Suboxone® vs methadone: What’s the difference?

When it comes to treating opioid use disorder (OUD), Suboxone® and methadone are two of the most widely-prescribed medications that doctors trust to help people on their recovery journey. Both reduce cravings and ease withdrawal. But how you take them, where you get them, and what treatment looks like day-to-day are different enough that one could be a much better fit for your life than the other.

If Googling the differences between Suboxone and methadone has left you with more questions and even more open tabs, it’s not you. We wrote this guide to help make it easier to understand how these two medications differ, minus the complicated medical jargon.

What is Suboxone?

Suboxone is a prescription medication made up of two active ingredients: buprenorphine and naloxone.

• Buprenorphine is what’s called a partial opioid agonist. That means it activates the same brain receptors as opioids, but only part of the way. It helps calm cravings and ease withdrawal symptoms without producing a euphoric feeling. 
• Naloxone is an opioid antagonist, meaning it blocks opioid receptors. It’s there as a built-in safeguard against misuse. When you take Suboxone as prescribed, the naloxone mostly stays inactive. But if the medication is injected or used nasally (such as snorting), the naloxone activates and blocks any opioid effects.
  

Buprenorphine has been studied and used in medicine for more than 40 years. It was first approved as a pain medication in the late 1970s and early 1980s, but it has been used specifically to treat opioid use disorder in the United States since receiving FDA approval of buprenorphine-based medications in 2002, giving it more than 20 years of use in addiction treatment.

Suboxone uses

Suboxone is used to treat opioid use disorder as part of a Medication-Assisted Treatment (MAT) program. It’s taken at home as a film or a tablet that dissolves under your tongue and can be prescribed in person or through a telemedicine platform like QuickMD. Most people start on a stabilization dose and then work with their doctor to find the level that keeps cravings and withdrawal in check without over-medicating.

What is methadone?

Methadone is a prescription medication that’s been used to treat opioid use disorder in MAT programs for decades. It’s what’s called a full opioid agonist, meaning it fully activates the opioid receptors in your brain. Like Suboxone, this significantly reduces withdrawal symptoms and cravings. 

Because methadone is a full agonist, it can produce euphoric effects and dangerous respiratory depression at higher doses, which is why dosing is carefully managed by a medical clinician. The right dosage provides stability without a feeling of euphoria or breathing difficulties. 

When methadone is initially prescribed, it’s taken in-person at a specialized clinic to make sure it’s being used safely. However, some states allow people to take several days’ worth of their prescribed dosage home if their doctor feels it’s appropriate.

Methadone uses

Severe opioid use disorder can be treated with either methadone or Suboxone with equal effectiveness. When methadone is first prescribed, it’s taken in-person at a clinic or doctor’s office, which means daily visits in the beginning to take your dose in person, under the guidance of a clinician. For many people early in recovery, that built-in routine and regular contact with a care team can help them feel grounded. As you stabilize, some states allow take-home doses so you don’t have to visit as frequently over time.

What is the difference between methadone and Suboxone?

Suboxone and methadone are both effective treatments for opioid use disorder, but they differ in how they work, how you take them, and where you get them. Let’s take a closer look at how they compare. 

1. Drug class

Methadone is a full opioid agonist, meaning it fully activates the brain’s opioid receptors. Suboxone contains buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. As a full agonist, methadone turns the opioid signal all the way on, while buprenorphine brings it up just enough to help relieve symptoms without fully triggering opioid receptors.

2. Benefits

Both Suboxone and methadone have their own unique benefits that can make these medications a good fit for different individuals on their recovery journey. 

Suboxone benefits

• No daily clinic visits: You can take Suboxone at home after getting a prescription from your doctor, so treatment fits around your schedule. 
• Lower misuse and overdose risk: Buprenorphine has a ceiling effect, meaning its opioid effects max out after a certain dose, and taking more won’t produce feelings of intoxication or euphoria.

Methadone benefits

• Stronger craving and withdrawal relief: Methadone’s full agonist action can provide relief from intense withdrawal symptoms, particularly for people who have used opioids long-term.  
• Daily clinician contact: Daily clinic visits mean consistent face time with a care team. Having regular check-ins in-person can help people feel more supported in their treatment. 

3. Composition

Suboxone contains two active ingredients: buprenorphine and naloxone. It comes as a film or tablet that dissolves under the tongue. Methadone contains a single active ingredient (methadone hydrochloride) and is available as a liquid, tablet, or dispersible tablet taken orally.

4. Side effects

Common Suboxone side effects include:

• Headaches (approximately 35% initially)
• Nausea or vomiting (approximately 15% initially)
• Constipation (approximately 12% initially) 
• Trouble sleeping (approximately 1 to 10% initially) 
• Sweating (approximately 14% initially)
  

Suboxone’s ceiling effect means its overdose risk is significantly lower compared to full agonists like methadone.

Common methadone side effects include:

• Sweating (approximately 45 to 50% initially) 
• Constipation (approximately 15 to 30% initially) 
• Drowsiness or sedation (approximately 35% initially) 
• Weight gain (average of 20 lb in men over the first four years of treatment)
• Nausea (Reported in 15%–60% of patients, with higher rates [up to 60%] often found in studies of patients on chronic therapy.)
  

Because methadone is a full agonist, the risk of overdose is higher if it’s not dosed correctly. This is why dosing is managed so closely by doctors and clinicians.

5. Withdrawal symptoms

Withdrawal symptoms are a normal part of the recovery process. They’re a sign that your body is adjusting to your medication. Withdrawal symptoms are similar for both Suboxone and methadone. These can include:

• Muscle and body aches
• Anxiety, irritability, or restlessness
• Nausea, vomiting, or diarrhea
• Trouble sleeping
• Sweating and chills
• Cravings

6. Accessibility

When prescribed by a doctor and taken under medical supervision, Suboxone can be taken at home. This means fewer trips to a clinic and more flexibility in managing your treatment.

Here at QuickMD, we prescribe Suboxone when appropriate as part of a Medication-Assisted Treatment (MAT) program. We offer same-day appointments, and your medication can be picked up at your local pharmacy or delivered straight to your door, making treatment as private and convenient as possible. No waiting room or trip to the pharmacy.

Methadone access is typically more limited because it can only be dispensed in-person through federally certified Opioid Treatment Programs (OTPs). If you live in a rural area or somewhere without a convenient OTP, the daily commute can make it difficult to get treatment. Some states are working to expand access, but availability still varies widely depending on where you live.

7. Treatment length

There’s no universal timeline for either medication. Every person’s recovery journey looks a bit different. Some people stay in a MAT program for a year or two, and others stay on for much longer. Research recommends a minimum of 12 months on either Suboxone or methadone, and many doctors encourage continuing beyond that.

Your doctor can help you figure out the right timeline based on how you’re doing and what you both feel comfortable with. For some, staying on medication long-term offers a lasting sense of stability. There’s no right or wrong answer or definite timeline. 

Methadone vs Suboxone: Key differences summarized

This table offers an at-a-glance look at how methadone and Suboxone stack up next to each other. 

Suboxone vs. methadone: final thoughts

Both Suboxone and methadone are life-changing medications in the fight against opioid dependency, but they each have unique qualities. What matters is that your medication is working for you and that you feel supported in your recovery. 

If you’re ready to start your journey toward recovery, reach out to QuickMD today. Our team is here to help you every step of the way. Recovery is not only possible, but it’s also within your reach. With the right support, you can take control of your health and create the life you deserve.