withdrawal symptoms, which reduces your chance of relapse.

Once you are less physically dependent on opioids, your doctor may prescribe Suboxone instead. This medication helps you stay compliant with your treatment plan. It further reduces your withdrawal symptoms and opioid cravings. Suboxone is generally the preferred treatment because there’s less potential for abuse or addiction.

You should not use Suboxone or methadone alone, though. Both drugs should be part of a treatment plan for opioid dependence recovery. Your treatment plan should be customized according to the level of care you require. Other treatment services may include behavioral therapy, counseling, and other support systems.

Find Help for Opioid Use Disorder Today

If you are struggling with opioid addiction, abuse, or dependence, help is available. Methadone or Suboxone may be a helpful part of your treatment plan. Call Zinnia Health at (855) 430-9439 to learn more about your path to recovery.

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