Buprenorphine vs Methadone

Buprenorphine vs Methadone Vs Suboxone for Pain Relief FAQs

Buprenorphine vs methadone vs suboxone, three arguably controversial prescription drugs that are typically used to treat withdrawal symptoms in addicts, are used in lower doses for sufferers of chronic pain. They are often employed in cases where treatment is indefinite or long term and are used to treat conditions such as chronic lower back pain, osteoarthritis, fibromyalgia, and neuropathic pain.

What’s most effective for each individual in terms of chronic pain management doesn’t always depend solely on one method or another’s ability to relieve pain, and factors such as side effects, risk and even cost often play a role in these decisions as well.  There are many other prescriptions that are used for pain relief, particularly narcotics, however the use of buprenorphine, methadone and suboxone is becoming more prevalent in Canada and in other parts of the world. On the surface, these three drugs may seem very similar both in use and effectiveness, but there are some stark contrasts between them. Below we’ve compiled a list of frequently asked questions to help you make an informed decision and, if appropriate, consider more natural alternatives.

Buprenorphine vs Methadone Vs Suboxone Covid-19 Stats & Facts

Buprenorphine vs Methadone Vs Suboxone FAQs

Why was there a decline in distribution of methadone during Covid-19 pandemic?

According to the article from CIDRAP “Less methadone, more buprenorphine distributed amid COVID in US“, the decline in methadone distribution during the COVID-19 pandemic was significant. In March 2020, methadone dispensing decreased by 5%, while buprenorphine dispensing increased by 10%. By April 2020, methadone dispensing had decreased by 12% compared to the previous year, while buprenorphine dispensing had increased by 22%. In May 2020, methadone dispensing decreased by 13%, while buprenorphine dispensing increased by 23%.

The article also notes that the distribution of Buprenorphine vs Methadone increased during the COVID-19 pandemic due to its flexibility, which allows for take-home doses and reduces the need for patients to visit clinics. Additionally, buprenorphine can be prescribed by physicians with a waiver, whereas methadone can only be prescribed by clinics that are certified by the Substance Abuse and Mental Health Services Administration. The pandemic restrictions and clinic closures made it difficult for patients to access methadone, leading to an increase in Buprenorphine vs Methadone usage.

Can Buprenorphine vs Methadone vs Suboxone be used to treat acute pain?

Buprenorphine vs Methadone vs Suboxone are not typically prescribed for acute pain because they are opioid agonist medications primarily used for the treatment of opioid use disorder and chronic pain. However, in certain situations, they may be prescribed for short-term pain relief by a qualified healthcare provider. It’s important to note that Buprenorphine vs Methadone & Suboxone medications have a high potential for abuse and dependence, so they should only be taken as prescribed and under close medical supervision.

What happens when you mix Methadone & Suboxone?

Mixing Methadone and Suboxone can be dangerous and potentially life-threatening. Both medications work in different ways and can have different effects on the body. Methadone is a full opioid agonist, which means it binds to the same receptors in the brain as other opioids like heroin or fentanyl, while Suboxone is a partial opioid agonist, which means it binds to the same receptors but only partially activates them.

If Methadone and Suboxone are taken together, they can compete for the same receptors in the brain, leading to unpredictable effects. This can cause withdrawal symptoms, as well as respiratory depression and other serious side effects. It is important to never mix these medications without the guidance of a medical professional.

Additionally, it is worth noting that Methadone and Suboxone are typically prescribed for different reasons. Methadone is commonly used in medication-assisted treatment (MAT) programs for people with opioid addiction, while Suboxone is often used as a maintenance medication to prevent relapse and manage cravings. Mixing these medications can potentially interfere with the effectiveness of treatment and should be avoided.

Does Methadone work better for pain than Suboxone?

Both methadone and suboxone produce an opioid high, although this effect is thought to be more pronounced in methadone, perhaps explaining why it’s often preferred to suboxone. Though their pain relieving effects are said to be similar in terms of usefulness in chronic pain management, users find that suboxone is less effective on the whole. Methadone is also said to increase energy while suboxone produces a more leveled effect. But, the problems with these two drugs has very little to do with whether or not they work or do not work. They are pain relievers, and they do relieve pain. However, they can pose some serious and long term health risks that may make users think twice before using them for chronic lower back pain or the lingering discomfort from an injury.

Why is Buprenorphine preferred over Methadone?

Buprenorphine is often preferred over methadone for opioid addiction treatment because it has a lower risk of overdose and can be prescribed in an office-based setting, while methadone must be dispensed through a specialized clinic. Additionally, buprenorphine has a ceiling effect on respiratory depression, meaning that the risk of fatal overdose is lower than with methadone. Buprenorphine vs Methadone also has a lower potential for abuse and dependence compared to methadone. Finally, buprenorphine has a lower risk of drug interactions and fewer side effects than methadone.

Can Methadone be used for severe pain?

Yes, methadone can be used for severe pain. Methadone is a potent opioid medication that is used to manage severe pain in patients who are tolerant to other opioids or who have not responded to other treatments. Methadone’s analgesic effects are similar to other opioids, but its unique pharmacological properties allow for longer-lasting pain relief and may also help reduce the development of tolerance and physical dependence. However, methadone is a highly regulated medication that requires careful monitoring and dosing by a healthcare professional due to the risk of overdose and other adverse effects.

Does Suboxone block Methadone?

