Suboxone vs. Methadone: What’s the Difference?

Methadone and suboxone are two types of medication used to help treat opioid and opiate dependence or addiction. Methadone, a Schedule II controlled substance, is typically used to treat pain in patients, working to change the way the brain reacts to pain receptors, but is also used to help prevent the occurrence of opioid / opiate withdrawal symptoms from occurring in patients who are undergoing opiate addiction recovery programs.

Suboxone, a Schedule III controlled substance, is a prescription medication used to treat opioid-addicted, or dependent, individuals, in a recovery program setting. Both methadone and suboxone are partiel opioids themselves, prescription controlled substance medications, used to help combat opioid dependence and addiction. So, with all of these similarities, is suboxone the same as methadone? No. Because, despite all of these similarities, there are also differences between suboxone versus methadone.

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What is the Difference Between Methadone and Suboxone?

So, what is the difference between methadone and suboxone? Well, the difference(s) between methadone and suboxone are actually rather varied. Suboxone vs methadone causes less respiratory depression, and likelihood of overdose than methadone when in use, but methadone typically has less side effects. Of course, there are other differences of suboxone vs methadone, including treatment methods, routes of use, risks, costs, and even benefits. Other difference(s) between methadone and suboxone include:

Common Side Effects

Each medication has side effects associated with regular use. Some of these side effects may even be serious and require medical intervention. It’s important to recognize and understand the potential negative side effects associated with any medication that you are prescribed. Below are the various side effects associated with both Methadone and Suboxone.

Methadone

Typical side effects may include:

  • Lightheadedness
  • Dizziness
  • Sleepiness
  • Nausea
  • Vomiting
  • Sweating
  • Constipation
  • Stomach Pain

Serious side effects may include:

  • Addiction
  • Severe Breathing Issues
  • Heart Rhythm Issues
  • Severe Stomach Pain
  • Seizures
  • Allergic Reaction

Suboxone

Typical side effects may include:

  • Lightheadedness
  • Dizziness
  • Fainting
  • Sleepiness
  • Nausea
  • Vomiting
  • Sweating
  • Constipation
  • Numbness of Mouth
  • Swollen or Painful Tongue
  • Redness in Mouth
  • Trouble Focusing
  • Faster or Slower Heart Rate
  • Blurry Vision

Serious side effects may include:

  • Addiction
  • Severe Breathing Issues
  • Coordination Issues
  • Allergic Reaction
  • Opioid Withdrawal
  • Low Blood Pressure
  • Liver Problems
  • Irregular Heart Rhythm

Route of Administration

Each medication is administered either via oral dose, tablet, or sublingual administration. Keep in mind that the method of administration may also play a role in some of the side effects listed previously. For example, Suboxone oral administration via sublingual lozenge can cause pain or discomfort in the mouth, specifically to the tongue. If you experience side effects resulting from the route of administration of your medication maintenance program, talk with the prescribing treatment professional about alternative administration options to lessen the burden.

Methadone Administration

  • A Tablet
  • A Dispersible Tablet (can be dissolved in a liquid)
  • A Concentrated Solution (to take by mouth)
  • A Solution (liquid)
  • All Doses Are Taken In The Presence Of A Doctor

Suboxone Administration

  • A Sublingual Oral Film (to be placed under the tongue, or between the gums and cheek to dissolve)
  • A Doctor Monitors The Beginning Doses, But Over Time Suboxone Can Have The Potential To Be Taken At Home At A Low Dose

Additional Variables that Make Suboxone vs Methadone Different

Other differences between suboxone vs methadone can include price, dependent on insurance, dosage, and length of time used, and how the medications are used in individual therapy programs. Despite the similarities of the medications, there are many differences as well, as the world works to combat opioid addiction and dependence in both illegal and medical uses of the drug type.

Each of these drugs or maintenance medications also comes with inherent benefits. For some, the benefits of Methadone may outweigh those of Suboxone. For others, the opposite may be true. Understanding the benefits of each medication and how use of the medication may impact your life is important.

