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/
Somewhat of a surprise was the recent ruling that the state of Massachusetts cannot ban the powerful new painkiller, Zohydro, from being prescribed in the state. The manufacturer of Zohydro, Zogenix, had argued that the ban was not constitutional and must be reversed.
The state governor, Deval Patrick, had announced his intention to make Zohydro unavailable since the manufacturer’s initial plan was to provide it without a tamper-proof component to deter abuse and potential overdose.
Judge Rya Zobel ruled that the state of Massachusetts had exceeded its authority in banning the drug, and she consequently implemented a preliminary injunction temporarily reversing the ban. The governor expressed disappointment that the public’s safety concerns were not sufficient to halt the sale of Zohydro, but he stated he would pursue other channels for addressing the widespread opioid abuse problem that is continuing to grow in the state and across the country.
Opioid pain medications have become a primary drug of abuse for … Read more
When a parent enters treatment for opioid addiction and begins methadone dosing, hopefully that person embraces the recovery process and the resumption of certain responsibilities that may have been neglected during addiction.
Many parents in addiction live with a sense of regret and shame over not always being there for their children. Opiate addiction is particularly brutal and can derail a person’s priorities for extended periods of time. Families can suffer, and their bonds strained to the limit for years because of drug addiction.
When a parent begins to find true recovery and is able to take an honest look at their life, they recognize how their mistakes affected others – most often their families and particularly their children.
Effective parenting requires a notable combination of talents & abilities – obviously love mixed with patience, availability, consistency, and attention. These qualities suffer and are diminished for a majority of addicted parents when drugs are in control. As the years roll … Read more
The State of Massachusetts is experiencing dramatic levels of opioid abuse and their Governor, Deval Patrick, is sharply focused on addressing the problem. A compelling Boston Globe article has highlighted the growing problem with heroin and other opiates across the state noting that 185 people died of heron overdose between November 2013 and February 2014.
Also mentioned in the article was the state’s plan to increase funding for drug treatment by $20 million and to prohibit the sale of Zohydro, a highly potent prescription painkiller that has drawn much attention and criticism due to its ability to potentially worsen the opioid epidemic in America.
Governor Patrick has declared the opioid abuse problem a public health emergency and is taking active measures to increase the availability of naloxone to Massachusetts public workers so that they can intervene to save the lives of those experiencing an opiate overdose. Naloxone is a powerful opioid antagonist that reverses the effects of opioid overdose within … Read more
Receiving increased attention across the country are concerns about prescription pain medication and to what extent prescribers are using caution and due diligence in administering them.
In addition to opioid addiction treatment centers that often employ methadone, pain management clinics also utilize methadone as well as other beneficial but potentially addictive opioid medications such as hydrocodone for breakthrough pain. Often, in addition to painkiller prescriptions, pain management physicians will prescribe powerful benzodiazepines like Xanax and Klonopin to manage patients’ stress and anxiety symptoms.
The potential problems which can emerge from these medication combinations is fairly extensive. First, uninformed patients can develop a rapid physical dependency on pain meds if not properly educated. Patients also run the risk of accidental overdose when combining powerful drugs like methadone, oxycodone, and xanax. There is a serious risk to the community when a physician overprescribes because powerful pain medications and benzodiazepines have a premium “street value”, and are often diverted and sold to naive, … Read more
People in recovery from addiction face very substantial stresses. The stress of trying to cope with cravings & urges, the stress of facing life and trying to resolve problems, and the common pressure of trying to make ends meet when finances are not in good shape.
While many addicted individuals find that they are more resilient than perhaps they ever believed, loss can sometimes be a particularly crippling experience. People from all walks of life suffer and struggle with losses – divorce, the death of a loved one, the loss of a job, income, security, or health.
A recent New York Times article briefly profiled a young woman released from prison who was trying to stay clean from heroin. She really missed her child who had been removed from her custody. While she loved her baby, she also recognized she was not yet ready to resume the pressures and responsibilities of parenting until she got herself on more solid, sober … Read more
An interesting post was made on the DrugFree.org website related to a recent survey which found that the primary drug of abuse among “affluent” addicted women was prescription opioids or heroin.
The definition of affluent included those whose annual family income exceeded $100,000. Of those who entered treatment for their addiction, 61% of them identified prescription opioids as their predominant addiction problem.
The survey found that 70% of those who developed an addiction reported that their initial use was related to a prescription of legal medications for the treatment of pain or emotional problems.
The opioid epidemic has shown how universal addiction problems actually are by transcending all types of assumed barriers and biases. Opioid addiction is a very clear brain disease and poses risk, even in prescribed legitimate uses, to those individuals with no prior addiction-related problems or high risk behaviors.
For individuals receiving prescription pain medication, it is imperative that they have a thoughtful and candid discussion with … Read more