For Your Health-Julie Chicks, M.D.

No. The fundamental difference is that illicit opioids are often used to achieve intoxication, while Methadone, Sublocade, and Suboxone are prescribed to help reduce opioid cravings and withdrawal symptoms. These medications are prescribed or administered under controlled, monitored conditions and can be safe and effective for treating opioid use disorder when used as directed. Unlike heroin and other misused opioids, they work more gradually and help maintain stable medication levels in the brain. Maintenance treatment can help stabilize individuals, allowing them to address medical, psychological, and other aspects of recovery while reducing the risks associated with illicit opioid use.

Yes. Medical research indicates that treating pregnant women with Sublocade, Suboxone, or Methadone can support healthier outcomes for their infants. MAT with Sublocade or Suboxone can help reduce neonatal withdrawal symptoms and may decrease the infant's hospital stay. Methadone is recognized as an established option for MAT during pregnancy because it has been available much longer than Sublocade and Suboxone, providing more extensive safety data. Less information is available regarding Vivitrol. The decision to use any medication during pregnancy should be based on an individualized risk-to-benefit assessment. When considering whether to continue MAT during pregnancy, you should consult with your treating physicians (OB and MAT prescriber) to determine the best option for you and your baby.

Sublocade and Suboxone are medications used to treat opioid use disorder, and access to treatment can vary based on provider availability and applicable treatment requirements. Physicians and other qualified healthcare providers must meet federal and state requirements to provide these treatments. Many qualified providers may not offer addiction treatment services, which can make programs more difficult to find. Sublocade, Suboxone, and Vivitrol may also be available through appropriate opioid treatment programs (OTPs).

Methadone is an opioid medication that fully stimulates opioid receptors in the brain. Sublocade and Suboxone contain buprenorphine, a partial opioid agonist that only partially stimulates these receptors. Both Methadone and Sublocade or Suboxone treatment can be initiated without completing full detoxification from other opioids beforehand.

It is important to understand that the appropriate dose of Suboxone for you is the dose that helps control opioid cravings and withdrawal symptoms. For many individuals, doses ranging from 8 to 16 mg, and occasionally 24 mg, may be sufficient. Sublocade is a long-acting injectable form of buprenorphine, with dosing determined by your healthcare provider based on your individual treatment needs.

If detoxification is your treatment goal, we will support you in achieving it. Should you later decide to continue with MAT using Sublocade or Suboxone, that option remains available.

No. The ease of tapering off Sublocade or Suboxone varies considerably among individuals. Some people find tapering from Sublocade or Suboxone straightforward, while those same individuals may experience significant difficulty with Methadone dose reductions. Some individuals struggle with discontinuing weaker opioids such as hydrocodone (Vicodin), while others experience minimal difficulty discontinuing any opioid. This variability demonstrates why standardized or “cookie-cutter” protocols are often ineffective. You are an individual and deserve treatment tailored specifically to your needs.

Methadone was the first medication approved for opiate dependence treatment. Federal law restricts its use for opiate addiction to opiate treatment programs (OTPs). MAT services in OTPs are highly regulated and structured, requiring daily attendance for at least the first 90 days, along with onsite individual and group therapy. When these regulations were developed in the early 1970s, this structure was believed to enhance treatment success rates.