Benefits of Methadone

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Methadone and buprenorphine are both recommended to use in the detoxification process from opioid addiction or dependence, in opioid treatment therapy. Withdrawal from methadone to suboxone can happen if more severe side effects occur, or as patients try to find a different method of recovery that works best for them. Methadone is taken orally, allows for patients to undertake their daily responsibilities at home and work, and comes as a recognized Essential Medicine by the World Health Organization. Other benefits of methadone use in opioid treatment therapy include:

  • Reduction of Overall Opioid Drug Injection
  • Because it Reduces Drug Injection, it Also Helps Prevent HIV Transmission
  • Reduces the Death Rate Associated With Opioid Dependence
  • Reduces Criminal Activity by Opioid Users
  • Reduces the Risk of Relapse
  • Is Easy to Administer
  • Is Effective, Especially in Conjunction With Other Opioid Treatment Therapies Like Counselling and Group Support

Benefits of Suboxone

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The use of buprenorphine vs methadone, largely has the same kind of benefits, although different avenues applied to achieve those outcomes. Many people looking into the treatment tend to wonder, “is suboxone safer than methadone” to use? Or if they can use suboxone to get off of methadone. Since methadone and suboxone are both opioid agonists, it is possible to wean off of one in favor of the other, but the switch should be orchestrated and observed by a Doctor or other medical professional over time, otherwise the risk for onsetting opioid withdrawal symptoms may occur. Otherwise, studies have shown that neither methadone or suboxone – although suboxone has been noted to be more tolerable than methadone, and patients tend to stick with treatment plans longer because of it – are safer than each other inherently, but separate individuals may prefer one method over the other. Otherwise, the benefits of suboxone include:

  • Reduces the Risk of Mortality in Opioid Substance Abuse
  • Reduces the Risk of Adverse Outcomes
  • Reduces the Risk of Relapse
  • Is Easy to Administer
  • Is More Tolerable in Extended Use
  • Higher Treatment Retention Rates
  • Reduces the Overall Use of Opioid Drugs
  • Is Effective in Opioid Substance Abuse Disorders, Especially in Conjunction With Other Opioid Treatment Therapies

Is Methadone Stronger than Suboxone?

So, the question still remains, is methadone stronger than suboxone? Not technically. Methadone and suboxone in the long-term tend to have similar lasting effects, although as a Schedule II controlled substance, methadone is considered to have a higher abuse risk potential than suboxone, as a Schedule III controlled substance. Suboxone compared to methadone has also been noted to be more tolerable for patients to take, and has higher treatment retention rates than methadone as a result.

Dangers of Mixing Methadone and Suboxone

The general side effects of methadone and buprenorphine (suboxone) are for the most part rather similar, although suboxone has more common potential side effects than methadone. The list of the side effects of methadone and buprenorphine can be found above under the differences between methadone and suboxone heading.

Now, although it is possible to move from using methadone to suboxone, or suboxone to methadone, for treatment purposes in a medically controlled setting, it is important that mixing methadone and suboxone does not occur. This is because the interactions between both methadone and suboxone with other types of drugs, can result in higher risk of polysubstance use, and even overdose or death. Mixing methadone and suboxone themselves can also lead to the onset of opioid withdrawal symptoms, as these drugs multiply the effects of the opioids being pumped into the system, while also working against one another. Here is a small list of potential opioid withdrawal symptoms:

  • Shaking
  • Sweating
  • Fever
  • Chills
  • Feeling Hot or Cold
  • Runny Nose
  • Watery Eyes
  • Goosebumps
  • Joint Pain
  • Muscle Aches
  • Diarrhea
  • Vomiting
  • Nausea
  • Insomnia
  • Mood Swings
  • Cravings
  • Depression
  • Headache (suboxone)
  • Hallucinations (methadone)
  • Trouble Concentrating (suboxone)
  • Tremors (methadone)

Potential opioid overdose symptoms can include:

  • Slow or Shallow Breathing
  • Limp Muscles
  • Drowsiness
  • Loss of Consciousness
  • Pinpoint Pupils
  • Cool, Clammy, or Blue Skin
  • Slurred Speech
  • Blurred Vision
  • Slowed Reflexes

What’s the Safest Alternative to Methadone and Suboxone?

So, when it comes to suboxone vs methadone, the real question is which method works best for the individual patient. Patients have the choice between either methadone or suboxone, but they can also choose an alternative therapy treatment set or medication assistant. The biggest alternative to methadone and suboxone, that is noted to be safer and less of an abuse risk, is naloxone.

The medications rank in this order, from most risky to least, in terms of safety: methadone, subutex (straight buprenorphine), suboxone (buprenorphine and naloxone) and then naloxone at the end. Naltrexone is another alternative to methadone or suboxone in the case of medically assisted opioid treatment therapy.

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