Can You Take Methadone and Suboxone Together?

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Key Takeaways

  • Methadone and Suboxone should not be taken together due to overdose risk.
  • Methadone and Suboxone are used sequentially in opioid addiction treatment.
  • People switch from methadone to Suboxone due to stigma, convenience, and safety.
  • Switching requires tapering methadone and a 72-hour wait before starting Suboxone.

Methadone and Suboxone can be part of medication-assisted treatment of opioid use disorder (OUD), but can you take them together, or do their drug interactions prevent that?

Well, the answer is no; methadone and Suboxone can’t be taken together.

Using methadone while on a Suboxone treatment plan can cause one of two things to happen:

Overdose

Because both methadone and Suboxone act on opioid receptors in the brain, taking them together can cause the brain’s breathing center to stop working.

In extreme cases, this can lead to coma and death.

Severe withdrawal effects:

If someone injects Suboxone intravenously too soon after taking methadone, they can experience severe withdrawal symptoms.

This is due to the initial activation of opioid brain receptors by methadone, followed by sudden blockage of these receptors by the naloxone component of Suboxone.

Opioid withdrawal symptoms include runny nose, excessive tearing, goosebumps, and inability to sleep

How Are Methadone and Suboxone Used in Opioid Addiction Treatment?

Methadone is usually taken before Suboxone in OUD treatment. It activates opioid receptors in the brain, giving patients the same feelings of euphoria as they get with drugs of abuse.

As people get weaned off of drugs of abuse, they’re switched to Suboxone.

Suboxone also activates brain opioid receptors but to a much weaker extent.

This means it doesn’t cause euphoria but prevents opioid cravings and makes withdrawal more tolerable, which is a valuable asset in relapse prevention.

However, the choice between methadone or Suboxone depends on the type of patient.

For example, patients who are more likely to drop out of treatment will benefit from methadone rather than Suboxone.

Patients who are more likely to suffer side effects will benefit from Suboxone treatment rather than methadone.

At times, patients who continue to experience withdrawal symptoms despite taking Suboxone will require switching to methadone.

Why Do Some People Want to Switch From Methadone to Suboxone?

The three main reasons why people want to switch from methadone to Suboxone are:

Stigma

Methadone has had many regulations over its long history, so substance abuse patients who still take the drug are often the victims of social stigma.

Methadone can only be received at methadone clinics, unlike Suboxone, which is more widely available, and those visiting methadone clinics often fear judgment by others

Ease

Methadone requires daily visits to a methadone clinic for administration. In contrast, Suboxone can be used at home after consultation with a physician

Lower risk of overdose

Methadone has much stronger effects on the brain compared to Suboxone. Its risk of overdose and other side effects is also much greater.

On the other hand, Suboxone has a much more favorable safety profile while being equally effective.

According to a study from the United Kingdom that evaluated 71 patients, methadone and Suboxone equally reduced addiction to heroin and prevented relapse.

Another study of 164 participants from the United States also concluded that both drugs have similar efficacies

How to Switch From Methadone to Suboxone?

Switching to Suboxone from methadone can be hard because methadone is a more potent opioid agonist than Suboxone.

This means the first step is to prepare yourself and keep in mind that switching to Suboxone might be challenging for your physical and mental health.

The second step is to consult an addiction specialist, who will determine your readiness to switch to Suboxone.

If the physician thinks that you are ready to switch, they will start a tapering regimen where the dose of methadone is gradually decreased over days until it is brought down to 30 or 40 milligrams.

You’ll then have to wait for around 72 hours without taking methadone. After 72 hours pass, you can take your first dose of Suboxone.

More About Methadone and Suboxone

Methadone and Suboxone are opioid agonists. This means that both drugs activate opioid receptors in the brain.

The difference lies in how strongly both drugs act.

Methadone is a full opioid agonist, which means it strongly activates opioid receptors, giving people the same feelings as drugs like morphine.

Its effects also last longer and it poses similar health risks as morphine, which is why it needs to be taken under supervision.

Suboxone is a combination of buprenorphine and naloxone.

Buprenorphine is a partial opioid agonist, meaning it does not activate the brain opioid receptors as strongly as methadone.

This doesn’t cause people to feel the same high as methadone. But it does reduce cravings for opioids and makes the drug much safer.

The naloxone in Suboxone acts as a safety feature.

It’s inactive when Suboxone is taken by mouth but becomes active if someone injects the drug into a vein.

In this case, naloxone blocks opioid receptors in the brain and leads to unpleasant withdrawal symptoms.

This is why it’s also called an opioid antagonist.

Need to Switch to Suboxone? Make an Appointment With Curednation

We understand if you want to switch from methadone treatment to Suboxone. But it must be done under medical supervision.

Curednation provides telemedicine opioid addiction treatment services, so you can recover from the comfort of your home. Book an appointment today

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