Changing from Methadone to Suboxone – Is it Safe?

If you’re currently taking methadone for opioid abuse disorder and are considering switching to the much safer Suboxone, there are things you need to know.

Where Did Methadone Come From?

Methadone was first created in a German lab circa 1937. It has been long rumored that Hitler used Methadone as a pain killer for his soldiers under the name Adolfin or Amidon. The rumor discussion believes that Nazi soldiers were given methadone so they could better endure pain and injury while on the battlefield. While that’s a great story, there’s no information to substantiate it.

After World War II, all German patents, trade names and research records were requisitioned and expropriated by the allied forces. The records on the research work of the I.G. Farbenkonzern at the Farbwerke Hoechst were confiscated by the U.S. Department of Commerce Intelligence, investigated by a Technical Industrial Committee of the U.S. Department of State and then brought to the US.

It was only in 1947 that Amidon was given the generic name “methadone” by the Council on Pharmacy and Chemistry of the American Medical Association (COUNCIL…1947). Since the patent rights of the I.G. Farbenkonzern and Farbwerke Hoechst were no longer protected each pharmaceutical company interested in the formula could purchase the rights for commercial production of methadone for just one dollar (MOLL 1990).

Commercial production was first introduced in 1947 by the US company Eli-Lilly. Only then methadone was given the trade name Dolophine, derived from the Latin dolor (pain) and finis (end). Many companies in other countries soon followed and methadone was given many trade names, some of which still exist: Adanon®, Adolan®, Althose®, Amidone®, AN-148®, Anadon®, Biodone®, Butalgin®, Diskets®, Dolamid®, Dolophine®, Dopridol®, Eptadone®, Heptadon®, Heptalgin®, Heptanal®, Heptanon®, Ketalgin®, Mephenon®, Metasedin®, Methadone®, Methadose®, Methox, Miadone®, Pallidone®, Petalgin®, Phenadone®, Physeptone®, Sedo Rapide®, Symoron®, Tussol®, Westadone®. Source: indro-online.de

What is Methadone and How Does it Work?

Methadone is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives. For optimal results, patients should also participate in a comprehensive medication-assisted treatment (MAT) program that includes counseling and social support.

Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. Source: psychiatry.uams.edu

Is Suboxone “Better” than Methadone?
Yes. Methadone is a schedule 2 drug, whereas Suboxone is a schedule 3 drug. Methadone has a very high potential for abuse. Methadone is a “full agonist”. It activates the patient’s opioid receptors at 100% and can give patients a euphoric effect. Suboxone on the other hand is a “partial agonist”. It activates the receptor only partially and patients report feeling “normal” when taking it. People don’t typically feel “high” while taking Suboxone.

According to a client at Nashville Suboxone Recovery: “Methadone gets into your bones. Getting it out of your bones take a long, long time. Withdrawals last for weeks if you try to quit methadone cold turkey. What helped me was moving from methadone to Suboxone and then tapering off Suboxone. My Suboxone taper was ten times easier than my previous methadone tapers. Suboxone made it possible for me to completely quit narcotics, which I still can’t believe. If you’re just starting opiate replacement therapy be sure to start with Suboxone, not methadone. Suboxone is much more gentle and easier to come off of.”

Can I Switch from Methadone to Suboxone?
The short answer is “yes”. However, unlike short-acting opioids like hydrocodone, heroin and oxycodone, methadone has a very long half-life due to being a full agonist. Meaning, it takes a longer period of time for methadone to leave your system than do shorter-acting opioids.

“Methadone gets into your bones. Getting it out of your bones take a long, long time. Withdrawals last for weeks if you try to quit methadone cold turkey. What helped me was moving from methadone to Suboxone and then tapering off Suboxone. My Suboxone taper was ten times easier than my previous methadone tapers. Suboxone made it possible for me to completely quit narcotics, which I still can’t believe.”

Some patients find it challenging to transfer from methadone to Suboxone as a result of methadone’s long half life and strong attachment to the opioid receptors. Patients need to reduce their dose down to thirty to forty milligrams of methadone then take their last dose 72 hours before taking Suboxone. Both of these steps can be difficult for a methadone patient. 72 hours can feel like a very long time to go without any opiate replacement therapy. Thirty to forty milligrams of methadone is much lower than a typical daily dose.

“If you’re just starting opiate replacement therapy be sure to start with Suboxone, not methadone. Suboxone is much more gentle and easier to come off of.”

In some cases, a MAT doctor will prescribe a small amount of methadone for someone who is still on a higher dose than thirty to forty milligrams per day, allowing the patient to slowly transition, go into withdrawal, and then administer Suboxone to alleviate withdrawal symptoms. Though not so easy to do, people do do it successfully every day.

IMPORTANT: Before you Switch from Methadone to Suboxone
Do not attempt to transition from methadone to Suboxone on your own – It’s simply not safe. Be sure to schedule an appointment with a Suboxone physician whose specialty is Suboxone therapy. Explain to them your typical daily dose of methadone along with the last date and time of your most recent methadone usage. Only a MAT-trained, board certified physician can determine the best strategy to help you transition from methadone to Suboxone with the least amount of discomfort and withdrawals.

Click here if you would like to transition from Methadone to Suboxone safely.