Many people incorrectly think that Suboxone treatment and methadone maintenance are essentially the same. While it is true that both are used as a remedy for opiate dependence, they really are quite different.
Suboxone treatment is designed to control active withdrawal and then via a progressive dose reduction called a “taper” the patient is weaned off of Suboxone when their withdrawal is over and hopefully remains sober. Suboxone treatment is provided most often as an outpatient treatment by a Federally approved doctor. Most providers require patients to come in for visits once a month after the patient is stabilized on Suboxone. Unfortunately Suboxone providers are limited to 100 patients by law.
Methadone maintenance is designed to transfer the patient’s dependence from opiates to methadone, an opiate-like medicine. Methadone is provided at licensed methadone clinics that typically require the patient to come daily. Also, most methadone clinics try to maintain the patient on methadone and do not try to wean the patient off of methadone. Several negatives associated with methadone maintenance is the lack of an exit strategy, the need to go to the clinic daily, less than optimal environment at many clinics with lots of active drug users present, as well as just about any type of drug one might desire.
Dr. Russ feels that at this point the only reason for methadone maintenance is cost since methadone costs pennies per dose while Suboxone is quite expensive, up to $40 per day. Also many, including Dr. Russ, feel that methadone frequently causes some permanent changes that is not the case with Suboxone.
A less known use of both methadone and Suboxone is pain management. In this realm, methadone is clearly vastly more powerful than Suboxone. This is the one area where methadone can be administered in a doctor’s office and not a clinic.