Suboxone vs Methadone for pain management is a common question asked of physicians. Both are prescribed medications used for treating and relieving pain most common after surgery. Although they are in the same group, this article will discuss the six major differences between the two.
What is Suboxone?
Suboxone, commonly known as “blockbuster”, is a prescription medication that is a combination of buprenorphine and naloxone. It is often prescribed for patients suffering from opioid dependence, addiction, and in the management of chronic pain. The buprenorphine component is a partial opioid agonist that ensures the delivery of reduced opioid doses in patients addicted to stronger opioids while naloxone is an opioid antagonist that blocks the effects of the agonists hence reversing their effects.
What is Methadone?
Methadone is a prescription medication often sold under the brand name Dolophine. Like Suboxone, it is used in the management of chronic pain as well as in maintenance therapy in people suffering from opioid dependence. It is relatively cheap and effective. However, caution has to be taken while using it as it has great risks of causing fatal overdoses and dependence.
The Differences Between Suboxone vs Methadone for Pain
Agonist Effects
While both Methadone and Suboxone are partial opioid receptor agonists, their agonist effects are different. Methadone is a full opioid agonist that acts by binding to μ-opioid receptors while Suboxone contains both Buprenorphine which is a partial agonist that binds to μ-opioid receptor and Naloxone which is an opioid antagonist that binds to μ-opioid receptors, δ-opioid receptors, and κ-opioid receptors.
Qualification Criteria
Methadone is more addictive than Suboxone. It is therefore recommended that it is prescribed for patients with severe opioid addiction while Suboxone is prescribed for those patients with only mild addictive tendencies.
Wait Time
Methadone has a shorter waiting time as compared to Suboxone. In fact, it is advised that one should not take Suboxone in case one still has other opioids in their system. Buprenorphine, one of the constituents of Suboxone, has a very high affinity for opioid receptors. It, therefore, replaces any other opioids bound to the receptors resulting in their displacement into circulation. This causes an overdose which can be fatal. To administer Suboxone with no anticipation of withdrawal effects, doctors prescribe that it is taken approximately 24-48 hours following the last dose of opioids.
Medication Effects
Being that Suboxone and Methadone are both opioid receptor agonists, their effects are somewhat similar. The difference comes in at the clearance level whereby Suboxone takes a much longer time to clear as compared to methadone. Both drugs have the following effects:
· Feelings of euphoria and reduced anxiety
· Drowsiness
· Pupillary constriction
· Constipation
· Respiratory difficulties
Medication Adverse Effects
Like with all other drugs, both Suboxone and Methadone cause side effects. While they do not necessarily cause similar side effects, some of the effects are common to both drugs. They include:
· Nausea and vomiting
· Blurred vision
· Double vision
· Lower back or side pain
· Rapid weight gain
· Sweating
· Unusual weight gain or loss
· Cough or hoarseness
How to Administer
Both Suboxone and Methadone are available as oral formulations which are either tablets or liquids. There are also film strips which are not swallowed but instead placed under the tongue and they dissolve.
While both medications can manage opioid dependence, it is important that you consider these factors before you choose which one you’d want to use. You can seek a physician’s opinion as to which one between the two would be the best option for you.