Suboxone vs. Methadone – is it the same?

While the two are similar, Suboxone and methadone are not the same medication. The active ingredients in Suboxone are buprenorphine and naloxone. For methadone, the active ingredient is methadone hydrochloride.

Both medications are opioids, which means they act on the body in similar ways. Both suboxone and methadone are indicated for the treatment of opioid dependence, and in some cases, chronic pain.  

Page Topics
Suboxone vs. Methadone: Which is more effective? | Do people still use methadone? | Which costs more? | Can you overdose on them? | Which is easier to get off of? | Which is safer? | Do they interfere with each other?

Is suboxone more effective than methadone?

Both medications are effective for treating opioid addiction. However, most physicians (including myself) prefer to prescribe suboxone. The combination of buprenorphine and naloxone makes suboxone a safer and more flexible medication. And, Subutex and Suboxone can be used both in the short-term during detox and longer-term with maintenance programs.

One study comparing the effectiveness of methadone and buprenorphine (the main ingredient in Suboxone) found that they are equally effective for treating opioid addiction.

Does anyone still use methadone?

Yes, methadone is still used for treating opioid addiction, and to a lesser degree, chronic pain. While it isn’t talked about as much as it once was, use is actually on the rise, likely because opioid addiction and treatment are increasing. Doctors have been prescribing methadone for decades, long before I started practicing medicine.

Most of the time, I prescribe buprenorphine-based medications because they are better for the short term. Where it can take weeks to wean off of methadone, buprenorphine can help someone overcome the initial opioid withdrawal symptoms in the short term. Medications like Suboxone and Subutex are more flexible, and therefore more practical for clinical use.

Another reason Suboxone and other buprenorphine-based medications are the better choice is that they can be prescribed by approved doctors during an outpatient visit, like you do with other prescriptions. Methadone, on the other hand, requires individuals to travel to a specialty clinic where they take the drug under supervision. Now, people in recovery can treat their opioid addiction by taking medicine at home, without the additional step of traveling to the clinic.

Does Suboxone cost more than methadone?

Yes. Suboxone is a brand-name medication; methadone is a generic. As such, it costs more. Generic versions of Suboxone have been on the market since 2018. These are less expensive than the brand-name drug. But, the price of the medication isn’t the full story. Several other factors influence the price of treatment:

• Almost all health insurance plans, including Medicaid, cover both medications. You may be responsible for co-pays, and these costs will vary depending on your policy.
• Opioid treatment programs that prescribe methadone and Suboxone usually offer additional services, like counseling and medical check-ups. Some programs require these extra services.
• When you start taking methadone, you have to take it at the clinic. Making regular visits to the clinic to receive medication and counseling can increase the cost of treatment.

These numbers reflect the total cost of treatment, not the out-of-pocket cost to the patient. Most private & Medicaid insurance policies cover methadone, buprenorphine & Naltrexone.

Can you overdose on Suboxone and methadone?

Methadone overdose can occur and is well documented. However, that doesn’t mean that the medication is unsafe or ineffective. Most methadone overdoses happen to non-prescribed users, often when someone takes more than they are prescribed or mixes the medication with other substances.

Suboxone overdose is possible, but it’s rare. This comes down to two factors. One: it is only a partial opioid agonist. Two: it contains naloxone, which is designed to reverse opioid overdose. Because of the lower potential for abuse and overdose, suboxone is usually considered the safer medication.

Is Suboxone harder to get off than methadone?

Both are opioids, and withdrawal symptoms may occur when you discontinue taking the medication. Suboxone and methadone have a reputation for causing difficult detoxes, but the truth is that all opioids can cause these symptoms, and neither suboxone nor methadone is worse. Anyone who is discontinuing these medications should consult with their doctor to help them gradually and safely lower the dose. Following the advice of medical professionals will help reduce withdrawal symptoms and ensure a safe transition off of the medication.

Because suboxone is a partial opioid agonist while methadone is a full opioid agonist, the latter is more likely to cause dependence. Keep in mind that every person will respond to these medications in their own way, so while one is more likely than the other to be harder to stop, there are no guarantees.

Is suboxone safer than methadone?

Suboxone is considered a safer medication because it contains naloxone, an opioid blocker. Naloxone blocks the feel-good effects of the opioid while the buprenorphine diminishes withdrawal symptoms. Methadone, on the other hand, does not contain an opioid blocker to counter its main ingredient.

Because the risk of overdose is lower with suboxone, patients can take their medication home with them instead of reporting to a clinic like they do with methadone. As a result, suboxone makes medication-assisted treatment accessible to more people, especially those in rural areas where daily visits to a clinic are unrealistic.

Does suboxone interfere with methadone?

Suboxone is not prescribed alongside methadone- it’s one or the other. Taking both at the same time could cause an adverse reaction and send an opioid-dependent person into full withdrawals. Although methadone and suboxone are entirely different medications, they are both opioids, and taking them together will significantly increase your chances of overdose. Both of these medications should only be taken as prescribed by your physician.