Why Suboxone Is Safer than Methadone

Suboxone is a safer drug than methadone – and so treatment with Suboxone is far less likely to result in tragic overdose (although methadone too, is safe, if used strictly as directed). Suboxone is safer because it is a partial opiate agonist rather than a full opiate agonist and so it can produce only limited effects. It is partially because of this increased safety profile that you can get month long take home doses of this medication.

By John Lee · Updated November 20, 2015

Opiates are potent drugs. They can produce powerful euphoria, analgesia and also respiratory depression. Taken in high doses, opiates are dangerous, and respiratory depression can lead to death.

Methadone is a full agonist opiate. Taking increasing doses of methadone leads to increasing euphoria, analgesia and respiratory depression. If you take a high dose of methadone, you are at risk of an overdose death. Thousands of Americans die each year from overdoses of methadone (most overdoses occur from methadone prescribed for analgesia, not methadone used as addiction treatment).

Suboxone contains the active ingredient buprenorphine. Buprenorphine is a partial opiate agonist with a ceiling of action. When you take buprenorphine, it fills opiate receptors in the brain, and once these receptors are filled, withdrawal symptoms are reduced or eliminated. But because it is only a partial agonist, the drug can only partially activate the opiate receptors. As a result, buprenorphine can only induce limited euphoria, analgesia and respiratory depression.

Buprenorphine has a dosage ceiling. In most cases, the maximum effects of Suboxone are achieved with the 16 to 32 mg dosage when taken sublingually (under the tongue).¹ Once you reach this ceiling, taking increasing doses of the medication results in no increasing euphoria, analgesia or respiratory depression. Methadone has no dosage ceiling, and taking increasing doses of methadone can lead to death.

Suboxone is Safer

Suboxone is a much safer medication than methadone (although methadone, when used exactly as directed, also has a very good safety profile) and this is one reason why doctors can prescribe Suboxone in lengthy take home doses.

Although Suboxone is a relatively ‘safe’ opiate, it is still a powerful medication that merits respect. People have died after abusing buprenorphine, particularly when abusing this medication with benzodiazepines.