Tuesday, August 14, 2012

Suboxone vs Methadone


Hello once again my friends and welcome back to my blog about opiate addiction. This is my fifth and newest post on my blog (that suddenly isn't so new now). This blog is here to help anyone find information on a variety of topics in regards to opiate addiction. As someone who suffers from opiate addiction myself (a 2 year addiction to the Oxycodone 30 mg pills), I use this blog as a way to vent myself as well as to help any others suffering from addiction or knowing someone who does. An addiction to anything is a serious and often sensitive topic, but I'm hoping this blog will allow others (myself included) to not only find information on the matter but to also have the opportunity to speak their minds as well about the matter.

I have noticed an increase in page views for my blog, which made me very happy that this information is getting out there. However, I've yet to have anyone comment yet so please, please don't be afraid to comment on any of my posts. Hopefully we can get some conversations going and I will also answer you guys back as soon as I can, even on older posts. Like always, you guys can check out my other previous posts from my blog by clicking on any of the following links below (in order from 1st post to most recent post):

Welcome (1st Post)
My Experience With Suboxone
The Dreaded Withdrawals
Why We Got Addicted To Opiates

I would like this particular post to discuss and compare two methods that are commonly used to help those suffering from opiate addiction. The two methods are Suboxone and Methadone, and although used for the same purpose of treating opiate addiction, they are both indeed very different. It is also important to note that these two drugs can be used for other things as well but I am just going to focus on their use as a tool in helping with opiate addiction. Basically, I'll give you guys some brief background information on both, compare them, and briefly speak about my experience with Suboxone (I've never used Methadone myself), and will leave the rest to you guys to hopefully generate some conversation within the comment section. Feel free to comment any information you have about this topic, your experiences with either of the drugs, your likes or dislikes of either, and any suggestions you have towards this post or the blog in general. OK, lets begin.

Suboxone or Methadone, That Is The Question

Methadone (top, white pills)
And Suboxone (bottom, orange pills)

Suboxone and Methadone are both drug medications that can be used for the purpose of helping opiate addicts eventually overcome their addiction to their drug of choice (DOC). The next most common action to take besides Suboxone or Methadone treatment is going cold turkey, although there are other ways as well. Suboxone and Methadone are preferred by many as they can help patients avoid withdrawals from stopping use of their DOC temporally until they choose to stop treatment with the Methadone or Suboxone, and opiates altogether. I want to stress this as while these two drugs will prevent most withdrawals and discomfort you would normally experience if you were to stop opiates altogether by going cold turkey, these two drugs carry the risk of withdrawals themselves when stopping them. I'm sure most of you guys know this already, but cold turkey is when one stops using their DOC without the aid of any replacement. So if someone like myself were using Oxycodone everyday for 2 years, then suddenly decided to stop opiates altogether, I would be going cold turkey. It should be noted that opiate withdrawal can be dangerous and is usually a painstaking experience. This is why it is important to not do anything drastic without first alerting those closet to you, your doctor, and your support network.

Withdrawals are the discomfort you feel when you stop using your DOC after a period time of continued use. Withdrawals vary based upon the person, drug they were using, length of time they were using, method of using, and dosage of the drug they were using. Some medications, like Advil, carry no risk of withdrawal while others, such as Oxycodone, Suboxone, Methadone, Valium, Xanex, and numerous others can bring about withdrawals after discontinuing of use. Some common symptoms (among many others) of opiate withdrawals are listed below:

Cold Sweats
Pins and Needles Feelings
Stomach Discomfort/Cramps
Restless Legs
Trouble Sleeping/Insomnia
Diarrhea/Trouble Going Bathroom
Loss of Appetite
Lack of Energy
Runny Nose
Feeling of the Common Cold/Flu
Depression/Emotional Issues

