Methadone vs Suboxone: Comparison and Contrast

Suboxone and methadone are two medications prescribed to treat opioid use disorder (OUD) as part of a medication-assisted treatment program (MAT). How do you know which medication will be more effective for your OUD treatment?

Although they employ similar mechanisms of action to address withdrawal symptoms and cravings, Suboxone and methadone have a few important distinctions that may impact your provider's choice for your treatment. Regardless of which medication may be more appropriate for you, you should always reach out to a qualified MAT provider to access treatment for opioid use disorder. 

If you are ready to get help managing opioid use disorder, speak with the caring professionals at Confidant Health’s online Suboxone clinic. Through a confidential virtual assessment, we can help determine whether Suboxone treatment may be most appropriate for your recovery needs. Get started today by scheduling an appointment with our team. Please note, as a virtual outpatient clinic, Confidant is not able to offer methadone services. 

What Is Suboxone?

Suboxone is a medication used to treat opioid use disorder. It consists of a pairing of buprenorphine and naloxone, which help to quell cravings and alleviate withdrawal symptoms. Buprenorphine is a partial opioid agonist that interacts with opioid receptors in the brain and produces similar effects to opioids but on a much milder scale. Naloxone, an opioid antagonist, binds with opioid receptors to block the effects of other opioids. This combination limits the euphoric effects the drug can have, which is known as a ceiling effect.

What Is Methadone?

Like Suboxone, methadone is a medication approved for the treatment of opioid use disorder. However, methadone is a long-acting full opioid agonist that produces the pain-relieving effects of morphine without the high. It also binds tightly to opioid receptors to block the effects of other opioids. 

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Methadone vs. Suboxone

Uses

Both methadone and Suboxone are used to treat opioid use disorder by minimizing withdrawal discomfort and cravings. This helps people manage OUD more successfully since they feel more comfortable and can stay focused on their recovery.

Ingredients

Suboxone consists of a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that is responsible for relieving withdrawal symptoms and opioid cravings. Naloxone, an opioid antagonist, is added to this medication to prevent misuse by blocking the effects of opioids.

Methadone refers to the generic name and single ingredient of this medication. It is a full opioid agonist that fully stimulates opioid receptors to induce mild euphoria and blunt the effects of other opioids.

Side Effects

Methadone and Suboxone have some similar side effects, including:

• Constipation
• Dizziness
• Drowsiness
• Nausea and vomiting
• Stomach pain
• Sweating

Suboxone may also increase the risk of additional side effects, such as:

• Blurred vision
• Inability to concentrate
• Rapid heart rate
• Numbness in the mouth
• Redness and irritation in the mouth
• Swollen tongue

Methadone and Suboxone side effects tend to be minimal when you receive the correct dosage, so it is essential that you reach out to your provider if you experience moderate to severe discomfort. This may be a sign that your provider needs to adjust your dosage.

Dosage and Forms

Although both Suboxone and methadone are used to treat opioid use disorder, they are administered in different dosages and forms.

Suboxone

Suboxone is available in two forms: sublingual films and tablets. Dosages are available in a 4:1 ratio of buprenorphine to naloxone as follows:

• 2 mg/ 0.5 mg tablets and films
• 4 mg/ 1 mg films
• 8 mg/ 2 mg tablets and films
• 12 mg/ 3 mg films

During the induction phase, your provider will prescribe up to 8 mg/ 2 mg daily once opioid withdrawal symptoms start. This will be divided into small doses throughout the day so your response to the medication can be observed.

Once you reach the maintenance phase, your provider will usually prescribe a once- or twice-daily dose of Suboxone to keep withdrawal symptoms under control. The maintenance dose is usually up to 24 mg/ 6 mg daily. Whether you receive films or tablets, you will place the medication under your tongue and allow it to dissolve fully. 

Methadone

Methadone comes in a wider variety of forms than Suboxone. Your methadone medication may be administered as one of the following:

• Oral concentrate
• Oral solution
• Oral dispersible tablet
• Oral tablet
• Injectable solution

Methadone dosage follows a similar induction phase as with Suboxone. Your provider will administer the first dose when you are experiencing opioid withdrawal symptoms. The initial dose is 20 to 30 mg orally. After two to four hours, your provider will monitor your symptoms and add an additional five to 10 mg orally if needed. 

Once you reach the maintenance phase, you may be prescribed a once-daily dose of up to 120 mg. The oral solution and concentrate are taken directly by mouth. Methadone tablets are dissolved in a glass of water or citrus-flavored juice before consumption, while methadone injections must be administered by your provider. 

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Suboxone vs. Methadone FAQs

Is methadone more effective than Suboxone?

Methadone and Suboxone stimulate opioid receptors to reduce opioid withdrawal symptoms and cravings. Both medications have proven to be effective in helping people abstain from using other opioid drugs. Since methadone is a full opioid agonist, it may be more effective than Suboxone when compared at lower doses. However, when both medications are compared at high doses, methadone and Suboxone may be equally effective at deterring opioid use.

Is it safe to switch from methadone to Suboxone?

It can be safe to switch from methadone to Suboxone under your provider's guidance, but Suboxone treatment may not be appropriate for everyone. Methadone is considered to be a stronger medication than Suboxone because it is a full agonist, so if you are on high doses of methadone, you could experience withdrawal symptoms when switching to Suboxone. If you are interested in accessing Suboxone care, consult with your provider to determine whether it is appropriate for you to switch from methadone to Suboxone. 

Can you take methadone and Suboxone together?

You should not take methadone and Suboxone at the same time. Methadone is a full opioid agonist, and the buprenorphine in Suboxone is a partial opioid agonist. Both of these medications interact with opioid receptors in the brain to reduce withdrawal symptoms and cravings. But when you combine a full agonist and partial agonist, you can instigate opioid withdrawal.

Confidant Health: Virtual Treatment for OUD

At Confidant Health, we understand that choosing to get help for OUD is a personal choice and one that you may not be ready to share with others in your life. Our online Suboxone doctors are here to provide confidential virtual OUD treatment so you can manage opioid use disorder on your own terms. Contact us today to schedule an intake assessment from the comfort and privacy of your home.

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