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/
Evzio is an FDA-approved emergency treatment that counteracts the effects of opioid overdose. It is an “auto-injector” designed to contain a retractable needle and a 0.4 mg dose of naloxone. Naloxone is a powerful opioid antagonist that reverses the effects of overdose with heroin or other opiates. Naloxone has been used throughout the country in the past few years and literally saved hundreds of lives.
Kaleo Pharma is the manufacturer of Evzio. The company specializes in innovative solutions for serious and life threatening medical conditions. Kaleo Pharma is based out of Richmond, Virginia, USA.
As has been documented in national media, very potent forms of heroin have become available much of it laced with other opiate derivatives like fentanyl. These combinations have proven lethal in a large number of cases often with younger people being the victims of overdose due to not understanding the extreme potency of the drugs being sold.
Products like Evzio in the hands of family and … Read more
Paul LePage, the governor of Maine, has announced that he is considering ceasing state-funded support for methadone. As an alternative, Maine is proposing that patients prescribed methadone be switched to a more affordable suboxone option as part of a $727,000 state budget cut. The story is here.
This is an indefensible decision with dire medical implications for opioid addicted patients currently receiving methadone. It equates to government officials making medical decisions that will negatively impact the health and well-being of thousands of people.
Representative Drew Gattine (a member of the Health & Human Services Committee) is quoted as saying the proposal shows a lack of understanding of the societal costs of addiction throughout the state of Maine.
Methadone and suboxone are both effective medications, but offer very unique characteristics and applications depending on the severity & chronicity of a patient’s opioid addiction. Buprenorphine (the actual opioid agonist contained in suboxone) has a much lower ceiling effect than does methadone … Read more
SMC Recovery based in Scottsdale, Arizona opened an outpatient addiction treatment program late last year. SMC provides a Medication-Assisted Program utilizing methadone and an Intensive Outpatient Program. Both treatment modalities are endorsed by SAMHSA as best practices in the field of addiction treatment.
Methadone programs across the USA cover a wide range of prices sometimes as high as $15.00 per day. However, SMC Recovery have implemented one of the most affordable rates in the country at just $55.00 per week. This is an outstanding value for anyone who has been struggling with opiate addiction and it is one of the most competitive rates we have learned of anywhere in the country.
Prospective patients are often unable to get started with outpatient methadone treatment because the cost is just too high for them. SMC Recovery have lowered this barrier considerably. We were informed by their staff that this price will most likely be active over the next year consequently providing … Read more
As we prepare for another new year, there is always this opportunity for welcomed changes and improvements in our lives. New years resolutions are often built around personal goals that people would like to achieve like quitting smoking, losing weight, or beginning a new hobby.
With opioid addiction, the desire for relief is always present. It is amazing what an individual can do when they are truly motivated and committed to a goal. It is true that people enter recovery every single day. What an incredible truth this is!
The big question is what does it take for a person to step onto the path of change and to point themselves in a new direction? The disease of addiction is one that is allowed to continue as a result of becoming stagnant, inactive. As a disease process, drug addition only gets halted when a person makes a decision to do something about it. If a person fails to take any … Read more
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