Quite frankly, these withdrawals suck and can make getting off opiates very challenging. The most common reasons that people struggle with when getting clean are these withdrawals along with the emotional drain opiate withdrawal can bring. It is very hard, but not impossible. In my opinion, there is nothing wrong with going cold turkey (under the right supervision). I also believe there is nothing wrong with using Suboxone or Methadone as a tool get clean off opiates as long as you truly have the desire to get off of opiates and aren't just getting a prescription for these drugs so you can have a supply of what I like to call "Backup Pills" in case you run out early, can't find any opiates, or don't have money to buy opiates. I only say this (and I realize I might sound like a jerk) because I once did this and know of others who did this. In my opinion, you cannot get clean and stay clean if you do not have the true desire to get clean (unless of course, you're locked up in jail or forced into a program). Believe me, I know how tough it can be to battle an addiction and I realize that people who go the Suboxone or Methadone route face just as much difficulty as those who go cold turkey. I am currently over 4 months clean off of Oxycodone after a 2 year habit of using 180-300 mg of Oxycodone a day at the height of my addiction. I have tried going cold turkey myself but could never stay clean very long, which resulted in me eventually going with an outpatient Suboxone program which has really helped me. However, I am not saying cold turkey is impossible as everyone is different and everyone needs there own type of care and rehabilitation. At the end of the day, it's not the route you went to get clean, it's the fact that you managed to get clean that counts the most.

Drugs? For a Drug Addict? Huh?

As I mentioned before, Suboxone and Methadone are given to patients for a period of time to help them overcome their addiction to opiates. Both Suboxone and Methadone are addicting and can be habit forming, especially if misused. So, why the hell would a doctor prescribed something addictive to an addict? The answer is a variety of reasons. Suboxone and Methadone allow patients the ability to stay away from their DOC while being able to continue their lives without the dreaded withdrawals we would normally face if not for the Suboxone or Methadone. This can be very important as it allows patients the opportunity to take their Suboxone or Methadone, stay practically withdrawal free for the time being, and get their lives back together. While on Suboxone or Methadone, patients can find jobs/careers, go to school, take care of their families/children, and other everyday things. Think about how hard it would be having to wake up early, go to work, come home to do some house work, make dinner, help the kids with homework, and going to little Jimmy's little league baseball game all while having to experience opiate withdrawals. This is why Suboxone and Methadone are preferred by so many people.

Another major reason people turn to Methadone and Suboxone is because it can help with cravings as well. Like I said before, these drugs aren't some miracle drugs that cure addiction and cravings but rather eases them. Based on my experience with Suboxone, I still get cravings here and there but would say they are greatly reduced with the use of the Suboxone. Keep in mind through that everyone is different. By being able to stay away from using your DOC, your mind, body, and schedule begin to change to what it was like before you started your addiction. Rather then waking up everyday craving your DOC (and for some, spending your entire day and night looking for more chasing that high), you are able to live a more normal life without constantly worrying about scoring your next high. Nearly all Suboxone and Methadone programs require their patients to submit to drug testing and to meet with doctors and/or consulars frequently, which help keep your life more structured with having someone to answer to if you screw up (it happens to the best of us).

OK, now that we got the good stuff out of the way, lets take a look at the bad stuff. Suboxone and Methadone unfortunately are addicting and can be habit forming. When the day comes when you and your support team decide that it is time to stop using either the Suboxone or Methadone, you will most likely experience some withdrawals. As I've said practically a million times already, everyone is different so it is tough to say how good or bad your withdrawals from Methadone or Suboxone will be. From what I have heard, it appears that Suboxone and Methadone withdrawals are not as bad as say Oxycodone withdrawal, but last wayyyy longer. Based on what I have been told and have read, the physical withdrawals from Suboxone appears to last any where from 7-21 days while the mental withdrawals take quite some time. The physical withdrawals from Suboxone are similar to those of most opiates. Once again, from what I have read, not experienced, the mental withdrawals and mind games continue for months and it usually takes a good 6 months to a year until your mind begins to feel almost completely normal. It sucks to hear, I know, but I want to be upfront and honest with you guys and not sugarcoat things. Everyone is different through so at the end of the day, who knows exactly how good or bad it will truly be.

