Suboxone vs. Methadone: What is the Difference?

Fighting opioid addiction can feel like an uphill battle, especially when trying to quit results in painful flu-like withdrawal symptoms and intense drug cravings. Although anyone can recover from opioid addiction as long as they get the right treatment, many people are scared to take the first steps toward recovery. However, one of the advantages of medically supervised detoxification is that doctors can prescribe medications like Suboxone or methadone as a part of medication-assisted treatment (MAT) to help alleviate cravings and withdrawal symptoms.

Despite common uses and indications, Suboxone and methadone are two very different drugs with several differences. Comparing methadone vs Suboxone can help you or a loved one determine which treatment is right for you.

What is Suboxone?

Suboxone is a combination medication that contains buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that activates opioid receptors but to a lesser degree than other opioids, effectively reducing withdrawal symptoms and cravings. Naloxone, on the other hand, is added to buprenorphine to help prevent misuse of the medication. If someone were to dissolve and inject Suboxone, the naloxone would activate, knocking opioids off opioid receptors and causing sudden and intense symptoms of withdrawal.

Suboxone comes in the form of a sublingual film that is taken on a daily basis. It was engineered with a “ceiling effect” so that when taken in high doses, it will not cause euphoria or a high.

Compared to methadone, Suboxone is a much newer medication. It was approved by the FDA in October 2002.

Suboxone Side Effects

Like all medications, Suboxone may cause side effects. Common side effects are:

  • Nausea
  • Headache
  • Insomnia
  • Sweating
  • Constipation
  • Dizziness
  • Drowsiness
  • Blurred vision
  • Back pain
  • Tongue pain or redness
  • Fainting
  • Irregular heartbeat
  • Difficulty breathing or swallowing
  • Mood changes
  • Difficulty concentrating

What is Methadone?

Before Suboxone was approved by the FDA and widely accepted as a treatment for opioid dependence, methadone was the most frequently used medication. Methadone is a full mu opioid receptor agonist, so it fully activates opioid receptors throughout the body. It comes in the form of a pill or dissolvable wafer that is taken orally on a daily basis.

While methadone is used to treat opioid withdrawal and addiction, it was first used in Germany in the 1940s as a painkiller. Methadone is sometimes abused in high doses for its euphoric and drowsy high.

Methadone Side Effects

Methadone may cause more pronounced side effects than Suboxone, however, side effects can vary from person to person. Common side effects of methadone include:

  • Nausea
  • Vomiting
  • Constipation
  • Dry mouth
  • Weakness or fatigue
  • Sleepiness or drowsiness
  • Difficulty urinating
  • Headache
  • Increased sweating
  • Sexual problems
  • Changes in menstrual periods
  • Mood changes
  • Itching
  • Rash
  • Swelling of the hands, feet, or ankles
  • Tremors or shaking
  • Changes in vision
  • Weight gain or loss
  • Trouble sleeping
  • Confusion or hallucinations

How are Suboxone and Methadone Similar?

Methadone and Suboxone are both considered opioids that have been clinically proven to help treat opioid addiction. These medications are intended to be used as a part of medication-assisted treatment (MAT), combined with counseling and behavioral therapy. By reducing cravings for opioids and withdrawal symptoms, both medications have several benefits, such as:

  • Reduce the risk of relapse
  • Improve treatment retention
  • Encourage healthy births among pregnant women who are addicted to opioids
  • Decrease the risk of Hepatitis C and HIV
  • Reduce the need for inpatient detoxification services
  • Improve survival rates of those trying to overcome opioid addiction

Another way these medications are similar is that they can both be physically habit-forming. This means that taking either methadone or Suboxone daily for extended periods of time can result in physical dependence. As a result, doctors slowly taper patients off of these medications rather than asking them to stop taking them abruptly.

Highlighting Key Differences Between Methadone and Suboxone

While methadone and Suboxone are essential tools used in the fight against opioid addiction, there are several differences between the two. Differences include:

Abuse Potential

Methadone is a Schedule II controlled substance and Suboxone is a Schedule III controlled substance. This means Suboxone has a lower risk for abuse, dependence, and addiction than methadone.

Mechanism of Action

While both medications achieve similar goals, they do so in different ways. As a full opioid agonist, methadone fully activates the body’s opioid receptors. By comparison, Suboxone is a partial opioid agonist, so it doesn’t activate these receptors to the same degree.


Due to the potential for abuse, methadone is heavily regulated, and it is only dispensed at approved methadone clinics. Suboxone, on the other hand, can be prescribed by most doctors and picked up at a regular pharmacy.


Suboxone is a brand-name drug that contains buprenorphine and naloxone. By contrast, methadone is the generic form of the drug. It may be sold under the brand name Dolophine and Methadose.

Formulation and Dosage

Methadone is typically given in the form of a liquid or wafer that dissolves in liquid. It has many different dosage options, more so than Suboxone. Suboxone comes in the form of a thin film that is placed under the tongue or between the cheek and gums where it dissolves. Suboxone is available in various doses, including 2 mg/0.5 mg, 4 mg/1 mg, 8 mg/2 mg, and 12 mg/3 mg. The first number indicates the amount of buprenorphine, while the second is the amount of naloxone.

Can You Take Methadone and Suboxone at the Same Time?

No, you should never combine methadone and Suboxone. Taking both medications at the same time can increase the risk of respiratory depression and overdose. Additionally, taking methadone while you are on Suboxone may activate the naloxone component, resulting in sudden opioid withdrawal. If you are taking methadone and considering switching to Suboxone, you must wait until methadone leaves your body completely, otherwise, you may experience precipitated withdrawal.

Find Help Today

If you or a loved one are struggling with opioid addiction, our team at Cobb Outpatient Detox can help. Our innovative, evidence-based medical detox programs in Georgia can help you navigate recovery and live the healthy lifestyle you deserve. To learn about our opioid detox programs or to get started with a confidential, risk-free assessment, please contact us today.

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