Detox is the process of separating an addict from their substance of choice, during which time withdrawals are generally medically managed. Various medications for drug detox are available but it is interesting to compare methadone vs. Suboxone, which are both used for managing opioid withdrawals. Prescription painkiller abuse rates nationwide are staggering, according to the National Survey on Drug Use and Mental Health, which is released by the Substance Abuse and Mental Health Services Administration. According to the 2015 report:
- 12,462,000 people misused prescription painkillers in the last year
- 6,365,000 people misused prescription painkillers in the last month
Numbers for heroin aren’t as high but are still shocking:
- 5,099,000 people have used heroin in their lifetime
- 828,000 people used heroin in the last year
- 329,000 people used heroin in the last month
With such incredible numbers of people actively using and abusing opioids and opiates, the necessity for medications such as methadone and Suboxone to help these individuals detox rises.
Methadone vs. Suboxone
Currently, methadone is the most widely used detox drug. It has been around longer than and is cheaper than Suboxone, a tried-and-true medication for treating opioid withdrawal. It is a full opioid antagonist, meaning it has greater effects on receptors in the brain, thus making it more potent. Treatment with methadone often results in individuals feeling slightly high while using it. The potential risk for addiction to and overdose from methadone is extremely possible due to its opioid-like effects. Suboxone, also known as buprenorphine, is a partial opioid antagonist. Its effect on brain receptors is lower, making it a less potent and “safer” drug. Due to its weaker effects, the potential for addiction and overdose is lower, but still present. Suboxone’s advantages over methadone include reduced feelings of euphoria in users as well as an increased ability to think clearly. It also has a “ceiling effect” where, after a certain amount of the drug is taken, additional doses produce no heightened effect. Individuals treated with Suboxone report missing the “nodding-off” feeling present during methadone treatment. When comparing methadone vs. Suboxone, doctors must take into account the severity of the addict’s use. Due to Suboxone’s weaker effects, it is better suited for those with mild to moderate opiate and opioid dependence. Methadone is suitable for any severity of dependence. Still, studies have shown a general equivalency in the effectiveness of methadone vs. Suboxone in alleviating and treating withdrawal symptoms. However, individuals treated with Suboxone have experienced a higher rate of completion of treatment compared to methadone.
What are the side effects of methadone vs. Suboxone?
As with all medications, both methadone and Suboxone come with side effects and health risks. There is no miracle drug for detoxing. Side effects of Suboxone include:
- Nausea/vomiting
- Headache
- Sweating
- Constipation
- Numb mouth
- Decrease in sleep
- Respiratory problems
- Fainting
- Sleepiness
- Dizziness
- Coordination difficulty
- Liver problems
- Potential allergic reaction
- Decrease in blood pressure
- Potential for hepatitis when administered intravenously
Side effects of methadone include:
- Difficulty breathing
- Shallow breathing
- Lightheadedness
- Fainting
- Hives or rash
- Swelling of face, tongue, lips or throat
- Chest pain
- Increased heart rate
- Hallucinations
- Confusion
- Cardiac problems (such as torsades de pointes)
Again, there is potential for addiction and overdose from both methadone and Suboxone. Each should be taken only under the care of and with a prescription from a doctor. Be open and honest with your doctor about any side effects that occur or if you feel you’re becoming addicted to the medication. Don’t remove yourself from one drug simply to become addicted to another. Keep your sobriety at the forefront of your treatment and use these medications only for their intended purpose. Sources: “Results From the 2015 National Survey on Drug Use and Health: Detailed Tables” Substance Abuse and Mental Health Services Administration “Buprenorphine vs methadone treatment: A review of evidence in both developed and developing worlds” Paul J. Whelan and Kimberly Remski “Other safety and adverse event information” Suboxone “Methadone” Substance Abuse and Mental Health Services Administration