OK, now this is where having people comment on these posts comes in handy. I have never taken Methadone myself and am getting most of my research from what I have heard from other people (people who have used it, my consular, and my doctor) and from what I have read. I do not want to sound like I am bashing Methadone on here so please excuse me if I sound that way. Basically, from what I have read and heard is that Methadone basically works just as well as Suboxone with keeping withdrawals and cravings at bay, but is much harder to come off than Suboxone or say, Oxycodone. In fact, I have heard that Methadone is one of the most difficult drugs to come off of. From what I have researched, it appears physical withdrawals last for weeks, or even months and can be quite uncomfortable to put it nicely. A common phrase I have heard to describe Methadone withdrawal is that "it gets in your bones." I'll let you guys take that phrase however you want to but it certainly scared me. The mental withdrawals are supposed to be just as bad as those of Suboxone, if not worse. Again, I do not want to bash Methadone as it has been around for quite awhile in the addiction community so it must be doing something right. I have also heard that it is not uncommon for patients of Methadone clinics to have to go every day to get their dose, while Suboxone can usually be obtained on a weekly, biweekly, or even monthly basis. I have also heard that the process of getting accepted into a Methadone program can be quite long and tiring, although I must say that I had to call around and search around for roughly 3 weeks before being accepted into a Suboxone program. Once again, please don't think that I have something against Methadone, I am just telling you guys what I have read and that this is where having you guys who have experience and knowledge of this topic comment can be very beneficial to others (myself included). The most important thing I can tell you is that to do your research and to talk honestly/frequently with your doctor and support network. Do not be afraid to ask questions/recommendations from these professionals on matters such as these, it can help a lot.

I know that Suboxone and Methadone can be used for variety of time periods. I have heard of people doing quick tapers with both (1 month or less), others who go 3 months-1 year, and others who go years on these drugs. I have also read, but never met, people who supposedly are on a Suboxone or Methadone program for life (not sure if this is just people talking out of their ass or if this really does happen so take it with a grain of salt if you wish). It is important you do your research and really talk it over with your support network with whatever method you choose as it is a decision that can basically affect the rest of your life and the path you choose you to go. I'm currently 4 months into a Suboxone program and was started at a relatively small dose (4 mg once a day) which I have stayed on since. The plan is that I will eventually start a process of tapering and will hopefully be off of all opiates within a year or so. I may also look into giving the Vivitrol shot a try after the Suboxone if I feel it to be necessary (I will hopefully write a post about the Vivitrol shot soon). Not only do I not have any experience with Methadone, but I have no experience with Suboxone withdrawal (besides going like 36 hours a couple times without a dose) so use your own judgement along with your research and doctor recommendations. Again, don't try to play doctor with these drugs adjusting your doses without permission as it can hurt you in the long run or even be dangerous. I know it can be tempting, but it can also be quite costly. Be smart my friends.


Suboxone Pills (top) and Suboxone Film (bottom)

Now that we compared the two drugs, lets take a quick look at each one individually. We'll start with Suboxone. Suboxone is a semi-synthetic opioid that is taken sublingually. Suboxone comes in either a pill form or in film form in dosages of either 2 mg or 8 mg. Suboxone is a relatively new drug in the opiate addiction community as it first entered the market for the treatment of opiate addiction in 2002 after being approved by FDA. There is a somewhat lack of information of Suboxone for long term use as the drug is still pretty new. It was however used from the 1960s to today as a  analgesics, although its primary use today is for both alcohol and opiate dependence.

The two main ingredients in Suboxone are Buprenorphine HCl and Naloxone HCl. The Buprenorphine is a opioid while the Naloxone is a opioid inverse agonist. The Burprenorphine is used to help keep the withdrawals and cravings at bay because when you take it, your body is still getting an opiate in it just like if you were to take say Oxycodone. However, it should be noted that Burprenorphine is a completely different drug in its own right than Oxycodone as both are their own kind of drug. The Naloxone is added into the Suboxone to prevent patients from abusing the drug. If a patient were to attempt to snort or inject Suboxone, they risk the possibility of going into precipitated withdrawals as the Naloxone will cause a nasty reaction with the Burprenorphine. The reason you will not go into precipitated withdrawals if you take Suboxone sublingually as directed is because the Naloxone is poorly absorbed when taken underneath the tongue where as it is better absorbed through the mucus membranes (snorting) or blood (injection). Suboxone should not be taken until your body has detoxed itself from other opiates such as Oxycodone as it can lead to precipitated withdrawals if you do not wait long enough to take your dose of Suboxone after you last used another opiate. Each opiate is different in the time it takes to leave your body and each can react differently with other drugs so it is important that you do your research and talk with your doctor about this matter (Man, I don't think I can stress that enough!)

