What’s the Difference Between Methadone and Suboxone?

The physicians at Symetria cite only trustworthy sources, including peer-reviewed journals, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

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Casadonte, P. (2013). Transfer from Methadone to Buprenorphine. Providers Clinical Support System. https://pcssnow.org/wp-content/uploads/2014/03/PCSS-MATGuidanceTransferMethadonetoBup.Casadonte.pdf

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Suboxone and methadone are two different medications that are both used to treat opioid use disorder. 

  1. Suboxone is a combination of two medications: buprenorphine and naloxone.
    1. Buprenorphine is a partial-agonist opioid used to reduce cravings and withdrawal symptoms. 
    2. Naloxone is an opioid blocker added to discourage abuse.
  2. Methadone is a synthetic opioid used to reduce cravings and withdrawals.

Category: Drug Addiction Treatment  > Suboxone and Methadone

Table of Contents

Is Suboxone the same as methadone?

No, but they share many similarities in treating the same condition, opioid use disorder.

Do methadone and Suboxone have the same ingredients?

No, they are different medications with different ingredients. 

  1. Methadone only has one ingredient, methadone hydrochloride. 
  2. Suboxone is a combination of two medications, buprenorphine and naloxone.

What is the difference between methadone and Suboxone?

Even though both help people with opioid use disorder, they are different medications.

Because it’s a full-agonist opioid, methadone is tightly regulated. Patients must report to a methadone clinic to get their dose dispensed to them. After several months of success, patients can take home several days of methadone dosage at a time. 

Suboxone can be filled at the pharmacy like any other medication, but pharmacies too often refuse to provide Suboxone. suboxone clinic can usually dispense onsite.  (See What is a Suboxone Clinic?)

Suboxone is the first choice for opioid use disorder because it’s people are less likely to abuse it and the naloxone blocker prevents overdose in case they do. However, methadone has been successfully treating opioid addiction for years and is a good option if you’ve already had success with it. Some switch to methadone if they haven’t been successful with Suboxone or want the extra daily accountability.

How Suboxone and Methadone Work in the Brain

Buprenorphine Doesn't Fully Cover the Receptor in the Brain

Can you take methadone and Suboxone together?

No, you have to choose either Suboxone or methadone. Combining both medications is dangerous because both are opioids, and this could cause an overdose. 

How do you switch from methadone to Suboxone?​

A patient’s methadone dose should be tapered down to 30 mg before starting Suboxone and Suboxone shouldn’t be taken until at least 24 hours after the last dose of methadone.  
 
Those on low doses of methadone can usually transition without noticing an increase in symptoms or cravings. In one study, all 25 out of 25 participants transitioned successfully.
 
That said, withdrawals often lead to relapse, so the switch should be carefully coordinated by your doctor(s). 

Should you switch from methadone to Suboxone?

If a patient is successfully treating their opioid addiction with methadone, there is no need to switch to Suboxone. But, if they continue to relapse or are non-compliant with the methadone program, Suboxone may be a better fit.

Should you switch from Suboxone to methadone?

It’s not common to switch from Suboxone to methadone, but can be a good option when patient’s aren’t successful on Suboxone

How do you switch from Suboxone to methadone?

Switching from Suboxone to methadone is easier because methadone does not have an opioid blocker. Methadone should be started 24 hours after the last dose of Suboxone. The initial dose of methadone will be adjusted based on the patient’s last Suboxone dose. 

See also: How to Get Off Suboxone

General Breakdown of Patient Medication Choices at Symetria

80 percent of patients are on Suboxone or Methadone

Is methadone stronger than Suboxone?

Not necessarily. Both medications satisfy the brain’s craving for opioids without the rush of euphoria that you get with heroin or oxycodone.  

The active ingredient in Suboxone, buprenorphine, is a partial opioid agonist, which means the feel-good opioid effect of the opioid is limited. People with tolerance to opioids won’t get high when they take Suboxone, but they will feel immediate relief from withdrawal symptoms. 

On the other hand, methadone is a synthetic full-agonist opioid. It has the same opioid effect in the brain as other opioids like heroin or oxycodone. The goal with methadone is to satisfy the brain’s cravings and prevent withdrawal symptoms with a safe, controlled dose approved by a doctor.

Addiction treatment is not a “one size fits all” solution. Both Suboxone and methadone are powerful tools for fighting opioid addiction, and it’s up to you and your treatment team to determine which one is right for you. 

Is methadone more effective than Suboxone?

Methadone and Suboxone are equally effective at treating opioid use disorder, though one study showed individuals on low doses of Suboxone (6 mg or less) are less likely to stay in treatment than those taking methadone.

What are the side effects of methadone vs. Suboxone?

Suboxone and methadone have similar side effects, including:

  • Constipation 
  • Nausea and vomiting
  • Drowsiness and fatigue
  • Dilated pupils
  • Insomnia
  • Sweating
  • Respiratory distress
  • Double-vision

The biggest difference is that Suboxone doesn’t cause the feel-good, euphoric feelings of traditional opioids. It’s less intense than heroin or fentanyl, but you can get high off of methadone, which is why it’s given only at a clinic.

Are you looking for a Suboxone or Methadone clinic?

Symetria is a top-rated medication-assisted treatment (MAT) clinic, with locations throughout Chicago, as well as Fort Worth and Houston. All locations are in-network with insurances and offer both Suboxone and Methadone. 

If you don’t happen to live in these areas, try calling the number on the back of your insurance card. If you don’t have insurance, visit FindTreatment.gov and type in your zip code. Then, on the next page, use the free or slider scale filters.

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Symetria has addiction treatment clinics across Illinois and Texas. You can likely get scheduled TODAY — medications or therapy.