Suboxone vs. Methadone

 Suboxone vs Methadone

Through the years, addiction to opiates has gone through a transformation. Thirty or more years ago, we used medicines such as clonidine, beta blockers, and benzodiazepines for symptom control. Then we started using methadone, and this was the mainstay for years. It could only be prescribed in special clinics. Over time, it appeared that an individual who was started on methadone, was given higher and higher doses. This was also the main medicine to use with pregnant patients.

Buprenorphine was marketed in the 1980’s primarily as a pain medicine.  In 2002, the FDA approved its use in the treatment of opiate addiction.  Buprenorphine is only a partial agonist, it is not equivalent in maintenance strength to higher dosages of the full agonists, methadone and LAAM. This means that there is a limited peak effect of the drug despite increasing the dose. This differentiates it from the other opiate agonists.

Due to the less likely chance of abusing Suboxone, and its partial agonist property, it makes this the best medicine we have for treating opiate addiction. Patients taking methadone still report a “high” and can get a greater effect when taking more of that drug. The issue with both medicines are that they last a long time, which is used to the benefit when treating addiction.

Finally, the studies are now reporting an improved outcome in babies born to addicted moms who were treated with Subutex (buprenorphine alone) during the pregnancy. The babies exposed to buprenorphine had fewer problems of opiate withdrawal than those whose mothers took methadone.