Like Methadone, not all doctors can prescribe Suboxone so you must find one who does. Don't expect your primary care doctor to be able to prescribe Suboxone or Methadone as law requires doctors who prescribe these drugs to be licensed and trained in addiction treatment. However, it is important you keep your doctor up to date with your use of Suboxone or Methadone along with your addiction and other health issues. Along with Methadone, most Suboxone programs require patients to submit to drug testing, see an addiction doctor, and to see a drug consular. Some programs require you to see these people more frequently than others and each program has its own set of rules, guidelines, requirements, and beliefs. It is important to note that in terms of mg's strength, Suboxone is a pretty powerful drug. It's not a drug that will get you high (although some people report experiencing a slight buzz/high the first couple of times they take it) but don't let that statement fool you. For example, someone who is down to 1-2 mg of Suboxone can still experience symptoms of withdrawals, proving how powerful this drug is. I say this because when many people taper off of Suboxone and get down to a dose below 2 mg, they think they will most likely experience little to no withdrawals. While tapering certainly helps, it must be done slowly and patiently and even then, a person will most likely experience some withdrawals. Once again, everyone is different through.


Alright, let's now take a look at Methadone. Methadone is classified as a semi-synthetic opioid that is used primary as an analgesic and for opiate dependence. Methadone has been in the addiction community far longer than Suboxone and there is quite a lot of information and research on Methadone out there. I highly suggest you get to know the drugs you put in your body, and I say this for any kind drug. Methadone was originally developed in Germany during the 1930s and is still widely used throughout the world today. The same receptors in which drugs such as heroin and morphine affect, are affected by Methadone which makes this drug quite useful in treating opiate addiction. Like Suboxone, Methadone must be taken under the supervision of a doctor and program with patients having to detox themselves off of any opiates before taking their first dose. Similar to Suboxone, patients who do not wait long enough after their last dose of opiate can risk going into precipitated withdrawal if the Methadone is taken too soon. Methadone programs may require patients to visit methadone clinics daily and may require the patient to take their dose in front of a nurse or doctor. However, after a period of time of meeting program requirements, patients may be given larger quantities of Methadone to take home (such as a week's supply). Methadone can come in a pill form, a pill to be taken sublingually, or in liquid form depending upon the patient, program, and situation at hand.

Like Suboxone, Methadone can be addicting and habit forming while also carrying the potential of being abused. Some users report being able to achieve a high/buzz off Methadone but it is known that Methadone tolerance can be built up relatively fast. Methadone treatment is usually ended after a period of tapering and when patients quit using Methadone, they risk facing withdrawals. As mentioned before, Methadone withdrawals can last anywhere from period of weeks to months depending on the person and their situation. It should be noted that research does suggest however, that when taken properly, patients can achieve success in maintaining sobriety and that Methadone has certainly proven successful for many. A new trend has emerged in which patients are put on Methadone over a period of time, then slowly taper down their dose before switching over to Suboxone. I have not met anyone who has gone this route but it does sound pretty interesting. However, in my opinion I feel you're better off just going with Suboxone if you plan on going this route as why waste your time with the Methadone to just eventually switch over to Suboxone? But, hey, I'm sure doctors have their reasons and know a hell of a lot more than I do.

Common Side Effects of Methadone

I found the following information from Wikipedia (I know, I know, take it however you wish) and thought it may be helpful for you guys to read. It is basically a comparison between Suboxone and Methadone. I just copied and pasted it below while putting it in blue font.