Suboxone contains buprenorphine and naloxone, while Methadone is a separate medication. Suboxone can partially block the effects of opioids, including methadone, which can be helpful in treating addiction. However, Suboxone does not completely block the effects of methadone and it is possible to take both medications together if it is deemed necessary by a medical professional.

What can you not mix with Buprenorphine or Methadone?

Buprenorphine vs Methadone should not be mixed with alcohol, benzodiazepines, other opioids, muscle relaxants, or sedatives as these combinations can lead to dangerous respiratory depression and even death. It is important to always follow the prescribing instructions and consult with a healthcare provider.

How long to wait between Buprenorphine and Methadone?

There is no definitive answer to this Buprenorphine vs Methadone question, as the length of time one should wait between taking buprenorphine and methadone may vary depending on individual factors such as the dosage of each medication, the individual’s tolerance to opioids, and any other underlying health conditions. It is recommended that individuals consult with a healthcare provider or addiction specialist to determine the appropriate timing and dosages for transitioning between these medications.

How to transfer from Methadone to Buprenorphine? 

Buprenorphine vs Methadone is a popular query for people looking to switch. Transferring from methadone to buprenorphine can be a complex process that should be carefully managed by a healthcare professional. Generally, a person needs to gradually taper off of methadone before beginning buprenorphine treatment. The length of the tapering process can vary depending on individual factors such as the dose of methadone and how long a person has been taking it. Once the methadone has been tapered down to a low enough level, usually between 30-40 mg per day, the person can then begin taking buprenorphine. However, it is important to note that the process should be individualized and carefully monitored by a healthcare provider to ensure safety and success.

What is Methadone/Suboxone Maintenance Therapy (MMT) program?

Methadone/Suboxone Maintenance Therapy (MMT) program is a treatment program that utilizes methadone or buprenorphine (Suboxone) as a medication-assisted treatment (MAT) for opioid dependence. It involves the long-term use of these medications to manage withdrawal symptoms and cravings while the person receives counseling and support to help them address the underlying issues that contribute to their substance use disorder. MMT has been shown to be effective in reducing illicit opioid use, overdose deaths, and criminal activity, and improving social functioning and overall health outcomes for individuals with opioid dependence.

Are there any FDA warnings issued?

Nearly a decade ago, the FDA issued a no-nonsense warning about the risks associated with using methadone whether for those with drug addictions or those being treated for chronic pain. Serious and life threatening effects and even deaths have been found to be related to regular methadone use.

Why can long-term use of Methadone be dangerous?

The biggest problem with the medication is how long it remains in the body. While the pain relieving effects of the drug last a mere four to eight hours, the chemicals that provide the effect stick around for much longer, as long as fifty-nine hours after ingestion. What this means is that over time as methadone is used to control pain, more and more of it builds up in the system, which can lead to toxic and disastrous outcomes. It’s for this very reason that long term use of Methadone for chronic pain management can be dangerous, and even deadly.

Are there more natural supplemental treatment options for chronic pain relief?

Buprenorphine vs Methadone Chronic PainInterestingly enough, there is another perhaps less publicized method for chronic pain management that is quickly becoming more and more popular in Canada, and it’s the literal polar opposite of opioid based medications in just about every way except effectiveness. Whole Body Cryotherapy, the external application of supercool liquid nitrogen, has long been used as a rheumatoid and psoriatic arthritis treatment, but is rapidly becoming a popular therapy for all sorts of chronic pain management.

The procedure is quick, simple and typically free of discomfort and side effects. Patients are stripped down to bare essentials and hop into a device called a cryosauna, which encompasses their entire body, less the head. A brief burst of liquid nitrogen fills the chamber, quickly cooling the skin’s surface prompting a glorious release of internal healing processes as well as numbing nerve endings that sense pain. While useful in chronic pain management, cryotherapy is also regularly employed for acute conditions like osteoarthritis of the knee, as well as injuries. In fact, most publicity that cryotherapy has enjoyed has been largely a result of the treatment’s use in athletes, many of whom find that their recovery time following events is dramatically reduced and that occupational injuries are quicker to heal following the cold therapy.\

Cryotherapy has been shown to be very effective for pain relief in numerous applications with reduced to non-existent side effects which has prompted the furthered study of its use in many different and well known common conditions such as repetitive strain injury and skin conditions like eczema. Results have found that while not every individual responds positively to cold therapy, many experienced reduced discomfort immediately and dramatic results with longer term use indicating its potential for success in chronic pain management.

The biggest benefit of course to cryotherapy when compared to medications like Buprenorphine vs Methadone Vs Suboxone is clearly the effects on the body alongside successful chronic pain management. Cryotherapy works to heal the individual and provide long lasting benefits without negatively impacting the mind or body of the affected person.

Buprenorphine vs Methadone and Suboxone only work to mask the pain and provide no further benefit to the body and in fact come with many risks, some of them serious and dangerous. Conversely (and unfortunately) there is one difference that may be responsible for keeping cryotherapy out of the mainstream and that is cost. While Buprenorphine vs Methadone and Suboxone are cheap to produce and covered in some cases by insurance, cryotherapy cSst is higher than pills and is often not covered by insurance.


The differences between Buprenorphine vs Methadone Vs Suboxone as chronic pain management techniques is very telling and indicative of how long term versus short term solutions can vary. There are many choices in treatment for chronic pain management, but when the risk of health hazards and potential for addiction are stacked up against newer, natural technology like cryotherapy, it’s difficult to make a case for outdated and dangerous treatment methods.


Buprenorphine. February 2023.

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