• Addiction & recovery

Suboxone vs. Methadone – How are They Different?

Nzinga Harrison

June 3, 2021


Opioid abuse has reached epidemic levels in the U.S. According to the National Institute on Drug Abuse (NIDA), around 50,000 people in the U.S. died of opioid-related overdoses in 2019. Opioids are a type of opium-based medication that can be obtained through a prescription or illegally off the streets. Opioid use disorder (OUD) occurs when a person continues to use opioids despite the fact that they cause emotional, mental, and physical complications. Opioid abuse has a huge negative effect on one’s quality of life.

An OUD is a chronic, relapsing brain disorder that is associated with increased rates of morbidity and mortality. Therefore, medical experts have introduced OUD treatment interventions like medication-assisted treatment (MAT) to address this growing concern. And Suboxone and Methadone are two primary medications used in MOUD to address opioid use disorder. Depending on the nature of your opioid use disorder, you may be recommended Methadone or Suboxone by your healthcare provider.

What Is Suboxone?

Suboxone is made up of two components known as buprenorphine and naloxone. Buprenorphine in Suboxone is a partial opioid agonist that inhibits opiate receptors and decreases cravings. The second ingredient, naloxone, works to counteract the effects of opioids. Both medications act together to decrease withdrawal symptoms associated with opioid use dependence. 

This medication comes as an oral film to put under your tongue (sublingual) or between your gums and your cheek (buccal). The film dissolves in your mouth and gets into your bloodstream within a few minutes. This medication can also be found as an oral tablet.

The U.S. Food and Drug Administration (FDA) states that Suboxone is suitable for the maintenance treatment of opioid use disorder and to manage opioid withdrawal symptoms. It is most effective when combined as a part of a comprehensive treatment strategy that involves counseling and psychosocial care. 

Suboxone functions by tightly binding to the same receptors in the brain as other opiates. This function helps dull intoxication, prevents cravings, and allows many people to transition back from a life of addiction to a life of sobriety.

Suboxone is a controlled substance. This means that even though it is approved for medical use, it does possess the potential for physical or psychological dependence when misused.

What Is Methadone?

Methadone operates by modifying how the brain and nervous system react to pain. It also reduces the debilitating symptoms of opiate withdrawal syndrome and inhibits the euphoric effects of opiate drugs during an addiction treatment program. Methadone dosages are built up steadily over time to minimize the possibility of an overdose. When taken as prescribed, methadone is a safe and effective medication to treat opioid use disorder.

Methadone comes in the form of: 

  • Oral tablet
  • Oral dispersible tablet (tablet that can be dissolved in liquid) 
  • Oral concentrate solution 
  • Oral solution
  • Intravenous (IV) form (which can only be administered by a healthcare provider)

People who have been prescribed methadone for OUD must receive their medication from a methadone clinic. Initially, you must go to the methadone clinic for daily dosing. However, after a period of stability, you will be allowed to take methadone at home between treatment visits. The length of methadone treatment generally lasts a minimum of 12 months. Anyone who wishes to stop using methadone must do so gradually under the supervision of a healthcare provider to avoid withdrawal symptoms. 

Similar to Suboxone, methadone is also a controlled substance that can cause dependence in its users when misused or used over a long period.

The Benefits of Suboxone in Opioid Dependence Recovery

The first stage of Suboxone usage in OUD maintenance treatment is during induction. Suboxone helps people overcome and manage opioid withdrawal syndrome safely and effectively. 

Once the initial dosing of Suboxone has been stabilized , your healthcare provider will maintain that  dosage or increase the dosage if you continue to have cravings . Those who use Suboxone may also experience: 

  • Pain relief 
  • Overall Calmness and a sense of well-being 
  • Reduced stress levels 

Unlike methadone that can only be administered by a licensed methadone clinic, Suboxone can be prescribed in an outpatient setting

The main benefits of Suboxone include:

  • Fewer cravings for opioids
  • Suppression of opioid withdrawal symptoms
  • Reduced risk of relapse 

Other specific advantages of Suboxone are:

High Success Rate: According to the National Institutes of Health (NIH), out of 600 people addicted to painkillers, many taking Suboxone sublingual experienced a 49% decrease in the use of opioid pills.

Convenience: Since this medication can be obtained through an outpatient clinic or your local physician, you will not be required to stay at an inpatient center, nor do you have to go to a clinic for daily dosing.  

Affordability: Many OUD programs provide you with visit and payment information to help you file with your insurer and to qualify for a prescription assistance program. 

