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Methadone vs Buprenorphine for Opioid Treatment

Methadone and buprenorphine are the most commonly used and best studied medications used to treat opioid addiction. They are both opioid agonists, meaning they bind to opioid receptors the way opioids do, but they don’t cause the same euphoria as opioids. As a result, they mitigate withdrawal symptoms and cravings for people in recovery while allowing them to function more normally.

Methadone is the older of the two drugs. It has been in use for about 60 years while buprenorphine has been in use for about 10 years. This means methadone has a longer history than most drugs on the market and is well understood.

Methadone has three main advantages over buprenorphine. First, it’s cheaper. Methadone is a generic drug and it is cheaper than every available form of buprenorphine. This mainly matters if you are paying out of pocket or if you are running a clinic with a tight budget. The second advantage of methadone is that it’s easier to get. This is partially because methadone is cheaper and partially because it’s better known and more people are comfortable prescribing and administering it. Methadone can also be distributed by clinics while buprenorphine must be prescribed by addiction doctors.

The third advantage is that methadone can be used to treat chronic pain while buprenorphine can’t. Many people who become addicted to to opioids were originally prescribed opioid painkillers to manage chronic pain and became addicted. After detoxing, the pain may still be there and methadone is one way to manage that.

By most other criteria, buprenorphine is the better drug. It’s biggest advantage is that it’s much safer. While methadone is a terrible drug for getting high, people do build a tolerance and abuse it. You can also die from a methadone overdose. In fact, it accounts for about a third of prescription drug related deaths. In contrast, it is nearly impossible to die from a buprenorphine overdose. Buprenorphine has a ceiling effect, meaning that after a certain dose, taking more of the drug has no effect. This means no additional mood elevation and no additional breathing suppression.

There are more ways to take buprenorphine. The most popular form, Suboxone, is taken daily under the tongue. The FDA has recently approved a monthly injection of buprenorphine called Sublocade. This means instead of going in for your daily dose of methadone, you can get your monthly shot and be done. Buprenorphine has more reported side effects than methadone but they are typically milder and buprenorphine’s side effects don’t include death.

Buprenorphine is the medication most people will likely prefer, but it’s important to remember  that no medication works for everyone. Many people are miserable on methadone and buprenorphine but many people also say these medications are the only way they were able to quit opioids.

If you or someone you love is struggling with opioid addiction, Gardens Wellness Center can help you detox safely and decide on a treatment strategy. Call us today at 844-828-1050 or email us at info@tgwcdetox.com to learn more.