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What’s the Difference Between Methadone and Suboxone?

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In Medication Assisted Treatment for Opioid Use Disorder (OUD), the two most popular medications are Methadone and Suboxone. What’s the difference between the two and which is appropriate for you or your loved one?

 

Methadone is a full agonist opioid. That means it fills the opioid receptor in your brain and gives you the same euphoria as other opioids like heroin or oxycodone while it eliminates cravings and pain of opioid withdrawal. The difference with Methadone is it is long acting so that you can reach a certain dosage and maintain it; as opposed to short acting opioids where you build a tolerance and then continually need to increase frequency and dosage to achieve the desired effects.

 

Suboxone is a partial agonist. It contains four parts of the partial opioid agonist buprenorphine and one part of the opioid antagonist naloxone. When you take it, it only partially fills the opioid receptor. It eliminates opioid cravings and pain of opioid withdrawal, resulting in a patient feeling more "normal".

 

"Suboxone is typically the first medication a patient at Symetria Recovery receives to reduce and eliminate the cravings and withdrawal symptoms associated with detoxification," states Symetria Recovery Chief Medical Officer Dr. Abid Nazeer.

 

Methadone comes in liquid, wafer or tablet form and is taken orally. Suboxone is a film or tablet that is take sublingually, under the tongue or in the cheek where it dissolves.

 

Today, Methadone is more often used in more severe cases of OUD. There is a higher risk of overdose and you must visit a Methadone clinic every day to receive your dose. There is much less of a risk of overdose with Suboxone. You can receive a prescription and take it every day on your own.  It is highly recommended to be treated by a comprehensive outpatient clinic where Intensive Outpatient (IOP) therapies such as behavioral, mental and emotional counseling occurs with medication for best outcomes.  A one-stop shop allowing you to live and work while eliminating cravings and triggers allows for proven change.   

 

According to research supported by NIDA, the National Center for Advancing Translational Sciences, the Centers for Disease Control and Prevention, the US Food and Drug Administration, the Substance Abuse and Mental Health Services Administration, the Office of National Drug Control Policy, as well as the Laura and John Arnold Foundation from April 2018 to June 2019 - 

"Only treatment with buprenorphine or methadone was associated with reduced risk of overdose at both time points. Indeed, treatment with either of these medications was associated with a 76% reduction in overdose at 3 months and a 59% reduction at 12 months. Compared with no treatment, buprenorphine or methadone treatment was also associated with a 32% and 26% relative reduction in serious opioid-related acute care use at 3 and 12 months, respectively. Serious opioid-related acute care use was defined as an emergency hospitalization with a primary opioid diagnosis code.

Despite these findings, treatment with buprenorphine or methadone is uncommon, recorded in only 12.5% of the patients in the study. The most common treatment pathway was nonintensive behavioral health (59.3%), followed by inpatient detoxification or residential services (15.8%), not receiving any treatment (5.2%), receiving naltrexone (2.4%), and intensive behavioral health (4.8%). Nonintensive behavioral treatment was also associated with reduced risk of overdose at 12 months and reduced risk of opioid-related acute care use, a finding that may reflect differences in the population of patients referred to this type of treatment. The authors discuss barriers to the use of methadone and buprenorphine and suggest strategies for increasing their use."

 

So, which is better? The answer is that both are effective treatments and it depends on your situation and level of OUD. The best way to determine which is best for you is to educate yourself about both and consult your doctor.  Symetria Recovery is one of only 2.7 percent of treatment centers to provide three opioid recovery treatment medications - Methadone, Buprenorphine (Suboxone) and Naltrexone (Vivitrol).

 

For more information on clinics to suit your OUD, substance use, abuse or dependency, contact Symetria Recovery

Dale Willenbrink
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