1. What is methadone and how does it work?
Methadone is an opioid medication commonly used to treat opiate addiction and relieve pain. It is not, however, used to treat other non-opiate drug addictions to substances like alcohol, marijuana or cocaine. Methadone blocks the receptors in the brain that are affected by opiates, such as prescription pain pills and heroin, enabling users to experience a more gradual detox process rather than a more extreme and painful withdrawal process. Methadone is available in the form of a pill or oral solution, and has been available in the US for more than 65 years.
Methadone reduces the drug cravings and harsh withdrawal symptoms that are often associated with a patient’s relapse, without creating the sense of euphoria associated with the abuse of opiates. Methadone’s effects last between 24 and 36 hours, and therefore most patients benefit from a single daily dose.
2. What is buprenorphine, brand name Suboxone?
Subutex and Suboxone (buprenorphine) were approved for the treatment of opiate addiction by the FDA in 2000. It may be used as a short term withdrawal medication or as a longer term maintenance medication. It offers a more flexible and less restrictive form of opiate medication therapy than methadone, but it is equally effective in treating addiction and normalizing brain opiate function. Unlike methadone, physicians may write a prescription for Suboxone which the patient can simply take to any pharmacy. For some patients there may also be less side effects than methadone. Regular physician medication visits should be supplemented by participation in a counseling program.
Suboxone is a combination of buprenorphine and naloxone (also known as Narcan). Naloxone is an opioid antagonist, which is used to counter the effects of an opiate overdose as well as the euphoric feelings associated with opiate use.
3. What is the difference between methadone and Suboxone?
Buprenorphine, the active ingredient in Suboxone, and methadone are both opioids, and activate the opioid receptors on nerve cells. Both are long acting medications, and that makes them very useful for the purposes of opiate addiction treatment. However, there are very key differences that distinguish these two medications from one another.
Methadone is a full mu opioid agonist. This means simply that it will continue to produce its effects on the opioid receptors until all receptors are fully activated or the maximum effect is reached. This is similar to the way heroin impacts the brain as it is also a full agonist. Methadone however, once the right dosage is achieved, can eliminate the euphoric effects felt from illicit use, without allowing the painful effects of having too low of a dose of methadone.
Buprenorphine is what is called a partial agonist, which means it does not activate the mu receptors to the same level as methadone. The effects felt have a ceiling, meaning they will not reach and excessively pleasurable level, no matter how much the dose is increased. Buprenorphine or Suboxone, can still have effects on respiration and minimal euphoric feelings, but not near to the extent of full agonists.
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