Methadone has been used to treat opioid addiction since the 1960s, and like Suboxone, it’s a synthetic opiate agonist. This means that it stimulates the areas of the brain affected by opiate addiction. It is generally taken once every 24 to 36 hours and helps eliminate physical withdrawal symptoms while also helping to stop cravings for unsafe opiates, such as heroin and morphine.
One of the major pros of methadone is its well-studied nature. It has been used for more than 30 years and has been studied and tested multiple times during that duration. This means scientists understand the way it affects the body more thoroughly than they do suboxone. As a result, it’s easier for them to find a healthy and safe dose quickly and without much experimentation.
However, one of the major problems with methadone is that it’s possible to continue using other opioids while taking it. Unfortunately, this makes it harder for people with severe addictions to recover successfully.
People struggling with opioid addiction have noted that the two-pronged approach of suboxone is a great way to detoxify the body. The buprenorphine ensures that they don’t feel the kind of physical and emotional distress that makes withdrawal and recovery so difficult, and the naloxone makes it more difficult or impossible to use other opioids at the same time, making relapse less likely.
Suboxone also works on a quicker time scale than methadone, and it can be administered in both an inpatient and outpatient setting. Those prescribed are usually able to take their prescription home with them, and continue a normal schedule with work, school, and regular activities as they continue on suboxone until they’re able to manage their life in recovery without it.
Methadone, on the other hand, is still usually used in a clinical setting, with patients needing to visit a clinic daily to get their dose. This can interfere with many responsibilities in life and can make returning to regular activity, such as work, much more difficult.
Another evidence-based medication for opioid use disorder is Vivitrol (extended-release naltrexone), an opioid antagonist formulated as a once-a-month injection. This medication is delivered once every 4 weeks instead of every day, which might help address concerns about needing to take a daily medication, as well as the potential problems that could arise if someone is also taking other drugs like alcohol, benzodiazepines, and others.
The downside to Vivitrol is that it only acts to prevent relapse, it doesn’t alleviate the symptoms of withdrawal. This means that the patient needs to have stopped using opioid medications for between 7-10 days before they can be treated with Vivitrol, and it makes participation in therapy and other elements of recovery more difficult.