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/
Guilford County is the third most populated county in the state of North Carolina. Located within Guilford County are the cities of Greensboro and High Point – both of which are experiencing a surprising increase in opioid addiction and related overdoses.
The High Point Enterprise news reported that the High Point Vice and Narcotics unit has begun to make a favorable impact on the problem with multiple arrests of those trafficking heroin locally. The article documents that 70 reported High Point opioid overdoses have occurred thus far in 2014 with 9 of those ending in death. Six people were arrested the week of July 14 and are being held on multi-million dollar bonds for their roles in selling or trafficking heroin. To emphasize the local impact, the HP Enterprise reported that 7 overdoses occurred within a 24 hour period on May 16, 2014.
Behavioral Health Group (BHG) is a leading provider of opioid addiction treatment services with programs presently covering eight U.S. states. BHG provide both maintenance and detox services in an outpatient setting and utilize a variety of FDA-approved medications for the treatment of opioid addiction such as methadone and buprenorphine. Buprenorphine is the active ingredient in Suboxone.
The company currently has 37 treatment center locations in Colorado, Kansas, Kentucky, Louisiana, Missouri, Oklahoma, Tennessee, and Texas. BHG operate in accordance with a number of core values that define their services, to include: character, enthusiasm, compassion, teamwork, and perseverance.
The organization’s website states that they incorporate best practices into their treatment approaches and use outcome-based metrics to consistently improve their service delivery. BHG has achieved full accreditation among their various facilities which means that they meet or exceed quality standards of care as determined by the Joint Commission on Accreditation of Healthcare Facilities.
Medication-assisted treatment is the industry standard for … Read more
Soon to be released is a new oral buprenorphine based product called Bunavail. Bunavail is manufactured by Biodelivery Sciences and is a combination of buprenorphine and naloxone. It is a thin film formulation that is designed to adhere to the inner cheek where it quickly dissolves and is absorbed into the mucosal lining of the mouth.
The medication is touted as delivering about twice as much active ingredient into the patient’s bloodstream compared to sublingual suboxone. Bunavail is scheduled to be released in the third quarter of 2014. A press release by the company mentions that the medication will compete with other products in the $1.7 billion dollar opioid dependency treatment market.
Bunavail is a new advancement in drug delivery technology according to the press release and is reported to produce less constipation than other competing buprenorphine products. Patients can also speak freely while the medication dissolves.
With an estimated 2 million plus people addicted to opioids in the … Read more
An article in Maine’s Bangor Daily News outlines a case recently decided in which the Town of Warren, Maine was found to have adopted an ordinance that was ruled discriminatory and in violation of the Americans With Disabilities Act.
CRC Health Group had been fighting to open a methadone clinic in Warren to provide treatment services to those struggling with the disease of opioid addiction. However, the town of Warren had opposed this initiative for several years. U.S. District Court Magistrate Judge John Nivison approved an agreement in which the town of Warren will pay $495,000 to CRC Health Group to drop its lawsuit.
CRC offers a variety of behavioral health treatment programs around the country and has a special focus in opioid addiction services utilizing medication-assisted treatment like methadone and buprenorphine.
Maine has a substantial opiate addiction problem and is in need of more resources for those individuals stuck in the vicious cycle of opiate addiction and withdrawal.
Historically, … Read more
Since the launch of Methadone.US, hundreds of thousands of visitors have searched the site and located important treatment resources to help them deal with a chronic opioid addiction. The city pages on Methadone.US list both methadone clinics and local buprenorphine (suboxone) physicians.
While the federal government maintains a similar database of medication-assistance providers, we focus on making this site convenient and easy-to-use for patients, families, medical professionals, and anyone interested in finding help for addiction problems.
We have some recent clinic additions to Methadone.US in the cities of Salt Lake City, Dallas, and Cincinnati. There are an increasing number of clinics around the country, and in larger metropolitan areas there are often numerous facilities available to serve the much larger population. To highlight local treatment programs, we offer Featured Clinic Listings for those methadone treatment providers who wish to profile their services to a larger number of prospective patients who are visiting their city’s page on Methadone.US.
A very exciting … Read more
People facing addictive disease cover a wide variety of maturity levels, individual capabilities, and in their level of desire for sober lives. What I mean is that some are further along in their mindset and are really ready to live drug free. They embrace the challenge, and they recognize that some work lies ahead in order to get their life properly sorted out.
Others are sometimes only motivated by the present crisis. They do the right thing only long enough to avert the crisis, and then they’re back to old behavior and old attitudes like they didn’t miss a beat. They straighten up just long enough to avoid probation revocation. They may stop using and “make nice” with a loved one as long as it takes to get some money or a favor, and then it’s back to addict behavior.
With opiate addiction, people from all walks of life can develop a problem – from the chronic troublemaker to the … Read more