"Buprenorphine and methadone are medications used for detoxification, short- and long-term maintenance treatment. Each agent has its relative advantages and disadvantages.
In terms of efficacy (i.e., treatment retention, mostly negative urine samples), high-dose buprenorphine (such as that commonly found with Subutex/Suboxone treatment; 8–16 mg typically) has been found to be superior to 20–40 mg of methadone per day (low dose) and equatable anywhere between 50–70 mg (moderate dose),[23] to up to 100 mg (high dose)[24] of methadone a day. In all cases, high-dose buprenorphine has been found to be far superior to placebo and an effective treatment for opioid addiction, with retention rates of 50% as a minimum.[23][24][25][26] It is also worth noting that while methadone's effectiveness is generally thought to increase with dose, buprenorphine has a ceiling effect at 32 mg.[27] That is, while a methadone dose of 80 mg will likely be more effective than a methadone dose of 60 mg (see Methadone dosage), a buprenorphine dose of 40 mg will not be more effective than a buprenorphine dose of 32 mg.
Buprenorphine sublingual tablets (Suboxone and Subutex for opioid addiction) have a long duration of action, which may allow for dosing every two or three days, as tolerated by the patient, compared with the daily dosing (some patients receive twice daily dosing) required to prevent withdrawals with methadone. In the United States, following initial management, a patient is typically prescribed up to a one-month supply for self-administration. It is often misunderstood that the patient has to receive other therapy in this situation, but the law simply states that the prescribing physician needs to be capable of referring the patient to other addiction treatment, such as psychotherapy or support groups.
Buprenorphine may be more convenient for some users because patients can be given a thirty-day take-home dose relatively soon after starting treatment, hence making treatment more convenient relative to those needing to visit a methadone dispensing facility daily. The facilities, which are regulated at the state and federal level in the US, initially are permitted to allow patients to receive take-home doses (to be self-administered at the appropriate time) only on a day when the clinic is regularly closed or on a pre-scheduled holiday. It is only after a minimum of several months of compliance (i.e., proven sobriety, demonstration of being able to safely store the medication) that patients of methadone clinics in most countries are permitted regularly scheduled take-home doses aside from the possible exceptions for weekends and holidays. Ultimately, American patients on methadone maintenance therapy are permitted a maximum of a one-month supply of take-home medication, and this is permitted only after a minimum of two years compliance. In the US state of Florida, patients cannot receive a one-month supply until five years of compliance. Most buprenorphine patients are not prescribed more than one month's worth of buprenorphine at a time. However, buprenorphine patients, as a rule, are able to get their one-month supply much earlier in their use of the drug than methadone patients.
Buprenorphine as a maintenance treatment thereby offers an advantage of convenience over methadone. In general, buprenorphine patients are also not required to make daily office visits and are often very quickly permitted to obtain a one-month prescription for the medication. Methadone patients in the United States who are not subject to additional strictures beyond the federal law regarding a patient's take-home supply also benefit in convenience. States with excessive regulation on methadone dispensation see professionals advocating for office-based methadone treatment, similar to the standard of office-based buprenorphine treatment. Such treatment with full opiate agonists is already available on a limited basis in the UK, and has been ever since heroin was made illegal, with an interruption of a few decades, which occurred, likely under pressure from the United States[citation needed] during the worldwide escalation of the War on Drugs, which occurred during the 1960s and 1970s. In fact, in the UK a doctor may prescribe any opiate to a patient, regardless of their complaint (excluding diamorphine and dipipanone for addiction, where they require a special licence from the Home Office). In practice, methadone is most often used, although morphine and heroin are also less frequently prescribed on a maintenance basis. The UK has a smaller number of opiate users, per capita, than the United States[citation needed], which many attribute to the availability of full opiate agonist prescriptions to users, which reduces the amount of opiates sold illicitly and, in turn, the number of users of other drugs who encounter and begin using the opiates. Therefore, it could be argued that buprenorphine may not be as attractive a treatment option in the UK due to full opiate agonists such as heroin maintenance being an option for a small number of addicts seeking treatment. (See Heroin prescription.)
Buprenorphine may have, and is generally viewed to have, a lower dependence-liability than methadone. In other words, withdrawal from buprenorphine is less difficult. Like methadone treatment, buprenorphine treatment can last anywhere from several days (for detoxification purposes) to an indefinite period of time (lifelong maintenance) if patient and doctor both feel that is the best course of action. Additionally, the opinion of those in the medication-assisted treatment field is generally shifting to longer-term treatment periods, which may last indefinitely, due to the anti-depressant effects opioids seem to have on some patients as well as the high relapse potential among those patients discontinuing maintenance therapy. The choice of buprenorphine versus methadone in the mentioned situation (by the patient) is usually due to the benefits of the less-restrictive outpatient treatment; prescriptions for take-home doses for up to a month early versus the possibility of heavy restrictions in some states and frequent visits to the clinic and the possibility of the "stigma" of going to a methadone clinic as compared to making trips to a doctor's office. Buprenorphine is also significantly more expensive than methadone and this seems to add to its better reputation. Also, in some states, there is a long waiting list for admission to a methadone maintenance program versus those with the money to afford seeing an addiction specialist each month in addition to the cost of medication. In studies done, methadone is considered more addicting physically and mentally.[citation needed] The sometimes less-severe withdrawal effects may make it easier for some patients to discontinue use as compared with methadone, which is generally thought to be associated with a more severe and prolonged withdrawal. However, no evidence thus far exists that sustaining abstinence post-buprenorphine maintenance is any more likely than post-methadone maintenance.
