Both methadone and Suboxone are opiates, and when using these medications as a form of addiction treatment you remain dependent on opiates. This means if you suddenly stop using methadone or Suboxone, you will experience opiate withdrawal symptoms.
While taking methadone or Suboxone once daily as directed by a doctor, however, you are no longer addicted – no longer a drug addict.
The hallmarks of addiction include:
- Compulsive use
- Taking a substance even though it does you great harm
- Drug cravings 1
Once appropriately medicated on Suboxone or methadone you should experience no drug cravings, your health should improve and you will use only once a day in controlled doses (not compulsive). Once using methadone or Suboxone for addiction treatment – you are no longer a drug addict.
Opiate Replacement Therapy during Pregnancy
Although moms-to-be often want to maximize health and well being during pregnancy (and often this means wanting to break free from all opiates) opiate withdrawal symptoms are very hard on the fetus and can lead to miscarriage. For this reason, pregnant women are not advised to attempt to detox off opiates.
The use of methadone during pregnancy has been extensively studied and it is proven safe for mom and baby. Women on methadone are far more likely to receive appropriate prenatal care and to give birth to health, full term babies. Methadone is considered the gold-standard treatment for opiate addicted pregnant women.
Suboxone is less commonly recommended as a medication for pregnant women as there are only a few studies in existence to confirm the safety of this medication for use during a pregnancy. Under some circumstances, (such as when methadone is unavailable or when a woman is already on Suboxone) doctors will prescribe Subutex during pregnancy. What limited evidence there is points to Subutex being a safe and effective medication for pregnant women.
Dangers of Opiate Replacement Therapy
Methadone is an opiate that works in the brain very similarly to heroin or OxyContin and just as you can OD on such drugs, so too can you OD on methadone. Methadone must be used exactly as directed and should never be combined with certain other substances. Suboxone is a far safer medication, although it too has resulted in overdose deaths when combined with benzodiazepines.
Methadone can result in fatal overdose and fatal overdose deaths involving methadone are on the rise (From 790 deaths in 199 to 5420 in 2006)2 although much of this increase is likely attributable to the increased use of methadone as a prescription analgesic.
Methadone is a very potent opiate with a very long half life and so it must be used with respect and with caution, and always exactly as doctor prescribed. The risks of methadone overdose and death increase dramatically when methadone is used with other drugs, such as with other opiates or with benzodiazepines and other sedative drugs. For people using methadone as a therapy for opiate addiction, the risks are greatest in the initial dose induction phase.
Methadone must also be stored as directed, completely out of the reach and access of children. A single daily dose of methadone is more than enough to kill a small child, and there are too many such tragedies every year in America. (While an opiate dependent adult may require 100 mg or more a day, just one tenth of that amount, 10 mg can prove lethal to a child and 50 or 60 mg can kill a fully grown adult without an opiate tolerance)3
Other than the risk of overdose, methadone is a very benign substance, whish does the body little harm, even when used in high doses over long periods of time ) A study of adult patients maintained on high doses of methadone for 14 years found no adverse health effects attributable to this use of methadone)*. People on methadone are sometimes bothered by non dangerous side effects, such as unusually heavy sweating, constipation, weight gain and a loss of libido.
Due to its dosage ceiling (after a certain point, taking additional quantities of Suboxone has little additional result) Suboxone is a far safer medication than methadone. This increased safety profile is one of the major reasons why you can take it home in month long doses.
Although it is safer, it still needs to be used as directed. People have died after mixing buprenorphine with sedative drugs, like benzodiazepines.
Page last updated Nov 03, 2010