Methadone program vs Suboxone program, which is the right treatment for addiction to OxyContin, fentanyl, Percocet, heroin, etc.?
When a friend or loved one develops an addiction to OxyContin, fentanyl, Percocet, heroin, or some other opioid medication, the symptoms may be varied, but one thing is for certain: your friend or loved one begins to act out of character. They are no longer the person you knew and loved. Depending on their personality and brain chemistry before the addiction, they might become secretive, anxious, depressed, dishonest, withdrawn, paranoid, restless and selfish. In addition to behavioural and health changes, there is the financial damage to the family, and the cost to society in the form of decreased productivity and increased social welfare.
There is also the cost, of course, of treatment or rehab for the opiate addict who wants to stop using and break their dependence. Some treatment centres are private and covered by private insurance; others are publicly funded so that anyone with an addiction to opioids can receive treatment. Treatment from opiate addiction usually involves some sort of replacement drug therapy to assist the user in breaking their physical dependence upon their drug of choice.
Which treatment program should I seek for addiction to OxyContin?
Both methadone and suboxone (buprenorphine) are used in the medically assisted treatment of addictions to opioids like fentanyl, heroin, Percocet and the like. Each drug has benefits and disadvantages. Though suboxone was once lauded as a miracle detox drug by some in the addictions field, methadone is still the most commonly used medication to treat heroin dependence. Why is this?
Methadone is what is known as a full opioid agonist, which means it is an opioid drug that binds to receptors in the brain and causes them to produce endorphins. It provides a full, unchecked effect of pain relief – and also that euphoric feeling that addicts are seeking. This puts methadone in the same class as oxycodone, codeine, and heroin itself, among others. That means methadone use comes with risks like:
- Overdose
- Potential for drug abuse potential; and
- Cardiovascular problems.
Buprenorphine, by contrast, is a partial opioid agonist, which means its activity at the brain receptors is limited. No matter how much is taken, it causes less pain relief and euphoria, but still reduces opiate withdrawal symptoms and even reduces the effects of additional opiate use, so if the patient attempts to use other kinds of opiates for a greater effect, they won’t get one. This would seem to give suboxone some obvious advantages over methadone. Yet, suboxone comes with some built-in disadvantages too:
- It does not mimic the same ‘high’ as methadone, leaving users feeling unsatisfied and potentially more likely to stop taking it and relapse on street drugs
- It is more expensive than methadone
- It is less effective at keeping patients in a treatment program
- It has been linked to hepatitis
- It can cause precipitated withdrawal if treatment is not initiated at the right time
Methadone program vs. Suboxone, which is really better?
Suboxone has been shown to suppress heroin use just as well as methadone – for those who stay in a treatment program, and who have a mild to moderate dependence to heroin, fentanyl, OxyContin, or other opiates. It may be easier for some (such as pregnant women) to tolerate than methadone and can cause fewer withdrawal symptoms for the baby. But suboxone is not recommended for those with a history of relapse, as it has a weaker efficacy and thus may not retain such highly addicted patients in a supervised treatment program. Methadone also is likely more superior to suboxone is patients who have a more severe addiction to opioids as in using large doses, or engaging in high-risk behaviours like IV drug use or mixing opioids with other classes of drugs such as cocaine.
As each individual case is different, it’s advisable to seek the advice of a doctor specializing in the treatment of opiate addiction to find out whether methadone or suboxone therapy would be best for you.