Another issue of concern for patients considering beginning any maintenance therapy or switching from one maintenance therapy to another is the transition associated with this switch. Due to buprenorphine's high-affinity to opioid receptors in the brain, care needs to be taken when a patient is transitioning from one drug (e.g., heroin) or medication (e.g., methadone) to buprenorphine. In essence, if an opioid-dependent patient is not in sufficient withdrawal, introduction of buprenorphine may precipitate withdrawal. In lay terms, in a sufficient dose, buprenorphine "pushes" any other opioids off of the receptors, but is itself not always "strong enough" to counteract the withdrawal symptoms this causes.[28] Thus, opioid-dependent patients, in particular those on methadone or another long-acting medication or drug, should be thoroughly honest with their prescribing doctor about their drug use, in particular in the days immediately preceding their induction onto buprenorphine, whether for detoxification or maintenance. In contrast, in general the transition from buprenorphine or other opioids to methadone is easier, and any discomfort or side-effects are more likely to be easily remedied with dose adjustments.
Buprenorphine, as a partial μ-opioid receptor agonist, has been claimed and is generally viewed to have a less euphoric effect compared to the full agonist methadone, and was therefore predicted less likely to be diverted to the black market (as reflected by its Schedule III status versus methadone's more restrictive Schedule II status in the USA), as well as that buprenorphine is generally accepted as having less potential for abuse than methadone. It is also worth noting that neither methadone nor buprenorphine causes euphoria when taken long-term at the appropriate dose. However, in at least one study in which opiate users who were currently not using an opioid were given buprenorphine, several other opioids, and placebo intramuscularly, subjects identified the drug they were injected with as heroin when it was actually buprenorphine.[29] This evidence tends to support the contentions of those who reject the notion that buprenorphine, when injected, is only marginally euphoric, or significantly less euphoric than other opiates.
In an effort to prevent injection of the drug, the Suboxone formulation includes naloxone in addition to the buprenorphine. When naloxone is injected, it is supposed to precipitate opiate withdrawal and blocks the effects of any opiate. The naloxone does not precipitate withdrawal or block the effect of the buprenorphine when taken sublingually. The Subutex formulation does not include naloxone, and therefore has a higher potential for injection abuse. However, Subutex is prescribed significantly less than Suboxone for just this reason. Methadone, on the other hand, is typically given to patients at clinics in a liquid solution, to which in general water is added. This makes injection difficult without evaporating the liquid and taking other measures. Therefore, injection of buprenorphine as found in the preparations provided to opiate users is simpler than injection of methadone, although data on the relative incidence is not currently available. Although, in general, methadone is not a drug of choice for opioid addicts due to its long-acting nature and relatively little euphoria associated with its use, especially when compared to other drugs of abuse such as heroin and Oxycodone, it is used by addicts to relieve withdrawal symptoms when their opiate of choice cannot be obtained. Most methadone bought from the black market is thought to be bought by already opioid-dependent persons attempting to circumvent the substance abuse treatment system and detoxify themselves with the methadone or simply by people wishing to use the drug recreationally, just as other opiates are used. In the US, buprenorphine is found far less often on the black market as compared to methadone.In North America (Canada) it is reversed, buprenorphine is found to be readily available on the black market,as methadone is usually not seen,buprenorphine is as easy to obtain as heroin.[citation needed]. The vast majority of the methadone diverted to the black market is not diverted from methadone clinics for opioid dependent persons, but rather it is diverted by a minority of the people who receive prescription methadone for pain[citation needed]
Since the late 90s in Austria, slow release oral morphine has been used alongside methadone and buprenorphine for OST and more recently it has been approved in Slovenia and Bulgaria, and it has gained approval in other EU nations including the United Kingdom, although its use currently is not as widespread. The more attractive side-effect profile of morphine compared to buprenorphine or methadone has led to the adoption of morphine as an OST treatment option, and currently in Vienna over 60 percent of substitution therapy utilizes slow release oral morphine. Illicit diversion has been a problem, but, to the many proponents of the utilization of morphine for OST, the benefits far outweigh the costs, taking into account the much higher percentage of addicts who are "held" or, from another perspective, satisfied by this treatment option, as opposed to methadone and buprenorphine treated addicts, who are more likely to forgo their treatment and revert to using heroin etc., in many cases by selling their methadone or buprenorphine prescriptions to afford their opiate of choice. Driving impairment tests done in the Netherlands that have shown morphine to have the least negative effects on cognitive ability on a number of mental tasks also suggest morphines use in OST may allow for better functioning and engagement in society."

