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Many folks seeking Medication Assisted Treatment for opioid addiction wonder whether to choose Suboxone (Buprenorphine) or Methadone. While this decision can only be made by you and your doctor, we can offer a few general pointers.
Methadone and Bupe are not interchangeable. They are targeted at two different patient populations, with some overlap. So, it's not just a matter of eenie meenie miney moe choose one--the choice is based on several different things.
Bupe (Suboxone) is intended for those with lighter addictions and/or shorter histories of addiction--usually those who are abusing Rx painkillers. Methadone is intended for those with heavier addictions and/or long histories of opioid use/abuse. The average needed dose of methadone is 80-120mgs, with some needing more and others less. It has been determined that Bupe works best for those who can stabilize at 60mgs of methadone or less. Those who require larger doses of methadone are unlikely to do well on Bupe, though it has happened.
Bupe is usually prescribed by specially licensed physicians in their own offices. It can be prescribed for up to one month at a time and you can (theoretically) get this amount right away, though usually the doctor will want to see you more often in early treatment to determine the right dose for you. You can get your Rx filled at any pharmacy and take the medication in the privacy of your own home.
Methadone can only be dispensed by clinics (unless it is for pain). There is a lot more "red tape" surrounding methadone treatment and it is heavily regulated by the government. It is dispensed from the clinic ONLY--you do NOT get a prescription, though with time you can earn take home doses. There is a higher risk of overdose with methadone, though both drugs are opioids and both cause physical dependence.
Suboxone includes an addition--an opiate antagonist called Naltrexone. This drug is supposedly inactive unless you attempt to crush or inject the tablets. If you do, the naltrexone is released, blocking the euphoric effects of the drug. Some patients have complained that it seems to block their own natural endorphins as well--others do not.
There is a version of Bupe--Subutex--that does not have the Naltrexone addition. Doctors often use it in pregnant patients or those with liver disease, as Naltrexone can be hard on the liver.
Both drugs can be taken for the short or long term.