Methadone and suboxone 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's most common formulations are a tablet or thin film, both of which are 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 tablet.
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 mg of medication daily. 24 mg is generally considered to be the dose at which maximum withdrawal relief is provided. For most addicted people, taking more than 24 mg of suboxone 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 24 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/
Zohydro ER (extended release) is a new opioid-based pain medication just recently approved by the FDA and scheduled to be released for use in March of 2014. More than 40 healthcare organizations, advocacy groups, and physicians have come forward in a desperate appeal to the FDA to revoke the approval of Zohydro ER.
The medication is touted to be many times more potent than standard dosage hydrocodone, and the mounting fear is that Zohydro could lead to immediate abuse and overdose deaths across the country. This concern is in part stemming from the recent explosion in heroin use in the United States and the steady increase in opioid overdose fatalities that has emerged in the last five years.
One characteristic of Zohydro that presents increased risk is that it can be easily crushed and then snorted or injected. The medication was designed specifically for special pain management scenarios in which standard pain management interventions are not effective.
The manufacturers of … Read more
As has been widely documented in recent news media, heroin addiction is on the rise in the United States and does not appear to be slowing down anytime soon. From densely populated metropolitan cities to rural America, opiates are finding their way into schools, places of employment, and the upper socio-economic strata.
A well-written piece is just out in Charlotte Magazine profiling an intelligent 21 year old man by the name of Alex Uhler who succumbed to the pull of heroin, and sadly died of a fatal overdose. His story clearly illustrates a number of complex issues around addictive disease: the shame associated with being addicted, the extent some will go to conceal their addiction, and that it is an illness which impacts all people regardless of race, money, intelligence, or status.
The article addresses the increased presence of heroin in Charlotte, NC partly in response to the crackdown on, and scarcity of, prescription opioids. The extensive piece, by Lisa … Read more
There is increasing momentum building for opioid addiction treatment in response to the growing opioid addiction problem in the United States. Many teenagers and young adults who are being introduced to prescription opiates are at risk for developing a crippling drug dependency. The risk is increased as these youth discover that heroin is a relatively cheaper alternative than pain pills purchased on the street.
The Partnership at DrugFree.org has published a 36 page guide outlining opioid addiction and the therapeutic role that medication-assisted treatment can have even for teens and young adults. Methadone, suboxone, buprenorphine, and naltrexone are highlighted in the guide with an accompanying description of each medication and its use in opioid treatment.
Opioid replacement therapy has historically been used as a treatment of last resort in adult populations. The dilemma is that a high percentage of opioid addicted individuals are unable to remain drug free with traditional models of treatment that do not include medication … Read more
A Reuter’s story was just released highlighting a large drug bust in New York City in which 25 people were indicted on drug charges including two physicians. The charges stem from evidence that a healthcare clinic called Astramed dumped $500 million in prescription opioids into New York City’s black market from 2011 through 2014. It is reported that a total of 5.5 million oxycodone pills were sold to local drug dealers via phony prescriptions. The Reuter’s article reports a federal indictment was issued in which 24 defendants were charged with conspiracy to distribute narcotics.
This story is especially disturbing and comes on the heels of other recent stories in the news like the overdose death of Philip Seymour Hoffman and the death of 17 people in Pennsylvania who had used the deadly heroin and fentanyl mixture only weeks ago.
The opioid abuse problem in the United States is reaching unprecedented levels and is causing concern in segments of society that … Read more
Benzodiazepines are a classification of drugs primarily prescribed to treat anxiety and panic attacks. They have been in use for over thirty years and are typically utilized for short term periods from several days to three months maximum.
Benzodiazepines are sometimes administered just prior to medical procedures or surgery to help calm a patient. Common examples include valium, ativan, klonopin, librium, and xanax. These medications have also been used successfully on a short-term basis to help reduce alcohol withdrawal as patients undergo alcohol detoxification.
For opioid treatment programs, benzos present a particular risk due to the higher probability of abuse and overdose death when mixed with methadone, other opioids, or alcohol. Benzodiazepines depress the central nervous system and can shut down respiration when combined with other CNS depressants. This lethal drug combination has resulted in numerous accidental deaths – even among experienced drug users.
While limited and carefully monitored benzodiazepine use can be clinically justified in some cases, prescribing … Read more
There are many hundreds of methadone clinics in operation across the entire United States. Wherever there is addiction, there are suffering addicts and concerned friends and family in search of answers … and treatment.
Methadone.US would like to profile a highly regarded opioid treatment program located in Greensboro, North Carolina. This program is part of a non-profit substance abuse services agency known as Alcohol and Drug Services (ADS).
ADS has been helping the Guilford County and surrounding Triad community for over 40 years. While ADS offers a range of addiction treatment and drug prevention programs, they excel in the area of treating opioid addiction through a combined use of opioid replacement medication (methadone) and structured counseling.
ADS has achieved CARF accreditation, is licensed by the State of North Carolina’s Division of Health and Human Services, and is an approved Medicaid and multi-MCO authorized provider. But ADS’ most outstanding accomplishment is the depth and quality of their opioid program services … Read more