I have also included some links below that provide further insight into Suboxone and Methadone.



Alright guys, well I hope that was enough reading for you all and wasn't too boring. I'll say this just one more time. I have used Suboxone for 4 months now (4 mg once a day) as the result of battling a addiction to the Oxycodone 30 mg pills. I have remained clean off of all other opiates and any other kinds of drugs as well. I have yet to experience Suboxone withdrawal although I have experienced Oxycodone withdrawal numerous times (it sucks!). I have also never once tried Methadone and thus have never experienced Methadone withdrawal. If you were to ask me which of the two drugs I would recommend, I would simply say that I have no experience with Methadone but that the Suboxone program I am currently on has been very helpful in me reaching my goal of clean living. So far, so good with the Suboxone and I hope to be careful/patient with my tapering so I can be best prepared for whatever withdrawals I may face when the day to stop using Suboxone comes for me.

Most of the information I have provided for both of these drugs comes from my own experiences, addicts I have talked with, doctors/consulars I have talked with, and what I have read in books or online. I'm not here to neither promote or knock any medication or drug, I simply wish to provide you guys with some information I think you may find useful. I really can't stress how important it is to do your research and talk with your doctors, don't just go by my stuff or what you think only. There's a reason those people are professionals and I'm some guy writing on an online blog (hey I'm being honest, but I really do hope I'm helping some people). Once again, thank you guys so much for reading my blog and the only thing I can ask of you guys is to please comment. I really do think hearing from numerous people will be very beneficial for everyone involved on this blog.

Until next time my friends, be careful, responsible, and most importantly happy. And remember, keep seeing that light. Believe me, it's out there somewhere.

Take Care Guys,



  1. Great post. My brother was a heroin addict for awhile and they put him on methadone. He is now going through methadone withdrawal. He is doing a little better than before but I wish there was more I could do for him.

    1. I heard Methadone withdrawal is quite difficult. I hope your brother is doing well with his recovery. Please stay strong.

  2. I wish both you and your brother the best of luck. I have no experience with Methadone or withdrawal from it but from what I hear, withdrawal from it is quite painful and uncomfortable. Hopefully one day, there will be a better option out there allowing for no withdrawal and better hope. We can only hope for now I guess. Patience and time are what we must look to for now. Tell him it does get eaiser after some time and the sober life is so worth the struggle to get there. Take care and thank you for both taking the time to read and comment on my blog, hope you found it helpful.

