Suboxone and methadone are the two leading medications available for the treatment of opioid addiction. They are both opioid replacement therapies that, when taken regularly, will prevent an individual from experiencing opioid withdrawal sickness. Suboxone was approved by the FDA in 2002, and this allowed local physicians to begin prescribing Suboxone from their offices to opioid addicted patients seeking help.
This was a landmark achievement in consumer choice and provided people another very useful option for dealing with opioid addiction. To treat a patient with suboxone, a physician must first complete a comprehensive course, and become approved, before being allowed to prescribe the medication.
Since opioid replacement medication by itself addresses only the underlying physiological dependence (but not the related psychological contributors to addiction), patients are required to obtain substance abuse counseling as a part of their suboxone treatment. This additional requirement helps to ensure that patients are receiving education & training in understanding their addiction, and in identifying methods for preventing opioid relapse in the future.
Many suboxone-approved physicians do not provide this supplemental addiction counseling, and will consequently refer their suboxone patients to local providers who offer drug treatment services.
While suboxone and methadone are similar in action, they are unique enough to offer distinctly different advantages. You can review our comparison chart to examine some of the differences between the two medications. Both methadone and suboxone are slow acting, long lasting opioid agonists that bind to the body's opiate receptors. This particular action eliminates opioid withdrawal sickness very effectively, and thus allows individuals to resume their daily lives.
Suboxone is actually a branded medication & product of the pharmaceutical company, Reckitt Benckiser. Suboxone is currently available as a thin film that is held under the tongue until the medication dissolves. Once dissolved, the medication is naturally absorbed through the tissues under the tongue and into the bloodstream. The newer film formulation dissolves somewhat more quickly than the previously available tablet form.
Suboxone is generally taken once per day although some patients with a milder opioid dependency may be able to take the medication every other day and remain comfortable. Suboxone does not produce a drug high for tolerant users, and does not interfere with one's daily activities. Many patients report feeling very comfortable while being maintained on suboxone and also during their gradual taper off of the medication.
What is in Suboxone?
Suboxone is a combination of buprenorphine and naloxone. Buprenorphine (an opioid agonist) is the ingredient that binds to opiate receptors and provides relief by blocking withdrawal symptoms (very similar to methadone). Naloxone is an opioid antagonist that reverses the effects of opiates and will cause withdrawal. This seems like a strange paradox having both ingredients in one tablet. However, do not worry. Remember, Suboxone is dissolved and absorbed under the tongue. The antagonist, Naloxone, becomes inert (has no effect) when dissolved under the tongue. So one only experiences the benefit of the Buprenorphine.
Why is Naloxone Added to Suboxone?
Specifically to discourage & prevent injection use of suboxone. Some addicted individuals may try to inject suboxone to obtain a drug high. When they do so, the Naloxone becomes immediately active (since it's being injected directly into the bloodstream), and it brings on sudden withdrawal symptoms making the individual feel very sick. This reinforces a person for using suboxone the proper way (under the tongue), and prevents future attempts at injecting suboxone.
How Do I Know if Suboxone is Right For Me?
This is a great question although a little difficult to answer. Suboxone tends to be effective for a considerable number of people addicted to opioids. Many of those who do well with suboxone are people who have a relatively shorter duration of opioid addiction or whose addiction is based on a comparatively smaller amount of daily opioid use. Heavy opioid users with a longer history of addiction sometimes respond better to methadone. However, there are notable exceptions.
Suboxone has a ceiling effect around 24-32 mg of medication daily. 32 mg is generally considered to be the dose at which maximum withdrawal relief is provided. For most addicted people, taking more than 24-32 mg of suboxone daily will not provide any more additional relief. Methadone has no such ceiling effect and its dosage levels can be raised much higher, consequently providing a greater level of comfort and symptom relief for more severe opioid dependencies.
In conclusion, 8 mg to 32 mg of suboxone may provide excellent relief for someone new to medication-assisted recovery. If they find that suboxone is not strong enough to manage their withdrawal symptoms, then methadone most certainly will since it has no "ceiling effect".
Taper programs aim to stabilize an opioid addicted individual on suboxone for a brief period of time and then taper their dosage down over a 60 to 90 day period. This taper period is not set in stone and can vary depending on the individual's need. The primary goal is to stabilize with suboxone and to then taper off with the end result being complete freedom from opioids and opioid replacement medication. Some patients do very well with a scheduled taper. Other patients may find that tapering is problematic and will switch to a period of maintenance. Maintenance with suboxone is effective and safe, just like with methadone. Upon first entering the market, Suboxone was mostly used for tapering off of opioids. However, it is commonly used today for extended maintenance in similar fashion to methadone.
For more on Suboxone Doctors, read: www.Methadone.us/suboxone-doctors/
Jana Burson is a North Carolina physician who specializes in the treatment of opioid addiction using medications like buprenorphine and methadone. Dr. Burson is a passionate caregiver and patient advocate with considerable experience in the field of addiction treatment. She maintains an informative blog on the topic of opioid addiction treatment and recently posted her comments and observations on a revealing 2012 study.
