What is the Difference Between Subutex® and Methadone?

Buprenorphine or Subutex® and methadone are medications commonly associated with drug detox treatment. They both are also used as pain relievers. The drugs and the way they are delivered differ in a number of ways when they are used for detoxification. These differences may help people determine which medication is most appropriate; individual response to the drugs also may redirect treatment if one method is not working.

A related drug to Subutex®, called Suboxone®, may be used in place of buprenorphine or at some point during buprenorphine therapy. Suboxone® contains naloxone, which slightly curbs the high associated with buprenorphine. This can be a preventative feature so people do not crush the pills and snort or inject them, as higher amounts of naloxone create withdrawal. This may prevent overdose and misuse of the drug and some people may start on one medicine and switch to the other after treatment is established.

Methadone is often abused and can be lethal in high doses. To prevent abuse, many countries strictly regulate its use, especially when it is injected, and have people enroll in clinics which they may need to attend daily in order to get a dose. This illustrates one of the biggest differences between Subutex® and methadone. In most regions people can obtain regular prescriptions for Subutex® and they do not need to check in at any form of clinic on a daily basis. The elimination of red tape in obtaining a prescription may be appealing.

Another way in which Subutex® and methadone are different is in the way they are delivered. Often, methadone detox treatment begins with injecting methadone, though there are also lower dose pills available for pain relief. In contrast, Subutex® is usually taken in pills that are placed under the tongue. Some may prefer this method to injection, particularly if addictive habits didn’t involve injecting drugs.

There are differing reports on how effective Subutex® and methadone are. Some suggest methadone is a better alternative for those who have suffered from prolonged heroin addiction. Others see the two treatments as nearly equal and suggest Subutex® is a better detoxification and maintenance drug for people recovering from addictions to many common prescription pain medications.

Subutex® and methadone share similar side effect profiles. They have a tendency to cause low blood pressure, dizziness, headache, nausea and vomiting, perspiration, sexual dysfunction, and itchy skin. Methadone is more indicated in potentially causing cardiac arrythmias, stroke, and hallucinations. Subutex® may cause a condition called miosis, which abnormally constricts the pupils. The side effects of both drugs can become more severe when they are mixed with tranquilizers, some psychotropic medicines, and opioid pain relievers. In terms of drug action, Subutex® has been investigated for potential antidepressant properties and studies suggest it may be effective.

The decision to use either of these drugs for detoxing or pain relief is difficult. Both have advantages and disadvantages. It can help to discuss these options with a doctor who can best advise patients based on their individual health circumstances.