Both Methadone and Suboxone are used as medications in national treatment programs for opioid use disorders. They efficiently eliminate precipitated withdrawal and drug cravings and normalize brain functions. However, these medications are different in their effects on the brain and prescribing policies, and sometimes patients want to switch. If switching from Suboxone to methadone is quite straightforward, then vice versa could be tricky. In this article, we will answer the main questions regarding Methadone to Suboxone transition.
Suboxone vs Methadone – What’s the Difference?
- Methadone is a synthetic opioid and a full opioid agonist. It works similarly to other drugs like Herion or Fentali. Methadone bends the same opioid receptors in the brain and calms crawling. However, it does not produce the same euphoria and rush as other opioids. Methadone for the replacement treatment has been used since the 1960s. The first patients were traumatized soldiers who came back from the Vietnam War and faced substance abuse.
- Suboxone consists of two medications: Naloxone and Buprenorphine. Naloxone is an opioid blocker, and Buprenorphine is a partial opioid agonist that reduces cravings and withdrawal symptoms but produces a milder high compared to full agonists.
In simple terms, Suboxone is a mix of opioids and opioid blockers. It was invented and started to be used in the Medicaid program in the early 2000s.
Side Effects Comparison
In general, medications have similar side effects, including addiction. Speaking of Methadone vs Suboxone withdrawal risk, patients face it with both types of medications as well. The main difference is that Suboxone does not cause a feel-good effect like Methadone.
| Common Side Effects | Methadone | Suboxone |
| Constipation | ✓ | ✓ |
| Nausea and vomiting | ✓ | ✓ |
| Drowsiness and fatigue | ✓ | ✓ |
| Dilated pupils | ✓ | ✓ |
| Insomnia | ✓ | ✓ |
| Sweating | ✓ | ✓ |
| Respiratory distress | ✓ | ✓ |
| Double-vision | ✓ | ✓ |
| Stomach pain | ✓ | ✕ |
| Fainting | ✕ | ✓ |
| Numbness in your mouth | ✕ | ✓ |
| Trouble paying attention | ✕ | ✓ |
| Faster or slower heart rate | ✕ | ✓ |
| Redness inside your mouth | ✕ | ✓ |
| Heart rhythm problems | ✓ | ✕ |
Benefits of Switching from Methadone to Suboxone
Despite the effectiveness of Methadone treatment, some patients felt uncomfortable staying in a program for a long time because of health problems, mental disorders, and others. There are the main reasons patients are willing to make a transition:
Lesser Side Effects
As Suboxone contains a partial opioid agonist, it is less addictive compared to Methadone. The euphoria after Suboxone use is limited and not as intensive as after Methadone. It creates a more stable lifestyle and mental state for the patient. Also, the risk of misuse and overdose on Suboxone is much lower than on Methadone.
Fewer Clinic Visits
Methadone is a strong opioid that is supposed to be used only under a doctor’s supervision in a treatment center. It could be prescribed two or three times a day, and the assistance center could be located at a great distance from you, so such visits could be inconvenient and time-consuming. Switching from Methadone to Suboxone solves this problem and provides more freedom and flexibility for a person because it can be used at home.
No Insurance Issues
Even though Suboxone and its component Buprenorphine are more expensive compared to Methadone, it’s usually easier to get insurance coverage for them. Methadone coverage is subject to federal dispensing requirements. Licensed opioid treatment programs can only provide it. If someone wants to stop taking opioids but is not registered in the recovery program, they won’t be able to get coverage or a prescription for Methadone. Because of this, many are switching to Suboxone.
No Stigma Associated with Methadone
For many people in US society, Methadone use is a synonym for drug use, but Subaxon doesn’t have such a negative association. That’s why some patients feel more comfortable on a Suboxone program.
How to Switch from Methadone to Suboxone?
If you decide to make a transition, first of all, ask for assistance from your doctor and clarify all the insurance issues. Also, determine if Suboxone is suitable for your particular case, as it is not as potent as Methadone and can be less effective in your treatment.
Another important question that needs a response is “Can you take Methadone and Suboxone together?” And the answer is “No!” It is necessary to reduce or stop taking Methadone for some period before switching to Suboxone because of Methadone’s long half-life and its strong attachment to the opioid receptors.
To make a transition safe, your doctor will reduce your Methadone prescription to 30 mg or less per day. This process can be frustrating for patients who get high doses of medication because it can take several months to even a year. However, trying to decrease the dose too quickly will only increase the discomfort and risk of relapse, and physical and mental illness.
After tapering your dose, the doctor will say how long to wait to take Suboxone after taking Methadone. Usually, patients have to stay clean for 48 to 72 hours. Only after that will Subaxone be efficient and start to block mu-receptors in your brain. This period could be challenging and uncomfortable as the person faces withdrawal symptoms. But usually, they disappear after the first dose of Suboxone is taken.
Bottom Line
How long can you be on methadone or Suboxone? Getting opioid addiction treatment is always challenging but also a brave decision. No matter what medical treatment you are getting, remember that both Methadone and Suboxone are great medications for coping with addiction. Also, this medication maintenance is a long-term treatment with no set timeline. That’s why choosing the option that is most suitable for you is crucial. The best way to do this is to visit the methadone clinic near you and discuss medication options with the doctor, who will support you and help you make the right decision or make the transition safely and properly.
