Suboxone vs Methadone and Other Alternatives to Suboxone

Last Updated: October 11, 2021

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Suboxone is the product of a mixture of two different types of substances – Buprenorphine and Naloxone. The former is an opioid medication that is sometimes referred to as a narcotic, while the latter will help block the effects of opioid medications, particularly the health effects that can trigger the abuse of opioids.

Methadone is in a similar category, as it will also help in the treatment of narcotic addictions, and it is also an opioid-based medication. However, these two drugs are not the same in every way.

The purpose of this text is to identify the key features of Methadone vs Suboxone, reviewing health information about the treatment functions of both, while comparing and contrasting with some of the available alternative medications.

Methadone vs Suboxone: What Are They?

These two are opioid-based medications that help in the management and treatment of opioid and narcotic addictions. Both drugs are classified as essential medicines by the World Health Organization, underlining a crucial contribution to the field of medicine.

There is a lot of research-based information that shows the efficiency of drugs like this in the treatment of abuse of opioids and opioid use disorder-related symptoms.

Of the two, methadone has been in use for a much longer time, since 1947. Since then, there has been a lot of success in the treatment of opioid use-related disorders.

A particular study showed that the likelihood of having a patient on methadone stay in a treatment program was over 400% more than in comparison to controls. These patients also had 33 percent fewer opioid-positive substance tests.

Buprenorphine-naloxone has also proven to be very effective in the treatment of opioid use disorders. A Swedish study to confirm this fact revealed a 100% treatment failure rate for placebo compared to 25% for patients placed on buprenorphine-based drugs.

Further research was carried out by the National Institute for Health in 2018, revealing more positive information to support the use of these medications for opioid use-related disorders.

The National Institute on Drug Abuse also has a strong opinion on the use of these medications for the treatment of opioid use disorders. The organization stresses that a medication-assisted treatment program, which is the combination of substance treatment and behavioral counseling, is crucial for overall health in the cleansing of the overdose and abuse epidemic of opioids and alcohol.

Some evidence to back this is the 37% decrease in heroin overdose deaths after Buprenorphine became available in Baltimore.

Based on this research and results, it is no surprise that both drugs have been approved by the Food and Drug Administration (the FDA) for the treatment of opioid use disorders (OUD).

Nurse is holding many colorful pills

Methadone vs Suboxone: What Are the Similarities?

To begin with, both these two are very similar types of drugs, starting with the fact that they are both narcotic analgesics. Both drugs help in the treatment of opioid use disorders and addiction – especially in the process of detoxification.

The drugs also share similar functions and side effects on the health of the user. These include headaches, light-headedness, dizziness, sweating, constipation, sleepiness, and nausea. These symptoms appear similar to alcohol side effects.

In some severe cases, using either one of these drugs can also trigger breathing problems and allergic reactions.

It is generally recommended that pregnant women be monitored by qualified doctors if there is a strong need to use opioid dependence and addiction treatment drugs, although it is considered to be safe with drugs that have a low risk for abuse.

However, a Pregnant Woman That Uses either One of These Drugs During Pregnancy Risks Having a Baby That Shows One or More of These Withdrawal Symptoms:

  • Crying more than usual
  • Hyperactive behaviors
  • Irritability
  • High-pitched cries
  • Trouble sleeping
  • Vomiting
  • Tremor
  • Diarrhea
  • Trouble gaining weight

Methadone vs Suboxone: What Are the Differences?

There are a good number of similarities here, but both are also different in a number of ways – right from the branding of the medication in various countries, to the withdrawal symptoms and overdose side effects of each drug.

These Differences Are Detailed in the Table Below:

Metric Suboxone Methadone
Other Brand Names Bunavail

Zubsolv

Diskets Dispersible

Dolophine

Methadone HCl Intensol

Methadose

Approval Date October 2002 August 1947
Treatment Function Opioid dependence and addiction Opioid dependence and addiction; chronic pain
Dosage Form Suboxone sublingual film

Oral tablet

Methadone compounding powder

Injectable solution

Oral concentrate

Oral solution

Oral tablet

Oral tablet, dispersible

Drug Class Information Narcotic Analgesic Combinations Narcotic Analgesic
Drug Schedule Information Schedule III controlled substance Schedule II controlled substance
Half-Life 37 hours 30 hours
Approved Age of Use 16+ 18+ (exceptions available)
Treatment Length At least 6 months  At least 12 months
Differing Side Effects Fainting

Mouth numbness 

Swollen/painful tongue

Redness inside the mouth

Attention and coordination deficit

Blurry vision

Liver problems

Low blood pressure

Stomach Pain

Seizures

Differing Withdrawal Side Effects Fever

Headache

Chills

Trouble concentrating

Sweating

Hot and cold flashes

Tremors

Hallucinations

As seen in the Methadone vs Suboxone comparison table above, methadone may typically require a longer period of treatment, and the latter has more unique withdrawal effects than Methadone.

