Suboxone vs methadone: What’s the difference?

Suboxone (buprenorphine and naloxone) and methadone are different medicines but are both used to help people fight opioid addiction (also called opioid use disorder or OUD). Your first treatment after a medically-supervised opioid withdrawal (detox) is often started with either Suboxone or methadone.

Learn More: Opioid Use Disorder: These Treatments Are Available, Now

People with opioid use disorder can have harmful or even fatal effects from using narcotics, especially if they have slowed down or stopped opioid use, and then start using opioids again.

• People with OUD can benefit from a program known as Medication Assisted Therapy (MAT) for long-term maintenance treatment to help prevent a dangerous relapse.
• These medicines are used in conjunction with medical oversight, counseling and support groups to help you have the most safe and successful overall recovery.

Suboxone

Suboxone is a brand name medicine that contains buprenorphine and naloxone. It comes as a sublingual/buccal oral film (placed under the tongue or between the cheeks and gum) and is given as a single daily dose. It is also available as a generic option.

Suboxone is approved for the first phase of opiate withdrawal (induction or detox) and well as the longer-term maintenance phase. Suboxone eases drug cravings and helps to prevent unpleasant symptoms (withdrawal) after you stop using narcotics.

• Buprenorphine is classified as an opioid medication (partial opioid agonist).
• Naloxone blocks the effects of the opioid (opioid antagonist), including pain relief or the high feelings that can lead to opioid abuse.
• Naloxone is used in some buprenorphine products to help prevent misuse by crushing, dissolving, or injecting the oral formulations.
• It can be given in a doctor's office by certified and trained physicians or you may be able to take the medicine at your house.

Suboxone is not FDA-approved for the treatment of pain, but might be prescribed "off-label" by some doctors for certain patients. “Off-label" use of a drug refers to when a doctor prescribes a medicine for a different purpose than those formally approved by the FDA and found in the package labeling.

Suboxone is classified as a schedule III medication by the DEA because it contains buprenorphine, an opiate, and is considered a drug that can be abused. Since it is not a full opioid agonist, Suboxone tends to cause less fatigue and it may be it easier to slowly discontinue this medicine.

Related questions

• How long does Suboxone stay in your system?
• How long does Suboxone block opiates?
• Does Suboxone show up on a drug test?

Zubsolv

Buprenorphine and naloxone also comes as a sublingual tablet formulation called Zubsolv. It is also is used to treat opioid addiction.

Sublocade

Buprenorphine is also available (without naloxone) as a long-acting formulation (Sublocade injection) given once a month to ease drug cravings and withdrawal symptoms. Sublocade is used in adult patients already on a stable dose of transmucosal (absorbed via mucus membrane) buprenorphine for a minimum of 7 days.

Sublocade may reduce the burden of taking a daily medication for patients in recovery.

Methadone

Methadone (Dolophine, Methadose, Methadone Intensol) has been approved by the FDA since the 1940’s. It is often given as an oral solution and treatment may involve regularly going to a registered clinic for your dose. Methadone is classified as an opioid medication. It comes as a generic option.

Methadone is approved for the first phase of opiate withdrawal (induction or detox) and well as the longer-term maintenance phase. It is also approved for the treatment of pain.

• Methadone, when used for opioid use disorder (OUD), eases drug cravings and helps to prevent unpleasant symptoms (withdrawal) after you stop using narcotics.
• Methadone comes as an oral liquid solution, a tablet for oral suspension, a concentrated oral solution, and an injection. The injectable form, when used for OUD, is only for temporary treatment in patients unable to take oral medication (such as hospitalized patients).

Methadone is classified as a schedule II medication due to its high potential for abuse. It is a highly regulated drug.

Side effects and warnings with Suboxone and methadone

There are many side effects and warnings with Suboxone and methadone treatment that you should understand. Talk to your doctor to learn more about these risks.

• Suboxone side effects and warnings
• Methadone side effects and warnings

This is not all the information you need to know about Suboxone (buprenorphine and naloxone) or methadone for safe and effective use. Review the full product information and discuss this information and any questions with your doctor or other health care provider.