Suboxone vs. Methadone


Suboxone vs. Methadone – similarities and differences

At a glance, suboxone and methadone treatments seem to be nearly identical. Here are the key differences between the two, and how they can aid in recovery.

  • Both are used to treat patients with opioid dependency or addiction. Both synthetic opioids.
  • Suboxone is a partial opiate agonist (effects are limited even when taken in large doses)
  • Methadone is a full opiate agonist (effects are not limited).
  • Methadone can be abused (overused) so patients start out taking it at a clinic, later are allowed take-home doses.
  • Suboxone is harder to abuse so patients are allowed to take it home.
  • For people with larger, more serious opiate habits and addiction, Suboxone may not provide effective relief from withdrawal symptoms. Methadone may work better for such individuals.
  • Suboxone is generally less addictive than Methadone.
  • Withdrawal symptoms of a Suboxone detox are generally less severe than Methadone detox.
  • The risk of an overdose on Suboxone is less than with Methadone.
  • The cost of Methadone is generally lower than Suboxone.
  • Methadone is taken as a tablet, liquid, or injection. Suboxone is taken as a tablet sublingually – under the tongue.

A physician will work with each patient to determine the right clinical approach. Learn more about Methadone or Suboxone treatment, or contact us for more information.

More than two million people in the U.S. have an addiction to prescription opioid drugs. There is no drug on the marketplace which can automatically cure opioid addiction. Methadone and Suboxone are the most used for treatments along with a handful of pharmaceuticals. 

Ages vary, however, most of the opioid dependence occurs with adults ages 18-24 with almost 15% using it in the twelve-month period. Additionally, more than 80 percent of older patients (57-80) report usage of at least one prescription pain medication daily. 

Addicted individuals cannot get off the drug on their own. Treatment is required. The goal of any opioid treatment is to decrease the cravings and dependence on opioids so they can live a productive life. 

suboxone v methadone concerted care group


Methadone, which has been a treatment for opioid addiction since the 1960s, stimulates areas in the brain affected by opioids. It is usually taken 24-36 hours apart. This treatment eliminates the intense craving for opiates, heroin, and morphine. It also effectively slows down withdrawal symptoms. 

The goal of methadone treatment is to gradually end the dependence on opioids. However, methadone is not for everyone. If the opioid user has asthma, breathing issues, or digestive issues, such as intestinal blockages, they are not prescribed this treatment.

Opioid-dependent patients who take methadone experience relief from withdrawal symptoms and opioid cravings. It also does not induce euphoria. 

Just thirty minutes after swallowing and the peak effects occur around three hours after swallowing it. Typically, the length of time for the full effects of methadone are fifteen (15) hours. With repeated dosing, the time expands to twenty-four (24) hours. Treatments may take 3-10 days for stabilization in the patient’s system. 

Side effects of methadone use may include: 

  1. severe heart issues
  2. dizziness 
  3. chest pain
  4. headaches
  5. uneven sleep patterns 
  6. nausea
  7. vomiting
  8. constipation
  9. dry mouth
  10. heavy sweating 
  11. sexual dysfunction
  12. menstrual issues 
  13. increased weight

Methadone is taken orally or by injection. The treatment center physician will instruct the patient on the proper dosage or use of the syringe for injections. Liquid methadone can be dispensed using a measuring pump. Dosages can be as small as one milligram.

There is no set time on the usage of methadone as a treatment. It may be prescribed for months or years. Only a medical doctor can prescribe methadone and they should conduct the assessment for the prescription. The physician also conducts treatment planning and reviews. Nurses dispense the methadone and supervise the consumption of the drug. 

A methadone interaction with other drugs or substances may be fatal. Patients who use drugs to depress the respiratory system increase the effects of methadone. Also, drugs that affect metabolism can depress the respiratory system.  Interactions may also occur between methadone and medications used to treat HIV and TB (tuberculosis). 

If the patient has severe liver disease, they will not be prescribed methadone as it may precipitate hepatic encephalopathy. Additionally, patients who are intolerant of methadone ingredients should not be prescribed methadone.

Overdose of methadone may occur if the patient uses drugs that depress the central nervous system such as alcohol or opioids. Patients should be informed of the risks of using these drugs in combination with methadone.

In case of overdose, naloxone should be administered. This reverses the effects of methadone. Because methadone has a long half-life, it is necessary to provide a prolonged infusion or multiple doses of naloxone over several hours. Patients who have overdosed should be transferred to a hospital and monitored for at least four hours.

Methadone maintenance treatment patients may become tolerant to the pain-relieving effects of opioids. If a methadone treatment patient requires pain relief, paracetamol may be dispensed. Methadone patients may require higher than normal doses to experience pain relief.


Suboxone may be prescribed as an option to methadone. It is, as stated in the list above, much less addictive than methadone. 

It is an opioid medication, commonly known as a narcotic. It combines buprenorphine, an opioid medication, and Naloxone which blocks the effects of opioid medication. Pain relief is blocked as it is normally a step towards opioid abuse.

Suboxone is habit-forming and can cause addiction or death if misused. It is prescribed and dispensed only by a physician. It is taken by the tablet which dissolves slowly under the tongue. It is not to be chewed or taken whole and is stored at room temperature.    

Blood tests are taken regularly during this time to confirm that the liver is functioning properly. Alcohol use is absolutely forbidden as it combined with suboxone can be fatal. 

There are a number of side effects from using suboxone:

  1. depression
  2. nausea
  3. decreased sex drive
  4. headaches 
  5. drowsiness
  6. dizziness
  7. swelling of lips, tongue, throat, and face 

Emergency medical assistance must be contacted immediately if any of these symptoms occur.

Suboxone users may also develop reactions when drinking alcohol or using sedatives and other tranquilizers. Usually, suboxone users are advised to avoid these substances during treatment. Most treatment centers will advise against their use and patients are trained in risk avoidance. Suboxone is also a fairly new type of treatment, unlike methadone which has been around for more than fifty years. It has not been tested as much as methadone so it is not as credible as a treatment as methadone. 

The cost of suboxone is much higher in comparison to methadone. Health insurance may cover it but there is usually an additional expense. A sliding scale is sometimes used for suboxone though its cost may still be prohibitive for some clients. 


Methadone is a Schedule II drug, as defined by the FDA, and has worked for more than fifty years as an effective and safe treatment for opioid addiction. Though Suboxone is an alternative to it, methadone has been shown to produce better treatment rates than Suboxone in reducing narcotic use, retaining patients in treatment, and decreasing illegal drug use. Regular Methadone maintenance also decreased the risk of contracting and transmitting Hepatitis B (HBV), Hepatitis C (HBC), and HIV/AIDS. It is more cost-effective than Suboxone and other treatments, too. 


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