Suboxone vs. Methadone

Overview of Suboxone & Methadone
Advantages and Disadvantages
There's no miracle cure for addiction!
"Don't meth it up, get subport!"
"We all have belly buttons, but your's looks funny!"

I. Overview of Suboxone & Methadone

	Methadone (Methadose)	Buprenorphine (Suboxone)
Classification	Full Agonist	Partial Agonist/Antagonist
Half-Life	8-59 hours	24-60 hours
Other Active Ingredients	None	Naloxone (opioid antagonist)
U.S. Legal Status	Schedule II	Schedule III
Dosage Schedule	Daily	Varies (Every 1-4 days)
Visit Setting	Clinic	Doctor's Office
Visit Frequency	Typically Everyday	Monthly - Biweekly
Abuse Potential	High	Moderate
Severity of Withdrawal	Severe	Mild-severe

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II. Advantages & Disadvantages

	Methadone	Buprenorphine
Allows addict to temporarily avoid withdrawal symptoms	Yes	Yes
Allows addict to obtain medication in a safe, clinical environment as opposed to the streets	Yes	Yes
Eliminates many health risks, such as those associated with IV administration	Yes	Yes
Dosage can be controlled and gradually reduced	Yes	Yes
Available at a relatively low cost	Yes	Not Usually
Level of addiction	High	Moderate-high
Daily clinical visits required	Yes	No
Causes euphoria	Sometimes	Rarely
Level of withdrawal	Severe	Moderate to mild-severe
Short duration for withdrawal	No	No

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III. There's no miracle cure for addiction!

The information listed above is intended to help guide anyone seeking to start an opioid replacement therapy regiment, whether the purpose is maintenance or complete detoxification. It's extremely easy to run around the World Wide Web collecting facts about addiction, and reading peoples' experiences with opioid withdrawal, only to scare the desire to quit right out of your bones; however, we must remain confident and remember that this is exactly what our addicted mind wants us to do. We will convince ourselves somehow, someway, that we need to stay on drugs, that "this isn't a good time to quit," and we are "better off" taking opioids on a daily basis.

Whether a person is taking Suboxone or methadone, the body will still be physically dependent on opioids as long as this treatment is continued, but it can make all the difference in the world to some folks — if there is a desire for freedom from addiction. Neither drug will work wonders by itself. Recovery is a process that, much like a car or truck, requires constant tuning and retuning, reflection, effort, persistence, and a good knowledge base. Coupled with an experienced drug counselor, support group meetings—whether Narcotics Anonymous, Alcoholics Anonymous, or SMART Recovery—and a positive attitude, methadone or buprenorphine can help pave the highway to a drug-free life, a life worth living.

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IV. "Don't meth it up, get subport!"

There are horror stories on both sides of the fence. Both Suboxone and methadone offer their own unique benefits; however, most of the stories about individuals coming off of Suboxone pale in comparison with coming off of methadone cold turkey. Your mileage may vary—this is largely dependent on the individual. In my own personal life, I have found Suboxone to be the better treatment for opioid addiction. I have experience with both drugs; I used methadone for detox on one occasion, and took Suboxone in the long-term. Suboxone helped me to break old habits, and it definitely prevented a relapse or two! I won't reiterate the advantages again, but I will say one thing: if you have to choose one, make sure you do extensive research and consider all variables.

If at all possible, don't use either drug. Suboxone and methadone should be reserved as tools, your last resorts. It is counterproductive to use either drug during active addiction (to those out there that use it in between fixes). This drug is here to help break associations with the drug underworld and get people back on their feet again, and using it any other way creates negative connotations in your mind. A lot of doctors are too quick to prescribe these medicines. For people with small to medium-sized hydrocodone habits, taking Suboxone or methadone is akin to using a saw to cut your sandwich in half—overkill. Long-acting opioids like buprenorphine and methadone are very tough to withdrawal from, and if you can stick it out for a week without using any short-acting opioids, you'll be much better off.

A lot of people who start Suboxone end up being on it for six months or even two years when the intention was to stop after a month or two. That's way too long for most people. An eight week program (or less) should be sufficient to reduce withdrawal symptoms to a bearable level. During those eight weeks, the patient should be involved in an intensive outpatient program. An intensive outpatient program usually includes attending support groups (NA, AA, etc.) three days a week, seeing a psychiatrist as needed, and speaking with a drug counselor. If the root programs, those which (a) led to drug use, (b) were exacerbated by drug use, (c) hidden by drug use, and/or (d) caused by drug use, are not acknowledged and fixed, the patient will likely find himself in a neverending cycle of misery and despair.

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V. "We all have belly buttons, but your's looks funny!"

Methadone will help some people, and buprenorphine will help others. Every human being has a unique body chemistry, and some may tolerate one drug better than another. Before making any decision we recommend talking to people and finding out what worked for them. Make sure the people you are getting advice from are clean, and involved in some sort of recovery program, if possible. Do plenty of research and read the "Prescribing Information" for each drug. Talk to individuals in support forums online, and read stories... you get the picture. Before deciding on anything, educate yourself and remember, these drugs are not miracle cures, and without any extra effort & support, these drugs will be but a candle in the wind.

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