Switching M.A.T. Medications

Doctor smiling with a stethoscope around his neck

Switching MAT Medications

During the recovery process, patients and providers may sometimes feel that a change in mediation is necessary. In some instances, a patient experiences side-effects from one medication and would benefit from making a switch, and other times it’s due to other issues such as chronic relapse or misuse of medication. Whatever the reasoning may be, patients may decide switch their MAT medication from methadone to Suboxone® with their provider’s supervision to achieve long-lasting recovery.

Why Make a Change?

While methadone is one of the most common and effective ways to treat opioid use disorder, it may not be ideal for all patients even when taken alongside substance use counseling and therapies. Because methadone is an opioid agonist, it still has the potential to be misused, which is why it’s only administered through certified treatment clinics by a medical provider. If a patient is in treatment for dependency on long-acting opioids, methadone is likely to be effective. Still, those who are adapted to short-acting opioid drugs may be best suited switching from methadone to Suboxone®.

Some reasons for switching from methadone to Suboxone® may include:

  • Reducing certain side effects for that individual
  • Better supporting that person’s long-term recovery
  • An individual may no longer need a full opioid agonist, finding Suboxone® provides the necessary support
  • Convenience of earning Suboxone® take-home medication much more quickly

Methadone is very effective for many who are first entering treatment for opioid use disorder. As a full opioid agonist medication, it is very effective, particularly for individuals who have been misusing opioids for a long period of time or at very high doses. However, after some time, patients may feel that they are able to make the step down to a partial opioid agonist such as Suboxone®. Suboxone® only partially activates receptors in the brand and has a “ceiling effect” that doesn’t increase the medications effects as the dose increases after a certain point.

Transitioning from Methadone to Suboxone®

Making the switch from methadone to Suboxone®, while common, requires a meticulous process due to methadone’s higher receptor affinity and long lasting effects. Patients making the switch from methadone to Suboxone® will need to reduce their dose down to about 40mg and take their last dose 72 hours before taking Suboxone®. During this time, patients may feel some mild discomfort, especially when tapering from higher doses, making the switch from methadone to Suboxone® preferable for those who are very motivated.

This process should not be rushed and a knowledgeable medical provider should monitor the process of transitioning from methadone to Suboxone® with support staff that can help make this transition smooth. Staying plugged in to your support network and continuing work with a counselor is critical during this time, as it is throughout the recovery process. The goal of the transition period is to manage the process closely to minimize side effects, and ensure no withdrawals are experienced, while improving the daily lives of patients who are looking to make changes to their daily routines and overall well-being.


Medically Reviewed By:

Cris Villalon

Cris Villalon