  3. The 5 day detox program you mentioned with the link in your comment sounds quite promising. Please let us know how your brother is doing when you get a chance. I'm curious to know how he is doing and how his treatment went. Again, thank you Mackenzie.

  4. Pretty nice post. I just came across your blog and wanted to say that I’ve really liked reading your posts.

    1. Thank you, I am glad to be able to help people who are in similar situation as myself.

  5. Delighted that I found your site, fantastic info. I will bookmark and try to visit more frequently.

    1. Thanks! I lost my password and account name so haven't been able to get on here in awhile. I plan on posting more in near future (hopefully tonight).

  6. Omg I'm going crazy I don't know what to do any more I was on methodone for 11years I did real good I switch and got on suboxen n I been on it for 3 years and I relapse I'm so tired of this life don't know what to do I get real bad headaches mood swing I'm very depressed. I'm very tayer of living like this

    1. Hi Hardlife38,

      I agree, opiate addiction can certainly take its toll and become tiresome. The important thing is to stick with your recovery and remain positive. Easier said than done, I know. If you don't mind sharing, I would like to know more about your situation. How much Suboxone are you currently on if you are still taking it? What was your drug of choice? I have written two posts about Suboxone, the first my experience with getting on it and the second post I wrote pretty recently is my taper with the Suboxone. I'm currently at 1 mg a day.

      Please keep strong and don't give up. You sound like a good person and should be proud you went so long without using while on the Methadone and Suboxone. From what I have heard, getting off of Methadone and even switching from Methadone to Suboxone is quite the challenge.

      I would love to continue talking to you so please keep me and the rest of us updated on your situation. I made this blog to help people just like you and me. Please remember there are literally thousands of people like you and me in the same boat battling addiction. The important thing is to remain sober, positive, and to take it one day at a time.

      Take Care and I look forward to hearing from you friend,


  7. I am currently on a methadone maintenance program, and I did not have to detox from opiates before starting my program as there is no opiate antagonist in methadone like there is in Suboxone, so that was a bit of misinformation. I know a lot of people that go to my clinic who still use opiates with their methadone. I would have preferred to get on Suboxone, personally, partially so that I would NOT be able to use any opiates without getting sick, therefore helping me to retain my sobriety more effectively; and also because of a lot of the other reasons mentioned above (i.e. convenience of take-homes, less severe withdrawals, etc..). The only reason, however, that I chose MMT was because I suffer from a great deal of pain and other symptoms due to a stomach condition that I have had for years(which is how I got drawn back into using pain pills and eventually heroin in the first place), and the Subutex and Suboxone didn't do A THING to alleviate them. I know a lot of other people who have chosen MMT over Suboxone for the same reason: pain management. Ironically, my dose of methadone (80 mg per day) turned out to be much more effective than the Oxy and heroin I was using in much higher doses. So as inconvenient as it is, and as scary as it is to think of the long term effects on my body, I unfortunately don't have a choice unless I want to go back to suffering just about every day and being unable to perform basic functions of daily life, such as keep a job, or even playing with my son. Methadone in combination with marijuana has turned out to be like a miracle in the treatment of all of my symptoms, which the doctors and specialists I was seeing for years had been unable to help AT ALL. Go figure.

  8. Hey Liz,

    Thanks for commenting on my blog. I honestly always thought that, like Suboxone, patients needed some time off from opiates before getting on Methadone. Learn something new everyday and I apologize for the misinformation.

    I'm a firm believer in that if it works, then by all means go for it. I'm sure being on Methadone carries less of the negative consequences associated with using opiates off the street. If it is working for helping you with your addiction as well as your stomach pain, then why not stick with it for as long as you and your doctor feel comfortable. It's one of those things were you truly have to sit down and weigh the risks with the benefits. As for the marijuana, I'm a big supporter of it as a tool in the medical community and even for the addiction community as well.

    Thanks again for commenting and I hope your recovery and pain issues go well.

    Take Care,


  9. Thank you for this information concerning suboxone and methadone. it is good to know that these are both medications that can be used for the purpose of helping opiate addicts overcome their addiction. It would be best to seek help from a doctor to see which choice is best for you. http://www.psychiatristsarasota.com/addiction-services