What is Suboxone?

Suboxone is a prescription drug that treats OUD in adults. It is intended to be used as part of a comprehensive treatment plan that includes counseling and behavioral therapy. Suboxone is a combination drug that contains two active ingredients: buprenorphine and naloxone.

Suboxone comes as a film or sublingual tablet, which means it dissolves under the tongue. Generic versions are also available. The film should not be cut or swallowed whole. Instead, dissolve it either under the tongue or on the inner cheek. Suboxone starts working quickly, reaching its peak effect within one to three hours. The usual maintenance dose is 16 mg/4 mg buprenorphine/naloxone daily. It is usually taken long-term or indefinitely.

Zubsolv is a sublingual tablet that works the same way as Suboxone but has slightly different dosages.

Benefits of Suboxone

Suboxone can be a highly effective treatment for opioid addiction when used as part of a comprehensive plan that includes counseling. Some benefits of Suboxone are:

• It can be used at home
• Lower risk of fatal overdose
• Reduced nausea
• It reduces the risk of premature and neonatal birth withdrawal symptoms
• Safe to use during pregnancy

What is methadone?

Methadone (one brand name is Methadose) is a full opioid agonist. It works by activating opioid receptors in the brain like other opioids, but in a more controlled way. Reduces appetite and withdrawal symptoms without causing the intense euphoria (“high”) associated with other opioids.

Methadone is usually taken as an oral liquid, although it is also available in tablet and injectable forms. Because of its potency and risk of abuse, methadone is provided under close supervision, especially in the early stages of treatment.

In addition to opioid use disorder, methadone is also approved by the Food and Drug Administration (FDA) to treat pain. And sometimes it is used off-label to treat neonatal abstinence syndromewhich occurs when a newborn shows withdrawal symptoms from drugs, such as opioids, that the pregnant person used during pregnancy.

The benefits of methadone

Methadone has been a cornerstone of opioid treatment programs for decades and is one of the most studied treatments for opioid use disorder.

Methadone usually requires a daily dose at a clinic. Since the pandemic, some states have allowed new services:

• Doses to take home
• Mobile units
• Integrated outpatient programs

This makes it easier for more people, especially in remote areas, to get the treatment they need. Long-term methadone therapy has been shown to be highly effective in reducing the risks of relapse and overdose while improving overall well-being.

Suboxone vs. Methadone for OUD

Studies show that drug treatment for opioid use disorder saves lives. Both methadone and buprenorphine (an ingredient in Suboxone) have been shown to decrease the chance of death, including death from opioid overdose. Methadone and buprenorphine are considered equally effective in reducing opioid use.

Methadone has been shown to be better at reducing cravings, but comes with a higher risk of overdose (more on that later).

Suboxone Side Effects Vs. Methadone

Both Suboxone and methadone have side effects ranging from mild to life-threatening.

Because of differences in the way it works, morphine is more likely to cause extreme sedation and respiratory depression (slowed, shallow breathing), especially in the early stages of treatment or if taken in higher doses. Suboxone is less likely to cause excessive sedation, making it a safer option in most cases.

Although not a complete list, the table below compares the most common and potentially serious side effects of Suboxone and methadone.

Suboxone vs. Methadone
	Suboxone (Buprenorphine/Naloxone)	Methadone
Common side effects	Discomfort or irritation in the mouth; redness of the mucous membranes in the mouth; headache; nausea; vomiting; sweating; constipation; insomnia; swelling of the limbs; dizziness	dizziness; dizziness; sedation; nausea; vomiting; sweating; constipation
Serious and potentially life-threatening side effects	Difficulty breathing (respiratory depression); extreme sedation or drowsiness; liver problems; opioid withdrawal; risk of misuse; severe drug interactions; allergic reaction	Difficulty breathing; extreme sedation or drowsiness; heart rhythm problems; serotonin syndrome (symptoms such as diarrhoea, convulsions, hallucinations and fever); low blood sugar; low blood pressure; convulsions; risk of misuse; severe drug interactions; allergic reaction

The risks of methadone and suboxone

When considering Suboxone and methadone for opioid use disorder, it is important to understand the risks and safety concerns associated with both medications. Both drugs can have serious interactions with other substances, such as:

Combining them with Suboxone or methadone can lead to dangerous effects, including severe sedation and life-threatening respiratory depression.

Methadone, because of its long half-life (how long it takes for the drug’s active ingredients to be reduced by 50%), requires careful dose management to prevent overdose and accumulation of the drug in the body. It is also associated with a potentially fatal heart arrhythmia called QT prolongation, so regular heart monitoring is recommended, especially for those with pre-existing conditions. heart diseases.

Suboxone, while generally safer, still carries risks, especially if mixed with alcohol or other central nervous system depressants. Both drugs should be used with caution in people with liver problems, and consultation with a healthcare provider is crucial to ensure safe and effective treatment.

Make sure your healthcare provider knows if you become pregnant at any time during treatment. Although both methadone and Suboxone are sometimes needed to manage opioid use disorder in pregnant women, it is important to be aware of the risks.

More specifically, taking methadone or Suboxone during pregnancy can cause neonatal abstinence syndrome. This does not mean that treatment should be stopped, but highlights the need for frequent monitoring by health professionals to care for both the laborer and the newborn.

Summary

Suboxone and methadone are both effective options for treating opioid use disorder, but they work differently and come with their own sets of pros and cons. Suboxone is often safer, with less chance of misuse, and is convenient because you can usually take it in the privacy of your own home. Methadone, on the other hand, requires more medical supervision because of the greater risk of misuse and potential complications, but may be better for those who have not had success with other treatments.

Ultimately, the choice between Suboxone and methadone should be made with your healthcare provider, taking into account your specific situation and needs. With the right support and treatment plan, recovery from opioid use disorder is within reach.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to back up the facts in our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable and trustworthy.

1. National Institute on Drug Abuse. Medications to treat opioid use disorder.

2. Centers for Disease Control and Prevention. Opioid use disorder: diagnosis.

3. Centers for Disease Control and Prevention. Commonly used terms.

4. DailyMed. Suboxone label.

5. Velander JR. Suboxone: Reasoning, Science, Misconceptions. Ochsner J. 2018;18(1):23-29.

6. DailyMed. Methadone label.

7. Patrick SW, Barfield WD, Poindexter BB; Committee on the Fetus and Newborn, Committee on Substance Use and Prevention. Neonatal opioid withdrawal syndrome. Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074

8. Office of Addiction Services and Support. Medications for the treatment of opioid use disorder.

9. Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev.

10. DailyMed. Methadone label.

11. Mattick RP, Breen C, Kimber J, et al. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev.

Of Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. He has over 14 years of professional experience.

Thank you for your feedback!

What is your feedback?

Other

Useful

Report a bug