Methadone and Suboxone
A Unique Approach
Methadone
A synthetic opiate first synthesized as a pain medication and later used for opioid addiction. Since the 1960's it has been used as "Opioid Replacement Therapy" or "Methadone Maintenance Treatment" to treat opiate addiction. It is considered a "full" (a "miu" in the Greek lettering) opiate. It is taken dissolved in or with Tang orange juice in the Ontario program.
Because of its long lasting half-life and ability to work orally in liquid form, it allows once daily use so withdrawal and cravings can be controlled. As long as your medication is taken orally daily "dope sickness" is avoided and you should be able to function normally. Properly dosed, you should not feel "high" or sedated. Of course, side effects are the same as other opiates (most commonly constipation and sweating at higher doses). We will assist you as necessary for strategies to deal with theses side effects should they occur. Also, if you miss your dose you would likely experience varying degrees of withdrawal depending on how your body individually handles the drug
Methadone is the oldest and most studied of treatments available for opiate addiction and is recommended to take in pregnancy should it be necessary.
Suboxone® (buprenorphine and naloxone together)
A newer and “patial agonist” being used in opiate replacement therapy since 2008 in Canada. It was first used in France as buprenorphine alone in 1995 and then formulated with naloxone to create Suboxone® introduced into the US in 2002 for opiate addiction, then the European Union in 2006. It is taken as a dissolving pill put under the tongue in Ontario.
It is not as powerful an opiate as methadone is some ways. Its advantages are: it is easier to stabilize quickly and is generally regarded as having less side effects as methadone. It is also regarded as easier to taper with a less severe withdrawal when discontinued than methadone.
Its main disadvantages are: the possibility of causing withdrawal if started too close to the time one has used their opiate of choice, and the cost. Many private insurance companies now cover suboxone treatment for medication assisted treatment. It is covered fully now for those on Ontario Works, Ontario Disability Program and Trillium. It is much safer in overdose and discourages abuse as it causes withdrawal when injected because of the naloxone component.
Still not approved in pregnancy, it is being investigated for that purpose and is promising in
preliminary studies.