The 2012 study by Saxon et al is reported in her blog to have followed more than 700 patients over 24 weeks who were receiving either methadone or buprenorphine (the active ingredient in Suboxone). These patients were checked for specific red flag elevations that would suggest emerging liver damage or liver inflammation. None of the patients receiving methadone or buprenorphine had significant abberations in liver functioning. This led the researchers to conclude that neither medication causes liver damage.
A 2014 follow-up study by Soyka and others (published in the American Journal on Addictions) found the same results … Read more
A common question among those seeking help is whether methadone or suboxone is the best choice for opioid replacement therapy. It reminds me of the age old debate … which is better, Ford or Chevy? Methadone has been used in opioid addiction treatment for about 45 years. Suboxone has been available to the public for 12 years. Each of these medications has been shown, through conclusive research, to be highly effective in eliminating opioid withdrawal. Both methadone and suboxone achieve a similar outcome, but with subtle differences. [view our comparison chart]
When opiate withdrawal symptoms are no longer a daily preoccupation and source of anxiety, individuals are free to invest their energy & time in productive, meaningful activities. Avoiding withdrawal sickness is the single greatest driver of continued opioid use, and often pushes an individual to desperate measures to maintain a supply of opiates so that they will not get sick.
People unfamiliar with addiction sometimes believe that … Read more
Access Recovery Solutions (ARS) Delray Beach is a newly opened outpatient opioid treatment program that offers both methadone and buprenorphine. They are a member of Addiction Medical Solutions who have other methadone clinics across the country.
ARS specialize in medication assisted treatment and have a unique Maintenance to Abstinence program designed to assist patients in eventually becoming free of opioid medications once they have experienced a period of stability. The program is built on a two year continuum of care treatment model.
The ARS clinic provides individualized treatment planning for patients, and their counseling approaches include cognitive-behavioral and motivational approaches up to and including an intensive outpatient program (IOP). IOP is a SAMHSA endorsed, evidence-based addiction treatment that is in widespread use across the United States due to its effectiveness in helping patients learn about and apply effective recovery tools.
ARS offer a variety of other programs and services to serve the Delray Beach community including a Speakers Bureau. With … Read more
When patients enter treatment for opioid addiction, their families are usually relieved yet apprehensive. They may have seen previous recovery efforts not be sustained and their loved one return to active substance use. So, families often learn to be cautiously hopeful.
With methadone treatment, there is a new component in the recovery process with the addition of medication assistance. Whether it’s methadone or suboxone, families become curious as to how their loved one will handle this new medication. As most readers know, there is considerable misinformation and misunderstanding about what methadone can accomplish. This leads a patient’s family supports to sometimes have a wary attitude toward methadone or suboxone.
I would like to share two stories that illustrate how family attitudes can shift. The first patient we’ll call Mary to maintain her anonymity. Mary was a local realtor who had developed an opioid dependence. She had been able to conceal her addiction from her parents, but finally reached a … Read more
Recently joining Methadone.US is a newly opened methadone treatment program in Scottsdale, Arizona: SMC Recovery. SMC offer methadone for opioid addiction as well as an Intensive Outpatient Program (IOP) for treating all varieties of addictive disorders.
Both modalities of treatment are deemed best practice interventions by the Substance Abuse and Mental Health Services Administration (SAMHSA) and they are evidence-based treatment models. Evidence-based means that the treatment approaches have been thoroughly researched and shown to be effective in helping patients achieve success with identified treatment goals.
More specifically, SMC Recovery offers medication-assisted treatment, IOP, outpatient, group counseling, family groups, and individual therapy to adults 18 years and older. Prospective patients in the Scottsdale area can reach SMC staff at (480) 998-4673 (HOPE) or via the email address listed on the Scottsdale page of the Methadone.US website.
SMC Recovery’s narcotic treatment program is available to all individuals who meet ASAM criteria for admission to opioid treatment. Priority admission status is provided … Read more
When one thinks of methadone treatment, they usually consider the power of methadone to eliminate opiate withdrawal and the value this has to someone fighting off withdrawal sickness.
Methadone treatment actually consists of more than just the “medication assistance” component. Real treatment always addresses the underlying lifestyle, thinking, and behavioral elements that are a significant part of the addictive process. These areas are specifically addressed through counseling. All opioid treatment programs providing methadone in the United States are required to also offer counseling to their patients in order to help them achieve true and lasting success.
Some patients will need more counseling & emotional support than others. But all patients new to the recovery process will need to receive basic education on addiction as an illness, how to build a personal recovery program, and to have an opportunity to develop new coping and relapse prevention skills.
Methadone clinics in the U.S. vary in the ways that they deliver counseling services. … Read more