Suboxone or Methadone? A Quick Comparison
anonymous Asks ...
My son is a heroin addict. He is 19 years old. He has been to rehab twice already. Is he too young to be on methadone? I don’t know if this is giving up on him or being realistic. He says he wants to stop but he simply can’t seem to accomplish this since he has relapsed within 2 weeks both times after feeling so good after rehab.
James Cloughley Says ...
Thank you for contacting ChooseHelp.com with your important question concerning your son's use of heroin and his challenges.
I can assure you that by supporting his use of methadone as an alternative is a good first step in his recovery process. It is much safer for him to be using methadone as an alternative than for him to continue to risk his life using heroin. When he is working a program he will be able to function normally once he is settled on an appropriate level of medication.
We all learn at different speeds and because he was unsuccessful keeping his recovery in tact previously doesn't mean that he can't be successful this time. Using methadone as a temporary measure is a great start for him. I see it as a bridge between detoxing and learning how to make different life choices based on his ability to self manage. That may take 6 months it may take a year to learn how to manage himself differently but It shouldn't take a life time. When he decides it's time to live his life without methadone he simply goes to his physician and asks him to help him, systematically, reduce his dosage until he gets down to zero. That time frame will also help your son develop a sense of self worth and self confidence that will help carry him to living a successful life without the use of drugs.
There are two medications that have been quite successful treating opioid addicts. Methadone, which you have mentioned already, and a drug called 'Suboxone'. To answer your initial question about your son being old enough to begin taking methadone. His age will not be a barrier to participating in a program. He would need to find a methadone provider (his physician should helpful in this regard) and have his physician refer him to methadone clinic. He would begin taking the methadone by going to a local pharmacy which provides the methadone and after about a month he would get 'carries' which means that he would have enough supply at home to last him for the week. It is done this way for two reasons.
One: to build a trust level between the doctor and the client and for the methadone doctor to be certain that the addict is not using any other drugs. They are quite strict around this and non-compliance could easily result in being asked to leave the program. He could be asked to provide a urine sample to ensure any client reports are accurate.
Two: to monitor the efficacy of the dose and to make any changes deemed necessary. Once he is stable on the medication meaning he is able to function quite normally he would be allowed his carries. As with any medications there are usually some pros/cons to taking it and this is no different:
1. There can be a risk of becoming addicted to the Methadone but that problem is taken care of by weaning down off the Methadone in a systematic and monitored way so that any risk and discomfort are almost non existent.
2. Methadone (is a synthetic opioid) has been around for approximately 60 years. There are no surprises about using methadone as a treatment for opioid addiction. Methadone is also relatively inexpensive so it you don't have any coverage you wont have to mortgage the farm.
3. It is possible to ingest a fatal dose of methadone but far less a risk than taking a fatal dose of heroin.
4. The effectiveness of Methadone is very high especially when using it to treat heavy users.
5. Some reports suggest that prolonged use of methadone can be hard on the liver but that is a question for your son to clarify with his physician while weighing the pros and cons of using methadone.
The common range for those starting out in this program is 50-100mg per day.
Suboxone is the other commonly used medication that is used to treat opioid users. it has been around since 2002 so it, as well, has a track record of note. There are a few differences to consider when thinking about using Suboxone as a treatment option.
1. The risk of becoming addicted to Suboxone is lower than methadone. That is because it works somewhat differently than Methadone. In both cases (Methadone and Suboxone) there is always the 'psychological' addiction that can occur when using either medication. That is a topic that would be dealt with with the clinic physician and perhaps a support group of some kind.
2. The risk of ingesting a fatal overdose is lower with Suboxone as well. Again in either case whether the addict uses Methadone or Suboxone he/she has to be committed to the process and the decision to get clean and sober if either program is to be successful.
3. Suboxone has been found to be less effective when treating heavier users
4. Suboxone is more expensive than Methadone so if finances are a consideration this may make a difference in how a decision is made.
5. The restrictions are not quite as intense around the use of Suboxone and your son could begin the program immediately without daily visits to a clinic or a pharmacy
6. Suboxone is not as proficient at managing the withdrawals from opiate use as is Methadone
The active ingredient in Suboxone is called 'buprenorphine'. If you are looking for any information on this drug before you decide on which program to access a quick look on Google should connect you to as much information as you require.
This is a very powerful way of beginning to live life without the use of substances. The decision as to which program is important and should not be made lightly. In many cases it is a life changing experience. But most importantly what it does provide is an opportunity to live life without the confusion, disorientation and unrealistic thinking that is a daily part of living a life with substance use as its main partner. This is a chance to learn how to live and maintain a lifestyle that can provide a more satisfying life experience. Isn't that the goal of most of us--just to be 'happy'? Choose wisely and work hard at it. He can have that good life if he wants it.
All the best and thanks again for selecting ChooseHelp.com for your source of support and feedback