The Benefits of Methadone in Opioid Addiction Treatment

Methadone is an opioid medication that’s been in use for the treatment of opioid use disorder for the past 50 years. Although it is primarily associated with the treatment of heroin addiction, it is also used in MOUD to treat addiction to many other opioid drugs. Methadone decreases opioid cravings and withdrawal and blunts or inhibits the effects of opioids during a relapse. 

People receiving Methadone for the treatment of OUD must take the drug under the guidance of a licensed practitioner. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), these medications can only be dispensed by a SAMHSA-certified methadone clinic. 

Methadone is effective and safe when used as prescribed. It helps individuals achieve and sustain recovery and reclaim productive and fulfilling lives. As with all medications utilized in the treatment of substance use disorders, Methadone is administered as part of a comprehensive treatment program. 

The benefits of Methadone maintenance treatment include:

  • Methadone treatment participants are more likely to remain free of opioid drugs and effectively manage opioid withdrawal syndrome than those receiving no medication for opioid use disorder.  
  • Methadone can significantly minimize cravings and relapses.
  • Methadone maintenance treatment is generally more affordable than Suboxone. 
  • This treatment significantly decreases the likelihood of contracting HIV, HEP C, and other diseases linked with intravenous substance use. 

Suboxone and Methadone Withdrawals

Since both Methadone and Suboxone are opioids, they can cause the development of physiological dependence and withdrawal. However, as a Schedule II medication, Methadone has a greater risk of misuse than Suboxone, which is Schedule III medication. 

Symptoms of withdrawal from either product can differ greatly in intensity from one individual to another. Withdrawal from Methadone can last around 2-3 weeks, during withdrawal symptoms from Suboxone. 

Abruptly quitting Suboxone or Methadone can cause similar symptoms as other opioid withdrawals but in less intensity. Common symptoms of withdrawals may include:

  • Runny nose
  • Watery eyes
  • Goosebumps
  • Shaking
  • Sweating
  • Feeling hot or cold
  • Diarrhea
  • Trouble sleeping (insomnia)
  • Nausea or vomiting
  • Muscle pains or muscle cramps

To avoid withdrawal symptoms, people who wish to discontinue their use must do so gradually under their healthcare provider’s supervision. Your doctor will eventually reduce the dose over time to help alleviate withdrawal symptoms. 

Suboxone vs. Methadone – Eleanor Health How are They Different -

Risk of an Overdose

Even though Suboxone contains naloxone, you can still experience an overdose. 

Symptoms of a Suboxone overdose may include:

  • Nausea and vomiting
  • Seizures
  • Abdominal pain
  • Loss of physical coordination and appearing drunk or drugged
  • Sleepiness
  • Slowed heartbeat
  • Irritability, anxiety, and mood swings
  • Trouble concentrating or remembering things
  • Depressed breathing
  • Coma
  • Death

Methadone overdose happens when someone unintentionally or deliberately takes more than the prescribed dosage. It can also happen if an individual takes Methadone with other painkillers. These painkillers include oxycontin, morphine, and hydrocodone (Vicodin). 

Symptoms of a Methadone overdose include:

  • Tiny pupils
  • Constipation
  • Nausea and vomiting
  • Spasms of the stomach or intestines
  • Confusion
  • Disorientation
  • Dizziness
  • Drowsiness
  • Fatigue
  • Muscle twitches
  • Weakness
  • Depressed breathing
  • Coma and death

Therefore, make sure you always use Methadone or Suboxone according to your doctor’s recommendations. 

The decision between Methadone and Suboxone can differ from individual to individual, depending on an individual’s unique conditions and circumstances.

OUD has the potential to be fatal. We are proud  that you’re taking action towards recovery; it’ll benefit your long-term wellbeing and help improve your life in many ways. Although detoxing from any addictive drug can be daunting, the long-term benefits greatly outweigh the dangers.

Talk to your doctor about Methadone and Suboxone therapy and how they can benefit you in your recovery process.

If you are seeking help with your loved one’s addiction, contact us today or complete our quick contact form below, to speak with an addiction treatment specialist.

If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in LouisianaMassachusettsNew JerseyNorth CarolinaOhio, Texas, and Washington.

Eleanor Health

Recovery for life.

Our mission at Eleanor Health is to help people affected by opioid addiction live amazing lives. We deliver whole-person, comprehensive care and are passionate about transforming the quality, delivery, and accessibility of opioid addiction treatment. Our actions are rooted in respect for each member's values, culture, and life experiences, and our commitment to their wellbeing is unwavering and without judgement.

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