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Substance Showdown: Methadone vs. Suboxone

Suboxone and Methadone were both created to help opiate addicts either through maintenance programs or detoxes. Methadone came first and was used to help heroin addicts stop the search for their high on the streets as well as keeping them IV use. Suboxone was created for anyone addicted to opiates and while it can be used as a maintenance drug is more commonly used in an opiate detox where eventually the individual will be clean of all drugs including the Suboxone. Methadone and Suboxone are both opiates. Methadone and Suboxone are distant cousins and will be entering the boxing ring of substances for a Substance Showdown. This substance showdown will have three rounds based on: health effects, insidiousness and legality, and withdrawal. The winner of each round will be the substance that is considered “worst”.  Who will come out on top?

Let the substance showdown begin!!


Suboxone: Like other narcotic medicines, Suboxone can slow your breathing. Death may occur if breathing becomes too weak.

  • extreme drowsiness;
  • loss of coordination, weakness or limp feeling;
  • blurred vision, slurred speech, thinking problems;
  • weak or shallow breathing;
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • pounding heartbeats or fluttering in your chest; or

Common side effects may include:

  • headache, mild dizziness;
  • numbness or tingling;
  • drowsiness, or sleep problems (insomnia);
  • stomach pain, vomiting, constipation;
  • redness, pain, or numbness in your mouth;
  • feeling drunk; or
  • trouble concentrating.
  • Addiction and dependence


Methadone has many side effects such as:

  • drowsiness
  • weakness
  • headache
  • nausea
  • vomiting
  • constipation
  • loss of appetite
  • weight gain
  • stomach pain
  • dry mouth
  • sweating
  • flushing
  • difficulty urinating
  • swelling of the hands, arms, feet, and legs
  • mood changes
  • vision problems
  • difficulty falling asleep or staying asleep
  • decreased sexual desire or ability
  • missed menstrual periods


Some side effects are more serious

  • seizures
  • itching
  • hives
  • rash

Methadone may cause other side effects such as respiratory depression and death.

The winner of ROUND 1 HEALTH EFFECTS IS METHADONE: While both methadone and Suboxone have some adverse health effects even when taken as prescribed or abused; methadone’s health effects are much more severe and frequent which makes it our winner for this round.


Suboxone: Suboxone and its active ingredient Buprenorphine are listed as Schedule III substances under the Controlled Substances Act. This is because it is allowed not only to be prescribed for medical use in the treatment of pain but also in the treatment of opioid dependence. Because Suboxone is so frequently prescribed for the treatment of opioid dependence it is considered safe by many of its abusers and is also in some cases being touted as being “safe”. The reason for this is because it supposedly has a lower potential for abuse and dependence. Many people see Suboxone as a safe drug to take in comparison with heroin or something of the like. The truth is substituting Suboxone with heroin, while it may be safer than heroin it is still not safe. Suboxone and its active ingredient are highly addictive and many people who are trying to get off of opiates using Suboxone soon find themselves with a bad Suboxone habit. Also because Suboxone can be prescribed to opiate addicts it has a high potential for being abused or sold to individuals who don’t even a prescription for it. Suboxone has managed to find a way into the underground illicit drug market and is used by many opiate addicts without prescription that can’t find anything else and/or don’t want to suffer withdrawal. This makes Suboxone very insidious.

Methadone: Methadone is a schedule II substance under the Controlled Substances Act which means that it less legal, if you will, than Suboxone. Methadone is insidious because it is just as addictive as heroin and gives its users the same high. It really does nothing helpful except to get people to stop using drugs such as heroin. Which is great, but is it really that great? Methadone has made its way to street and recreational users through methadone maintenance and methadone clinics that hand it out for a certain price. Methadone is very dangerous and easy to overdose on but because it is prescribed and touted as being safer than other opiates many people take it thinking they are better off when this just isn’t the case. This makes methadone probably one of the most insidious narcotics out there right now.

AND THE WINNER OF ROUND 2 IS METHADONE: While Suboxone is insidious, it is not nearly as dangerous as methadone nor is it as addictive. Both methadone and Suboxone are supposedly safer alternatives but Suboxone actually is, whereas methadone is just as dangerous as any other opiate out there; just as addictive too.


Suboxone: Early symptoms of Suboxone withdrawal:

  • Uncharacteristic irritability or agitation
  • Anxiety
  • Difficulty sleeping
  • Profuse sweating
  • Tearing
  • Runny nose
  • Frequent yawning

Later Signs of Withdrawal:

  • Stomach pain or cramping
  • Diarrhea
  • Dilated pupils
  • Nausea and vomiting
  • Confusion
  • Changes in mood

Methadone: Methadone withdrawal can be fatal. Also methadone withdrawal is described as being the most horrendous of all opiate withdrawals out there.

Physical symptoms:

  • Lightheadedness
  • Tearing
  • Runny nose
  • Yawning
  • Sneezing
  • Nausea
  • Vomiting
  • Diarrhea
  • Severe Itching
  • Fever
  • Sweating
  • Chills
  • Tremors
  • Akathisia
  • Tachycardia
  • Aches and pains, often in the joints and/or legs
  • Elevated pain sensitivity
  • Elevated blood pressure (may cause stroke)
  • sudden death

Cognitive symptoms:

  • Suicidal ideation
  • Susceptibility to Cravings
  • Depression
  • Reduced breathing (may be fatal between 2–4 hours)
  • Spontaneous orgasm
  • Prolonged insomnia
  • Delirium
  • Auditory hallucinations
  • Visual hallucinations
  • Increased perception of odors (olfaction), real or imagined
  • Marked decrease or increase in sex drive
  • Agitation
  • Anxiety
  • Panic disorder
  • Paranoia
  • Delusions

AND THE WINNER OF ROUND 3 IS METHADONE! Methadone definitely comes out on top even though Suboxone has a pretty nasty withdrawal too. The reason methadone wins this round is due to the fact that it lasts much longer and also can be fatal.


Methadone not only has more health effects, insidiousness and withdrawal it is all around a much more potent drug than Suboxone. That is what makes it the clear winner of today’s substance showdown between the two. Methadone won this battle with a real knockout. Suboxone is a lightweight.

If you, or someone you know, is struggling with addiction to Suboxone or Methadone, call us right now at  800-951-6135.


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