Table of ContentsView AllTable of ContentsMain Differences and SimilaritiesWhat Is Suboxone?What Is Methadone?For OUDSide EffectsRisks of Each
Table of ContentsView All
View All
Table of Contents
Main Differences and Similarities
What Is Suboxone?
What Is Methadone?
For OUD
Side Effects
Risks of Each
Opioid use disorder (OUD), also known as opioid dependence, is a complex condition that can be challenging to treat, but recovery is possible with the right plan for the individual. Two of the most effective medications for opioid use disorder areSuboxone (buprenorphine/naloxone)and methadone. While both options are similarly effective, they work differently and come with their own set of benefits and potential downsides.
Individuals withOUDmay have a physical dependence on opioids, such asoxycodoneor heroin, leading to withdrawal symptoms when they stop using the drug. They may also have strong cravings despite knowing the negative effects, and their substance use can become excessive or risky.
Opioid Use Disorder (OUD)The terms “narcotic addiction,” “opioid dependence,” and “OUD” all refer to the same thing: a reliance on opioids that disrupts daily life. However, opioid use disorder, or OUD, is now the preferred term as a less-stigmatizingway to describe it.
Opioid Use Disorder (OUD)
The terms “narcotic addiction,” “opioid dependence,” and “OUD” all refer to the same thing: a reliance on opioids that disrupts daily life. However, opioid use disorder, or OUD, is now the preferred term as a less-stigmatizingway to describe it.
Suboxone is a prescription medication that treats OUD in adults. It’s intended to be used as part of a comprehensive treatment plan that includes counseling andbehavioral therapy. Suboxone is a combination medication that contains two active ingredients: buprenorphine and naloxone.
Suboxone comes as a sublingual film or tablet, meaning it dissolves under your tongue. Generic versions are also available. The film shouldn’t be cut or swallowed whole. Instead, dissolve it either under your tongue or against your inside cheek. Suboxone starts working quickly, reaching its full effect within one to three hours. The usual maintenance dosage is 16 mg/4 mg of buprenorphine/naloxone a day. It’s usually taken long-term or indefinitely.
Zubsolvis a sublingual tablet that works the same way as Suboxone but has slightly different dosages.
Benefits
Suboxone can be a highly effective treatment for opioid dependence when used as part of a comprehensive plan that includes counseling. Some benefits of Suboxone are:
Methadone is usually taken as an oral liquid, though it is also available in tablet and injectable forms. Because of its potency and risk of misuse, methadone is provided under strict supervision, especially during the early stages of treatment.
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 daily dosing at a clinic. Since the pandemic, some states have allowed new services:
This makes it easier for more people, especially in remote areas, to get necessary treatment. Long-term methadone therapy has proven highly effective in lowering the risks of relapse and overdose while improving overall well-being.
Suboxone or Methadone for OUD
Studies show that treatment with medication for opioid use disorder saves lives. Both methadone and buprenorphine (an ingredient in Suboxone) have been proven to lower the chance of death, including death from opioid-related overdose.Methadone and buprenorphine are considered equally effective at reducing opioid use.
Methadone has been shown to be better at reducing cravings but comes with a higher risk of overdose (more about this later).
Both Suboxone and methadone come with side effects ranging from mild to life-threatening.
Because of the differences in how they work, morphine is more likely to cause extreme sedation andrespiratory depression(slowed, shallow breathing), particularly in the early stages of treatment or if taken in higher doses. Suboxone is less likely to cause excess sedation, making it a safer option in most cases.
While not a complete list, the table below compares the most common and potentially serious side effects of Suboxoneand methadone.
Safety Risks
When considering Suboxone and methadone for opioid use disorder, it’s important to understand the risks and safety concerns associated with both medications. Both drugs can have serious interactions with other substances, such as:
Combining these with either Suboxone or methadone can lead to dangerous effects, including severe sedation and life-threatening respiratory depression.
Methadone, due to its long half-life (how long it takes for the drug’s active ingredients to reduce 50%), requires careful dose management to prevent overdose and drug accumulation in the body. It’s also associated with a potentially fatal heart arrhythmia called QT prolongation, so regular heart monitoring is recommended, especially for those with preexistingheart conditions.
Suboxone, while generally safer, still carries risks, particularly if mixed with alcohol or other central nervous system depressants. Both medications should be used with caution in individuals with liver issues, and consulting 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. While both methadone and Suboxone are sometimes necessary for managing opioid use disorder in pregnant people, it’s important to be aware of the risks.
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 a lower chance of misuse, and is convenient because you can usually take it in the privacy of your home. Methadone, on the other hand, requires more medical supervision due to its higher risk of misuse and potential complications, but it might 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, considering your specific situation and needs. With the right support and treatment plan, recovery from opioid use disorder is within reach.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Medications to treat opioid use disorder.Centers for Disease Control and Prevention.Opioid use disorder: Diagnosis.Centers for Disease Control and Prevention.Commonly used terms.DailyMed.Suboxone label.Velander JR.Suboxone: rationale, science, misconceptions.Ochsner J. 2018;18(1):23-29.DailyMed.Methadone label.Patrick SW, Barfield WD, Poindexter BB; Committee On Fetus And Newborn, Committee On Substance Use And Prevention.Neonatal Opioid Withdrawal Syndrome.Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074Office of Addiction Services and Supports.Medications for the Treatment of Opioid Use Disorder.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.DailyMed.Methadone label.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Medications to treat opioid use disorder.Centers for Disease Control and Prevention.Opioid use disorder: Diagnosis.Centers for Disease Control and Prevention.Commonly used terms.DailyMed.Suboxone label.Velander JR.Suboxone: rationale, science, misconceptions.Ochsner J. 2018;18(1):23-29.DailyMed.Methadone label.Patrick SW, Barfield WD, Poindexter BB; Committee On Fetus And Newborn, Committee On Substance Use And Prevention.Neonatal Opioid Withdrawal Syndrome.Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074Office of Addiction Services and Supports.Medications for the Treatment of Opioid Use Disorder.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.DailyMed.Methadone label.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Drug Abuse.Medications to treat opioid use disorder.Centers for Disease Control and Prevention.Opioid use disorder: Diagnosis.Centers for Disease Control and Prevention.Commonly used terms.DailyMed.Suboxone label.Velander JR.Suboxone: rationale, science, misconceptions.Ochsner J. 2018;18(1):23-29.DailyMed.Methadone label.Patrick SW, Barfield WD, Poindexter BB; Committee On Fetus And Newborn, Committee On Substance Use And Prevention.Neonatal Opioid Withdrawal Syndrome.Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074Office of Addiction Services and Supports.Medications for the Treatment of Opioid Use Disorder.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.DailyMed.Methadone label.Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.
National Institute on Drug Abuse.Medications to treat opioid use disorder.
Centers for Disease Control and Prevention.Opioid use disorder: Diagnosis.
Centers for Disease Control and Prevention.Commonly used terms.
DailyMed.Suboxone label.
Velander JR.Suboxone: rationale, science, misconceptions.Ochsner J. 2018;18(1):23-29.
DailyMed.Methadone label.
Patrick SW, Barfield WD, Poindexter BB; Committee On Fetus And Newborn, Committee On Substance Use And Prevention.Neonatal Opioid Withdrawal Syndrome.Pediatrics. 2020;146(5):e2020029074. doi:10.1542/peds.2020-029074
Office of Addiction Services and Supports.Medications for the Treatment of Opioid Use Disorder.
Mattick RP, Breen C, Kimber J, et al.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.Cochrane Database Syst Rev.
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