Elderly woman hands with tremor

Are There Any Alternatives to Suboxone?

Based on all the information provided above, it is clear that methadone is a popular substitute, and the reverse is the case sometimes (buprenorphine-naloxone acting as a substitute for methadone) depending on the exact needs of each person.

However, there are other medication-assisted treatments for dependence or addiction to opioids apart from these two. These include Sublocade, Subutex, Zubsolv, Belbuca, and Vivitrol. These drugs have varying risk levels to dependence and withdrawal.

These Alternatives to Suboxone Are Compared Below:

Sublocade vs Suboxone

In a Sublocade vs Suboxone comparison, one finds that both of these medications contain buprenorphine, however, where Sublocade contains only buprenorphine, the latter is a combination of that and naloxone. Another difference is that the latter is available as a sublingual film that is placed under the tongue or in the cheek, Sublocade is administered as an injection. Sublocade has only come onto the scene recently, gaining approval for prescription in 2017. Finally, there is a monthly dosage administration limit for Sublocade instead of daily doses.

Subutex vs Suboxone

In a Subutex vs Suboxone comparison, one finds that the former only contains buprenorphine, so it does not have the opioid-blocking effects that naloxone gives suboxone.

Another difference is that the former is a milder opioid and as a result, the risk of withdrawal symptoms, dependence, or addiction is less severe.

It can be argued that while these milder effects seem like a good thing, they also have the rebound effect that Subutex is less effective for managing opioid use disorders in comparison.

Zubsolv vs Suboxone

In a Zubsolv vs Suboxone comparison, one finds that Zubsolv is the most similar drug on this list – although it is a more recent product. This substance also has lower opioid content in comparison, but functions in the same way otherwise and shares similar withdrawal symptoms.

The key difference here is that the former comes in tablet form while the latter is a sublingual film.

Belbuca vs Suboxone

In a Belbuca vs Suboxone comparison, one finds that the former is also a schedule III controlled substance like the latter. The drug is usually prescribed for the management of pain that is severe enough to require round-the-clock monitoring and a long-term opioid treatment program.

However, a similarity shared in this comparison is that the former also contains the active ingredient Buprenorphine and is administered through a buccal film formulation absorbed through the inner lining of the cheek into the bloodstream.

Vivitrol vs Suboxone

Vivitrol is the brand name of naltrexone, a drug designed to help clients struggling with addiction to opioids. When comparing Vivitrol vs Suboxone, one finds that this indication is shared, but the methods of administration and the mechanism of action of both drugs differ.

Vivitrol is administered through a monthly long-term release injection and serves as a passive deterrent against the abuse of opioids.

This approach of detox is milder than the daily use that doses of buprenorphine-naloxone required to remain effective. It also contributes to the fact that there are no known abuse risks or overdose risks with Vivitrol use.

Finally, a major difference here is that, unlike the latter, Vivitrol is also useful in the detox process and treatment of alcohol abuse and alcohol addiction.

Natural and Over the Counter Alternatives to Suboxone

In some cases of abuse or dependence on opioids, natural and over-the-counter products can be effective for treatment and recovery. It is strongly advised that a visit to the doctor should be made before taking any treatment, especially with over-the-counter medication. However, knowledge about these alternatives to Suboxone medicine can come in handy.

Natural Alternatives to Suboxone for Opioid Dependence Recovery Include:

Over-the-counter medication can also help with the recovery process, particularly by dealing with withdrawal symptoms.

Some of These Medications Are:

Drug addicted woman is suffering from withdrawal

Choosing the Safe Alternative

Summarily, there are a good number of medication-assisted recovery options for people dealing with opioid dependence.

Natural and over-the-counter alternatives also help to avoid the risk of picking up another habit of abuse while still getting the treatment needed. However, making a choice must be done based on the approval and supervision of a qualified healthcare professional.

If an individual is dealing with opioid misuse habits or addiction, it is important to seek help in a professional treatment clinic as soon as possible to give the best chance of a full recovery.

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Page Sources

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  2. NIDA. 2021, April 13. How effective are medications to treat opioid use disorder?. Retrieved from https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder
  3. NIDA. 2016, November 1. Effective Treatments for Opioid Addiction. Retrieved from https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction
  4. Schwartz, R. P., Gryczynski, J., O'Grady, K. E., Sharfstein, J. M., Warren, G., Olsen, Y., Mitchell, S. G., & Jaffe, J. H. (2013). Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009. American journal of public health, 103(5), 917–922. https://pubmed.ncbi.nlm.nih.gov/23488511/
  5. Liu, T. T., Shi, J., Epstein, D. H., Bao, Y. P., & Lu, L. (2009). A meta-analysis of Chinese herbal medicine in the treatment of managed withdrawal from heroin. Cellular and molecular neurobiology, 29(1), 17–25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689310/

Published on: January 24th, 2017

Updated on: October 11th, 2021

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.