Methadone Vs. Suboxone: Which Is Better For Treating Opioid Addiction?

Methadone and Suboxone are two leading medications that are FDA-approved to treat opioid dependence and addiction, which affect millions of Americans.

Both medications have their benefits and drawbacks.

According to the National Institute on Drug Abuse, both Suboxone and methadone are effective in treating opioid use disorder. Neither drug is definitively “better” at helping people recover.

A third FDA-approved medication, naltrexone (Vivitrol), is also effective for OUD and works through a different mechanism. The right choice depends on the individual’s history, health needs, and treatment goals.

Are Methadone And Suboxone The Same?

Although methadone and Suboxone are both used to treat opioid addiction, they’re not the same.

Primary differences between Suboxone and methadone include:

• chemical structure
• side effects
• withdrawal timeline
• what they’re used for
• cost
• prescriber access (primary care vs. OTP clinic)
• telehealth availability

What Is Methadone?

Methadone belongs to a class of drugs known as opioid agonists. It is fully synthetic and long-lasting. When taken, methadone binds to opioid receptors in the central nervous system.

Methadone can come in the form of:

• liquid solution
• tablet
• diskette
• powder

Methadone has been used to treat addiction to opiates like morphine and heroin since 1947. It is also FDA-approved to treat severe pain in people with chronic pain conditions.

Benefits Of Methadone Treatment For Opioid Addiction

Methadone can be used during opioid detox and as a long-term treatment for opioid dependence and addiction. It is a long-acting drug, and is safe and effective when taken as prescribed.

Benefits of methadone maintenance treatment for opioid addiction include:

• reduces opioid cravings
• reduces discomfort of opioid withdrawal symptoms
• blocks the effects of other opioids
• reduces opioid use
• increases likelihood of staying in a treatment program
• safe to use for a long period of time

People who take methadone for opioid addiction may receive this medication within an inpatient opioid treatment program or by visiting an outpatient methadone clinic.

Drawbacks Of Methadone For Opioid Addiction

Methadone isn’t a perfect treatment. No one drug is. Methadone for OUD must be dispensed through a federally certified Opioid Treatment Program (OTP). However, stable patients may qualify for take-home doses. SAMHSA’s 2024 final rule permanently expanded take-home access to up to 28 days for eligible patients, significantly reducing the daily clinic burden.

Methadone can also cause some unpleasant side effects when used, including:

• constipation
• weight gain
• euphoric effects, particularly during dose initiation or increases
• physical dependence

Methadone is also classified as a Schedule II substance, like many other opioids, meaning it can be misused and become addictive when taken in ways other than directed by a healthcare provider.

What Is Suboxone?

Suboxone is the brand name for a combination product that contains buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist).

Unlike methadone, Suboxone is approved only for the treatment of opioid dependence, and not chronic pain.

It can effectively block the effects of opiates and does not cause the “high” associated with the use of opioids like oxycodone, morphine, or heroin.

Benefits Of Suboxone For Opioid Addiction

Suboxone treatment offers many of the same benefits as methadone.

It can block opiates for about 24 hours, reduce opioid cravings, reduce overdose risk, and can be effectively used as a long-term treatment for opioid addiction.

In addition, Suboxone doesn’t typically cause the euphoric effects associated with methadone or other opioids such as oxycodone (OxyContin), fentanyl, and heroin.

Suboxone has what’s known as a “ceiling effect” that reduces the risk of misuse, respiratory depression, and drug overdose.

Furthermore, unlike methadone treatment, you don’t have to go to a clinic to get Suboxone. You can get a Suboxone prescription from a doctor to take at home.

As of January 2023, the X-waiver requirement for prescribing buprenorphine was fully eliminated. Any DEA-licensed provider can now prescribe Suboxone with no special training or patient caps required.

Drawbacks Of Suboxone For Opioid Addiction

Suboxone is safe and effective when taken as directed. Methadone has a longer treatment history dating to the 1960s, while buprenorphine products were FDA-approved in 2002. Both now have extensive evidence bases supporting their safety and efficacy for long-term OUD treatment.

One drawback of Suboxone is that it’s generally more costly than methadone.

For this reason, some hospitals, doctors, or rehab centers may prefer to prescribe methadone for its cost-effectiveness.

Similar to methadone, Suboxone can also cause unpleasant side effects in some people, such as dizziness and headaches.

Chronic use can also lead to dependence, which will require a detox plan if you intend to stop taking Suboxone.

How Effective Are Medications For Opioid Use Disorder?

Medications for opioid use disorder—and medication-assisted treatment—are the most effective treatments for overcoming opioid addiction.

Medication-assisted treatment refers to a whole-person treatment that combines the use of medications like methadone, buprenorphine, and naltrexone with behavioral therapies.

Benefits of this treatment include:

• improved recovery outcomes
• increased likelihood of staying in treatment
• improved birth outcomes in people with substance use disorders who are pregnant
• reduced opiate drug use
• reduced risk of opioid overdose
• reduced criminal activity and recidivism

Medications like Suboxone and methadone can be used within a detoxification program, inpatient treatment program, or outpatient treatment program.

Although medications will ideally be prescribed in conjunction with counseling, the use of methadone and Suboxone can also offer significant benefits in the absence of counseling.

Finding Opioid Addiction Treatment

Both Suboxone and methadone are effective treatments that are utilized to treat opioid use disorder.

While some healthcare providers and patients prefer one over the other, both are shown to be effective at reducing the risk of relapse, overdose, and increasing treatment retention.

If you or a loved one is addicted to opioids, call our helpline today to find an opioid treatment program that’s right for you.

Written by the Addiction Resource Editorial Staff